Diabetes in children - how to recognize dangerous symptoms and what to do next?

Hyperglycemia and impaired insulin secretion is the second most common endocrine pathology among children and adolescents. According to the World Health Organization, the incidence of children with diabetes is growing rapidly. In the next 5-10 years, the number of patients is projected to increase by 70%.

Can there be diabetes in a child?

The described pathology is diagnosed even in newborns, endocrine disorders occur regardless of age. Many parents are wondering whether there can be diabetes in children who do not have a genetic predisposition to the disease. The answer to this question is positive. There are different types of the disease under consideration, some of them develop due to external adverse factors or as secondary pathologies.

Types of diabetes in children

In addition to the well-known 2 forms of endocrine disease, classified according to the insulin dependence, there are other types of metabolic disturbances in carbohydrates. Rare types of diabetes:

Neonatal. This variant of the disease is diagnosed in newborns and toddlers up to 6 months. Such diabetes mellitus in children occurs in a transient and permanent form. In the first case, the baby's need for insulin gradually disappears on its own for half a year. Relapse of pathology in the future is likely to be 50%. The second subtype is characterized by a lifelong need for insulin.
MODY. The presented species is deciphered as a mature form of diabetes in young (Maturity-Onset Diabetes of the Yong). MODY is a genetic defect of pancreatic cells inherited in an autosomal dominant type (not associated with the sex of the child, transmitted from generation to generation). This diabetes has 9 subspecies, most of which are characterized by a mild course, sometimes additional insulin administration is not required.
Secondary. A rare form of the disease that occurs against the background of severe genetic disorders. Such diabetes can accompany the syndromes of Rogers, Wolfram, Alström, Rabson-Mendelholl, leprechaunizm, lipodystrophy and other pathologies.

1 type of diabetes mellitus

The described type of chronic endocrine disease (insulin-dependent) is the most common among toddlers. Diabetes mellitus type 1 in children is classified into 2 groups:

autoimmune;
idiopathic.

The first form of the disease is characterized by the presence of autoantibodies in the blood, which attack and destroy the island beta cells of the pancreas. As a result, the endocrine organ produces insufficient insulin to break down glucose. It is more difficult to explain idiopathic diabetes in children - the causes of this type of pathology are unknown. In the blood of the child, no antibodies are found, but the disease proceeds in a similar way.

2 type of diabetes mellitus

An insulin-independent form of the disease was previously diagnosed primarily in adults and the elderly. Diabetes type 2 in children began to develop relatively recently. This is due to a change in the lifestyle and diet of modern preschoolers. Malnutrition and low mobility provoke obesity, which leads to endocrine disorders.

Causes of diabetes mellitus

The factors that provoke the described pathology depend on its shape. Neonatal, secondary and MODY-diabetes arise due to gene mutations. These rare diseases associated with adverse heredity . The main causes of type 1 diabetes mellitus can be divided into 2 groups:

genetic;
external.

Hereditary predisposition in this case consists not in mutation of any separate genes, but in their special combination. The presence of diabetes mellitus in parents or other family members is not a guarantee of the development of pathology in the child. To activate and debut endocrine disruption, additional external factors are required:

poor-quality food (preservatives, nitrates, gluten);
toxins;
viruses ( rubella , parotitis, Epstein-Barr and others);
acute or chronic stress.

The causes of type 2 diabetes are the wrong way of life for children. Change in the functioning of the pancreas and metabolic disorders in the body occurs against the background of:

constant overeating;
obesity;
low mobility;
frequent use of "fast food".

Diabetes mellitus in children - symptoms and signs

A pronounced clinical picture of pathology in infants is observed much faster than in adults. Signs of diabetes in children are rapidly progressing due to such factors:

immaturity of enzyme and endocrine systems;
accelerated metabolism, including carbohydrates and sugars;
unformed neural bundles.

With insulin deficiency, glucose is not cleaved, and body cells experience an energy hunger. For its quenching, fats begin to be consumed with the formation of ketone bodies and acetone, which are toxic. This mechanism is responsible for the way diabetes is manifested in children. Disintegration products accumulate in the blood, provoking ketoacidosis and early symptoms of the disease.

The first signs of diabetes in children

If the MODY form develops, the disease proceeds gently with a mildly expressed clinical picture that the child's parents may not even notice. In other cases, diabetes mellitus progresses very rapidly - symptoms in children in the early stages of pathology include:

a constant feeling of thirst and dryness in the mouth;
enuresis ;
frequent urination ;
increased appetite;
desire to sleep after eating;
fatigue.

For several weeks, these signs of diabetes in children are increasing. Additionally observed:

causeless weight loss;
visual impairment;
susceptibility to skin infections;
neurodermatitis ;
mycoses;
itching of the skin;
ichthyosis.

Diabetic coma - symptoms

The condition in question occurs if the diabetes mellitus in children progressed without treatment. This is an extremely dangerous situation, in which even a lethal outcome is likely. The younger the child, the faster it is necessary to contact the hospital for qualified help. Diabetic coma in children is accompanied by loss of consciousness. This condition is preceded by the following symptoms:

headache;
anxiety, followed by apathy;
lack of appetite;
nausea and vomiting;
strong thirst;
stomach ache;
disorders of urination;
a bright blush on the cheeks with pale skin of the face;
deep and noisy breathing;
increased heart rate;
decrease in body temperature and blood pressure;
diarrhea with blood;
sinking of eyeballs;
sharp odor of acetone from urine;
cramps of limbs.

Complications of diabetes in children

Later, the detection of pathology or the lack of adequate therapy leads to severe consequences affecting almost all body systems, including the functioning of the brain. Complications of diabetes:

Neuropathy;
angina pectoris;
arteriosclerosis of blood vessels;
heart attack;
hypertension;
stroke;
nephropathy;
kidney failure ;
delays in mental and physical development;
retinopathy;

hemorrhage in the eye;
glaucoma;
cataract;
blindness;
nerve sensitivity of the lower limbs;
itching and flaky skin;
bacterial and fungal dermatological infections;
fragility of bones;
convulsions.

Diabetes mellitus - diagnosis

Confirmation of suspicions on the development of endocrine pathology is carried out on the basis of available symptoms and laboratory tests. The norm of sugar in the blood of a child depends on his age:

up to 12 months - 2.8-4.4 mmol / l;
1-5 years - 3.3-5 mmol / l;
over 5 years - up to 5.5 mmol / l.

To reliably diagnose diabetes in children and determine its type, a lot of additional blood tests are performed on the following indicators:

insulin and proinsulin;
C-peptide;
glycosylated hemoglobin;
tolerance to glucose;
acid-base state (CBS);
antibodies to beta-cells of the pancreas and glutamate decarboxylase;
genetic mutations.

It will also be necessary to pass urine to determine the concentration:

glucose;
ketone bodies;
acetone.

Treatment of diabetes in children

It is important for parents to realize that the received confirmed diagnosis is permanent. Until the methods of complete restoration of pancreatic functions and normalization of carbohydrate metabolism have been invented, the treatment of diabetes in children will therefore be life-long. Therapy should be comprehensive and permanent, it is necessary to strictly follow the doctor's recommendations, adhere to the diet and give time for physical activity.

The first thing that begins treatment is regular monitoring of blood sugar levels. To do this, purchase a glucometer and test strips. To effectively control the course of the disease, doctors are advised to have a special diary, which records not only the readings of the device, but also the attendant circumstances:

the presence of stress or infection;
consumed foods and beverages;
physical activity;
general state of health and mood.

Treatment of Type 1 Diabetes Mellitus in Children

This form of pathology is characterized by acute insulin deficiency in the child's body. To maintain normal life, it is necessary to compensate for the lack of a hormone from the outside. To control type 1 diabetes in children, daily injections of insulin are required. Dosage and frequency of injections are selected by the endocrinologist individually in accordance with several parameters:

age and weight of the baby;
degree of hyperglycemia;
ration of the child;
level of physical activity

Insulin-dependent diabetes mellitus in children can not be treated without insulin injections. Any alternative therapies are charlatanism and are dangerous to the child. The only effective control scheme for this type of disease includes:

daily injections;
diet compliance;
normal physical activity.

Treatment of Type 2 Diabetes Mellitus in Children

The described form of pathology is much less common, approximately in 10-20% of cases. Sugar insulin-dependent diabetes in children suggests a complex therapy, consisting of such activities:

normalization of body weight (in the presence of obesity);
physical activity;
constant observance of a diet;
taking hypoglycemic medications.

Recommended physical activities include at least 3 classes of active sports per week for 1-1.5 hours. In addition, the child needs to make daily walks (3-4 km), teenagers are recommended to go to 5-7 km. With parallel compliance with endocrinologist advice on nutrition, this is enough to maintain the concentration of sugar and well-being in the norm.

If the diabetes in children manifested acutely and provoked ketoacidosis, emergency replacement of insulin deficiency will be required. After stabilizing the glucose level and reducing the production of ketone bodies, you can stop injecting the hormone. To control the course of the disease, hypoglycemic drugs are prescribed in tablets. The only medication of this group, approved for use in pediatrics - Metformin.