In the blink of an eye your routines become different. Diabetic children, thanks to current advances, can lead a practically normal life, though, with some special care. We will discover the care to follow when a child has diabetes mellitus.
- What is it?
- Symptoms and diagnosis
Diabetes mellitus what is it?
It is estimated that there are 143 million people in the world with diabetes. The WHO considers that 50% of people who have diabetes are undiagnosed.
In Spain it is estimated that there are 29,000 children under 15 years of age with diabetes mellitus and each year there are about 1,100 new cases.
Diabetes mellitus is its scientific name. Mellitus come from the Latin and means “sweet or honey” and diabetes , meaning that it “passes through or is eliminated”. And why this curious name? Because diabetics have a high level of sugar or very high glucose in the blood and part of this glucose is eliminated in the urine. The doctors of the antiquity, when they suspected this disease, as they did not have analytical, tested the urine. If it was sweet, it was that the body eliminated sugar and, therefore, the patient had diabetes mellitus.
All symptoms of diabetes are a direct cause of high blood sugar levels.
Types of diabetes mellitus
There are two types of diabetes . Although in children the most frequent is type I, it is increasingly being diagnosed in children and adolescents.
- Type I diabetes
- It is an autoimmune disease where the body itself destroys the cells of the pancreas that make insulin (pancreatic beta cells), therefore, it makes us unable to metabolize glucose. The damage is irreversible and causes type I or juvenile diabetes, since its diagnosis is frequent to appear in childhood. Its treatment is to administer the insulin that the organism does not manufacture. Insulin is applied subcutaneously.
- Type II diabetes
- A few years ago this was the typical diabetes of obese adults. The increase in childhood and juvenile obesity is justifying this increase in the diagnosis of insulin resistance or type II diabetes. It is a multisystemic disorder of heterogeneous nature, in which genetic and environmental factors intervene. Its prevalence has increased in the pediatric age in recent years, in parallel with the increase in obesity. It is characterized by insulin resistance associated with progressive dysfunction of pancreatic cells. In general, the treatment is not giving insulin, because the body makes it, but changes in lifestyle (diet, exerciseand weight loss) and pharmacological treatments that help eliminate insulin resistance. If the disease progresses, administration of insulin may be necessary.
What causes diabetes mellitus?
Insulin is a hormone that is made in a gland called the pancreas. The pancreas is located in the abdomen, behind the stomach and helps in digestion secreting pancreatic juices and also produces insulin depending on the amount of glucose in the blood.
After the intake of food, blood glucose levels rise. At this time, the function of a healthy pancreas is to release insulin so that this glucose (the fuel of the cells) is “introduced” into the body’s cells. Insulin is the key that enables cells to obtain the fuel needed to create energy and perform their functions.
If the insulin is insufficiently produced ( type I diabetes ) or the cells are unable to recognize it ( type II diabetes or insulin resistance), the glucose can not get into the cells, it is not used and it increases its concentration in blood and urine, in an attempt to eliminate the “excess”. The fundamental consequence is that the functioning of the cells is impaired due to lack of energy.
All the symptoms of diabetes derive from this situation.
Type I diabetes mellitus in children: Symptoms and diagnosis
In all medical examinations the following question is very typical: What diagnostic suspicion does a patient have with polydipsia, polyphagia and polyuria?
Let’s decipher the question.
Children with diabetes usually have these symptoms:
- The child urinates many times and in large quantities. The need to urinate occurs even at night (nocturia). It is very typical for children to start wetting the bed at night when they were, previously, continents.
- The child is very thirsty and drinks lots of fluids. This thirst is to compensate for the loss of water through urine.
- The child is very hungry and eats much more than usual.
- Weight loss without dieting.
- Fatigue and fatigue.
These symptoms are very typical in the patient with a diabetic debut and are due to the fact that the increase in blood glucose (blood sugar) pathologically wants to be eliminated by the kidney (this is called glycosuria: presence of sugar in the urine). In order for glucose to be eliminated in the urine it has to be dissolved in large quantities of water, which is why the body demands a greater intake of water. This is the reason for the increase in thirst and urine in the child.
In addition, since there is not enough insulin, the cells can not use glucose as fuel and the signal that the organism sends is of greater energy requirements, that is, a sign that it is “hungry”. This is the cause of increased appetite and food intake.
But, no matter how much the child eats, the cells still lack energy and they have to find a “plan B” to obtain it: extract energy from body fat. This causes unexplained weight loss, fatigue (despite eating so much) and the elimination by urine of waste substances called ketone bodies. These ketone bodies, moreover, cause a very typical fruity breath odor.
The presence of any of the symptoms described justifies a visit to your pediatrician.
The pediatrician quickly suspects the presence of type I diabetes. Usually the family consults in two or three weeks after the onset of the first symptoms. The diagnosis is simple: the blood glucose is measured (glucose in blood), and if it is higher than 200 mg / dl, we have the diagnosis.
Treatment of diabetes mellitus in children
After the diagnosis of diabetes and after starting insulin treatment, some children may have a temporary improvement. The needs to administer external insulin decrease significantly. This is due to the pancreas recovers slightly and begins to produce some insulin.
This remission phase is not presented by all children and is rare in children under three years of age.
After the diagnosis, the specialist indicated to evaluate the child and start the blood glucose controls and the insulin treatment is the infant endocrinologist.