School of Dr. Komarovsky Diabetes mellitus in children. The development of diabetes in a child, how to help him? Severe infections

Diabetes mellitus is a very serious metabolic disorder (metabolic disorder) in which food is no longer broken down normally. This is especially true for the absorption of sugar (carbohydrates) by the body. The disease can damage the heart, blood vessels, kidneys, and nervous system, and cause progressive loss of vision.

Forms of diabetes

There are several forms of diabetes, but the two most common are type 1 and type 2 diabetes. Both forms can develop in a person at any age, but children are more likely to be diagnosed with type 1 diabetes.

About type 1 diabetes

Type 1 diabetes is caused by insufficient production of one of the important hormones, insulin, by the pancreas. When this happens, the body cannot properly metabolize sugars (particularly glucose). As a result, glucose accumulates in the bloodstream where it cannot be used by the body and is then excreted in the urine. This process leads to the main symptoms of diabetes:

Characteristically, type 1 diabetes can begin at any age, but periods of increased risk are 5 to 6 years and then 11 to 13 years. The first sign of diabetes is often an increase in the frequency and amount of urination. Moreover, this is especially observed at night, manifested, among other things, by repeated nocturnal urinary incontinence in children who have already gone to the pot on their own without “accidents”.

However, along with the above symptom, other important signs for the diagnosis of diabetes should be observed: the child complains that he is worried about thirst and a constant feeling of fatigue, begins to lose weight despite increased appetite. It is important to notice these symptoms early as children who are diagnosed late, high blood sugar and dehydration will already need intravenous insulin and certain fluids in the form of drips in a pediatric emergency room or in the emergency room. help to stabilize their condition.

Control and management of diabetes

Although it is not yet possible to cure diabetes, still children with this disease can lead a life almost normal for their age, if their health condition is under constant control.

It is very important to properly monitor the condition of a child with diabetes in order to avoid complications of the disease. Health management consists of continuous monitoring of blood sugar, insulin therapy given as multiple injections per day or through an insulin pump, and careful dietary management.

Keeping your blood sugar within the normal range can reduce the chance of symptoms of too high or low blood sugar and reduce the risk of long-term health problems associated with poor diabetes control.

In addition to a healthy diet, a child with diabetes needs at least thirty minutes of physical activity to give the body the strength to cope with the disease.

What parents of children with diabetes can do

As you take care of your child and support him, do not forget to gradually give him some of the responsibility for your health. He will become increasingly self-reliant and willing to take responsibility for managing his diabetes while maintaining a sense of independence.

Children over the age of seven usually have excellent motor skills to inject insulin on their own (but under adult supervision). They can also check their blood sugar several times a day using simple test strips and a blood sugar meter. But all these self-control and self-care activities of a child should be controlled by adults who know what diabetes is and how to live with it. Monitoring is necessary to make sure that the child is really acting correctly, acting in accordance with the recommendations of your doctor.

If your child is taking too much insulin, then his blood sugar levels may become too low (hypoglycemia), causing symptoms such as trembling, heart palpitations, nausea, fatigue, weakness, and even loss of consciousness.
If your child has too little insulin, then the main symptoms of diabetes (weight loss, increased urination, increased thirst and appetite) may return.

Establishing the right habits for living with diabetes in a young child has an important impact on a teenager's compliance with the rules of living with this disease.

In different regions, there are public active groups of parents whose children have diabetes. By contacting a similar group in your area, you can meet with other parents to discuss common concerns. You can also ask your doctor for a recommendation for such a group.

Diabetes (diabetes mellitus) is a serious disease characterized by high levels of glucose in the blood. It turns out that a person receives energy exclusively from glucose. It enters the cell and there, with the help of metabolic processes, it becomes a source of energy. And it turns out that the key that lets glucose into the cell is a hormone called insulin.

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Symptoms of diabetes.

If there is little insulin, then a situation is obtained in which there is a lot of glucose in the blood, but it is not in the cells, and the body experiences energy starvation. This condition is manifested by very special, indicative symptoms. These symptoms are:
thirst, and there is a feeling that the child can not get drunk;
active, very frequent urination;
constant hunger.
And this disease is called diabetes mellitus. Under the same phrase "diabetes mellitus" lies several very similar, but at the same time different diseases. These diseases are treated differently, so it is a very complex science - the treatment of diabetes. If the child has the above symptoms, you need to go to the doctor, clinic or laboratory and take a blood test for sugar. The disease is easily diagnosed. The normal glucose content is 3.3 - 5.5 mmol / l. The analysis is done in the morning on an empty stomach. The maximum (critical) content of insulin is 6.1 mmol / l. From 6.1 is diabetes. 5.5 to 6.1 is prediabetes. In urine tests, glucose will appear only if its content in the blood exceeds 10 mmol / l.

Types of diabetes.

If we recall the analogy with the key that opens the doors of the cells of the body, then in type 1 diabetes, glucose cannot enter the cell, because there is no key (insulin) at all, the cell is not ready to accept it. In the second option, there is a key, the cell is ready to take insulin, but the key is stuck and does not work. And until the cell learns to properly regulate metabolic processes again, the situation will not improve. And in the pancreas there are islands of cells. These islets are called the islets of Langerhans. These cells produce insulin. It regulates carbohydrate metabolism.

Diabetes mellitus type 1.

Under the influence of some factors that are currently unknown to science, antibodies begin to be produced that destroy the cells of these islets. This type of diabetes, in which these cells die, usually occurs in children or very young people, in almost 100% of cases before the age of 30. In adults, mature people, it never occurs. Therefore, it is called juvenile, that is, youthful, - diabetes of a young age. Or it is also called type 1 diabetes. In this type of diabetes, there is a catastrophic lack of insulin and the cells that produce it, and the treatment is only the administration of insulin.

Diabetes mellitus type 2.

There is also type 2 diabetes, which differs from the first in the most fundamental way. Its development is associated with obesity. That is, the body constantly has an excess of sugar, an excess of glucose in the blood. Not because the pancreas does not work well, but because of malnutrition. Type 2 diabetes develops, in which insulin is often enough or even more than necessary. But due to malnutrition, the cells of the body have “forgotten how to understand” insulin commands.

Treatment of diabetes mellitus type 2.

The main treatments for type 2 diabetes are:
1. Give the body physical activity.
2. Establish proper nutrition.
3. Reduce excess weight.
The right diet for diabetes is the usual complete diet for a healthy child: enough fruits, vegetables, protein foods. In the second type of disease, you need to monitor your weight and, if necessary, limit carbohydrate foods, especially sweets.

Is diabetes inherited?

Yes, it is inherited, especially type 2 diabetes. Because if dad is overweight and mom is overweight, then the way of life will be inherited, and, as a result, a predisposition to the disease. If a person in the family has elderly who are sick with type 2 diabetes, then he definitely has a tendency to develop this disease. Therefore, from childhood, he needs to be able to eat right, have physical activity, and not allow excess weight.
In type 1 diabetes, there is a chance of inheriting the disease, but it does not exceed 2-3% if the mother has diabetes, 5% if the father has the disease, and about 15% if both parents have diabetes. That is, there is no clear inheritance, but there is a risk factor. It is believed that some infectious diseases are the "trigger" of diabetes. If a child does become ill with diabetes, infectious diseases subsequently endure more severely than before. Therefore, in type 1 diabetes, the child is especially protected from infections, they are first of all vaccinated and they are given not only routine, but also additional vaccinations, for example, against influenza.

Conclusion.

Unfortunately, there is no cure for diabetes yet. But thanks to modern medicine, diabetes has evolved from a disease into a special way of life. With him you can learn to live and enjoy life. This disease must be treated correctly and with optimism. You also need to teach this to the child so that, as an adult, he lives a full life and at the same time does not depend on his mother and her reminders.
It is necessary to treat diabetes only by methods of official medicine with the use of insulin. Traditional methods of treatment can kill a person. Usually, after the discovery of the disease, parents are ready to grab at any straw to cure the child forever. After the first insulin injections, there may even be a temporary improvement (up to six months), when it seems that there is no diabetes. This is used by many "healers" who, against the background of such a picture, can promise to cure diabetes. But then it will become bad again, the frightened parents will again take the baby to the hospital, and the “healer” will tell them that he will not treat them further, because they go to the doctors. Don't fall into this trap.

Diabetes mellitus is a chronic disease that occurs when there is a lack of the pancreatic hormone insulin. Diabetes is one of the most common diseases of the endocrine system in children. The prevalence of diabetes mellitus among the child population (including children at an early age) has now increased. Newborn children with diabetes rarely get sick, more often it manifests itself during puberty.

Types of diabetes

In most cases, children develop type 1 diabetes.

The body needs energy to provide all its functions. Basically, he receives this energy from the processing of glucose (or sugar) when it enters the cell. Insulin is involved in the process of converting sugar into energy.

It is he who ensures the flow of sugar into the cell for further conversion into energy. The amount of insulin in the body changes: food intake contributes to the synthesis and release of the hormone, and less is produced during sleep and under the influence of certain drugs.

After eating carbohydrates, blood sugar levels rise. But under the action of insulin, glucose is absorbed by the cells of the whole organism, and therefore its level gradually (within about 2 hours) decreases to normal levels (3.3-5.5 mmol / l). After that, the pancreas stops secreting insulin.

When there is not enough insulin, the level of glucose in the blood is elevated, since it is not absorbed by the cells, and develops. There are types 1 and 2 of this disease (insulin-dependent and insulin-independent, respectively). In type 1, the disease is the result of damage to the pancreas.

In type 2, iron synthesizes insulin in sufficient quantities, but the cells of the body (their receptors) do not respond to it and do not use sugar from the blood, its level remains high.

Children develop insulin-dependent type 1 disease more often.

The reasons

There are many reasons for the occurrence of this disease in children:

A significant role is played by the predisposition to the disease, that is, a hereditary factor. If both parents suffer from this disease, then 80% of their children will have underdevelopment or damage to the cells of the pancreas. They will be at high risk of developing the disease, which may appear soon after birth or years or decades later. The presence of diabetes can predispose to the disease not only in the child's parents, but also in other, less close relatives.

An increased glucose level in a woman during pregnancy is also an unfavorable factor for a child: glucose freely passes through the placental barrier. Its excess (the child has a small need for it) is deposited in the subcutaneous fat layer, and children are born not only with a large body weight (5 kg, and sometimes more), but also with the risk of developing diabetes in the future. Therefore, a pregnant woman should adhere to the recommended diet, and parents should not rejoice (as is customary) at the birth of a child with a large weight.

Feeding children large amounts of easily digestible carbohydrates (chocolate, sweets, sugar, confectionery and flour products) leads to an excessive load on the pancreas and its depletion: insulin production decreases.
Excess body weight of a child leads to the deposition of fat in the body. Fat molecules contribute to a change in cell receptors, and they stop responding to insulin; sugar is not utilized even if there is sufficient insulin content.
A sedentary lifestyle of a child contributes to the emergence of excess body weight. In addition, physical activity itself causes an increased work of all tissues in the body, including pancreatic cells. Thus, with active movements, the level of sugar in the blood decreases.
Parents who are fond of unreasonable stimulation of immunity in children should keep in mind that by doing so they cause a violation of the interaction of two systems: activation and suppression of immune responses. In this case, the body begins to constantly produce antibodies. If the antibodies "do not detect » microorganisms, they destroy the cells of the body itself, including the cells of the pancreas. The occurrence of such a pathological immune response may also be associated with colds or viral infections that often occur in a child. Particularly unfavorable in this regard are mumps and hepatitis viruses.
The trigger for the development of diabetes in childhood can be an allergic reaction (including cow's milk), exposure to harmful chemical factors, the use of certain drugs (etc.), stress or excessive exercise.

Symptoms

Constant thirst in a child may indicate an increase in blood sugar.

Diabetes in children has several stages:

There is a predisposition to the disease.
The tissue of the pancreas is already affected, but there are no manifestations of the disease yet, it can only be diagnosed with the help of special examinations.
Diabetes has clinical manifestations, and its diagnosis at this stage is not difficult.

The specifics of the course of diabetes mellitus in children:

correct treatment in the initial, latent form gives a good result;
if left untreated, the disease progresses rapidly;
more severe course than in adults.

In the initial stage of the disease, blood sugar levels can rise only under any circumstances or stress, and in the later stages - even in the morning on an empty stomach. Not only carbohydrate metabolism is disturbed, but also other metabolic processes, protein synthesis, etc.

In the body of a child, acetone accumulates, under-oxidized metabolic products that adversely affect the nervous and cardiovascular systems. Diabetes leads to a violation in the immune system, the liver.

You can suspect this insidious disease in children based on the following signs:

increased thirst: children can drink several liters of water per day, they wake up even at night to drink water.
Frequent urination (sometimes even up to 20 rubles per day); Normally, urination in children occurs approximately 6 p. per day; enuresis or bedwetting may occur; urine is almost colorless, odorless, but on diapers or linen it can leave sticky marks or spots, resembling (after drying) starch.
Dryness of the mucous membranes and skin due to the excretion of fluid in the urine; diaper rash, itching and inflammation of the external genitalia in girls may appear.
Weight loss with good (and sometimes even increased) appetite; only in the later stages of the disease and in newborns is there a lack or a sharp deterioration in appetite in diabetes.
Decreased visual acuity is associated with clouding of the lens due to the deposition of sugar in it; retinal vessels are also affected due to the toxic effect of glucose.
Unreasonable fatigue and general weakness in a child occurs due to insufficient energy supply to the body; children begin to study worse, they are inactive, may lag behind in physical development, complain of a headache at the end of the day; characterized by apathy and drowsiness of the child.
With a decrease in immune reactions, pustular and fungal skin lesions, scratches that do not heal for a long time, may occur.
The muscle layer becomes flabby.
The bones are brittle, poorly fused with fractures due to.

Drowsiness of the child, severe, abdominal pain, and vomiting, the smell of acetone or pickled apples from the mouth: this condition requires immediate medical attention and examination of the child.

Morbidity schedule for the Moscow region in 2008

In some cases, children are admitted to the hospital already in a condition requiring resuscitation. In a severe form of diabetes, the cardiovascular system also suffers: the rhythm of cardiac activity is disturbed, pain in the region of the heart may disturb.

Diabetes mellitus leads to a violation of the structure and functioning of the kidneys, often inflammatory processes occur in them. The digestive system is also affected: the development of a disease of any of its organs is possible.

The liver is enlarged, development can occur and even.

Diagnostics

Clinical manifestations of the disease can be confirmed by a blood test for sugar. Normal blood sugar levels are 3.3 to 5.5 mmol/L. An increase in glucose levels up to 7.5 mmol / l can be observed with latent diabetes mellitus. A blood sugar level above this indicator indicates confirmation of diabetes.

There is also a diagnostic glucose tolerance test. First, the level of sugar in the blood on an empty stomach is determined, then they are given to drink 75 g of glucose (dissolving it in water); children under 12 years old are given 35 g. After 2 hours, a blood test is repeated from a finger for glucose. If the indicator is 7.5-10.9 mmol / l, then there is a latent form of the disease; an indicator of 11 mmol / l and above confirms the diagnosis of diabetes mellitus.

In addition, an ultrasound of the abdominal organs is performed in order to exclude the inflammatory process in the pancreas.

Treatment

Proper nutrition is the basis of the treatment of diabetes.

Treatment is selected for the child by a pediatric endocrinologist, depending on the type of diabetes mellitus.

For type 1 diabetes(it accounts for 98% of cases of "children's" diabetes) replacement therapy is carried out, that is, insulin is injected, which is not present or insufficiently secreted by the pancreas.

At the same time, the child must be provided with proper nutrition, avoiding starvation. In addition to the main meals, include intermediate ones (mainly the consumption of fruits and vegetables).

This is necessary in order to avoid the development of complications of diabetes in the form of hypoglycemic coma, which develops if a dose of insulin is greater than necessary for food processing. In this case, the entire supply of sugar in the body is consumed and energy starvation of the brain develops in the first place. This condition sometimes requires even resuscitation.

Hypoglycemic coma develops very quickly, in 20-30 minutes. Suddenly there is a sharp weakness, severe sweating, trembling in the body, a feeling of hunger. Headache, double vision, palpitations, nausea, vomiting, numbness of the tongue and lips may occur. Mood changes: from depressed to excited and even aggressive. If help is not provided, then visual and auditory hallucinations, unmotivated actions appear, then convulsions and loss of consciousness occur.

The child should always have a chocolate candy with him, which he could eat if he was given a larger dose of insulin than necessary at that time, and to prevent the development of coma. But carbohydrates should be limited in the child's daily menu.

For children, short-acting insulins are used, most often Actrapid and Protofan. They are administered subcutaneously with a syringe pen. Such a syringe allows you to clearly establish the dose prescribed by the endocrinologist. Often, children themselves can fill it and inject the drug.

Mandatory daily monitoring of blood sugar levels with a glucometer. His testimony, as well as the foods eaten, are noted in the diary, which helps the doctor to choose the right dose of insulin.

In type 1 diabetes, pancreas transplantation is also possible as one of the methods of its treatment.

In the treatment of type 2 diabetes is of great importance. The endocrinologist will dwell in detail on the nutrition of the child, depending on age. The principle of the diet is that it is necessary to completely exclude the use of easily digestible carbohydrates (chocolate, sugar, flour products) by the child and significantly limit other carbohydrates in the diet. These recommendations must be followed in order to prevent a sharp increase in blood glucose.

To cope with this task, it is necessary to calculate the so-called "bread units". A bread unit is understood as the amount of a product containing 12 g of carbohydrates, which increase the blood glucose level by 2.2 mmol / l.

In European countries, at present, each product has an indication of the bread units in it. This helps diabetic patients choose foods for their diet. In Russia, there is no such information, but bread units can be calculated by parents on their own.

To do this, you need to divide the amount of carbohydrates in 100 g of the product (this information is on each product) by 12. The resulting number of bread units should be converted to the weight of the product that will be consumed by the child.

Consequences (complications) of diabetes mellitus

Diabetes can lead to damage to the vessels of many organs with the development of irreversible consequences:

damage to the vessels of the retina will give a decrease (or even complete loss) of vision;
renal failure may occur as a result of damage to the renal vessels;
encephalopathy develops as a result of damage to the vessels of the brain.

In order to avoid such severe complications, it is necessary to ensure regular monitoring of blood sugar levels, careful and constant adherence to the diet (table No. 9), and clearly follow all the recommendations of the endocrinologist for the treatment of the disease.

Prevention

Prevention of diabetes in children should be carried out from birth. Here are a few provisions.

If parents from an early age teach their child to a healthy lifestyle, in the future diabetes will not prevent him from achieving heights. The main thing is to accept the diagnosis and not give up.

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Diabetes mellitus in children: how the disease develops, recommendations for prevention and treatment

Diabetes in children is not so much a physical problem as a psychological one. Sick children are more difficult to adapt to the team, they, unlike adults, it is more difficult to change their usual way of life.

A disease such as diabetes mellitus is included in the group of endocrine disorders with signs of a deficiency of the thyroid hormone - insulin. Pathology is accompanied by a constant increase in the amount of glucose in the blood.

The mechanism of the disease is characterized by a chronic form, provokes the appearance of alarming symptoms characteristic of the disease and is accompanied by a failure of all types of metabolism - protein, mineral, fat, water, salt, carbohydrate.

Diabetes mellitus in children has no age restrictions and can manifest itself at the most unexpected moment. The presence of endocrine system disorders are present in infants, preschoolers and adolescents.

Childhood diabetes is the second most common chronic disease.

Just like in adult diabetics, this form of the disease in children is exacerbated by additional symptoms. With the timely detection of pathology and the hasty adoption of the necessary measures to prevent the consequences of diabetes, positive results can be achieved and the child's suffering can be significantly alleviated.

Violation of carbohydrate metabolism is the main cause of diabetes in children at any age. Scientists were able to track other factors that affect the development of the disease in children. Some of them have been studied in detail, and some of the reasons are still under the heading of obscurity.

The essence of diabetes does not change from this and comes down to the main conclusion - problems with insulin will forever change the life of a sick child.

The first symptoms of diabetes in children: how to recognize them

Understanding that a child has diabetes is always difficult at the initial stage. The symptoms are almost invisible. The rate of manifestation of the disease depends on its type - the first or second.

In type 1 diabetes, the symptoms progress rapidly and the baby changes within the first week. Type II diabetes is characterized by severity, the symptoms do not appear as quickly and not so clearly. Parents do not notice them, do not take the child to the doctor until complications occur. In order not to aggravate the situation, it would not be superfluous to find out how diabetes mellitus manifests itself in children.

Consider the most common symptoms of childhood diabetes:

In order for the child's body to receive an energy reserve for the proper organization of life, insulin must convert part of the glucose that enters the blood. If diabetes has already begun to develop, the need for sweets may increase. This is due to the hunger of the cells of the body, because in diabetes there is a violation of carbohydrate metabolism and not all glucose is transformed into energy.

For this reason, the child always reaches for sweets. The task of an adult is to distinguish the pathological process from the love of sweets.

A child with diabetes often feels hungry. Even if children eat enough food, it is difficult for them to wait for the next meal.

This can cause headaches and even trembling of the legs and arms. Children ask for food all the time and choose high-carbohydrate foods - flour and fried foods.

Decreased motor ability.

A diabetic child experiences an all-consuming feeling of fatigue, he lacks energy. He gets irritated for any reason, cries, does not want to play even his favorite games.

If you find a frequent recurrence of one or more of the symptoms, contact your doctor and get your blood glucose tested.

Children are not always able to objectively assess their needs and weaknesses, so parents should be on the alert.

Signs of diabetes in a child: what precedes the disease

In addition to the symptoms of the first stage, the disease is further accompanied by more obvious signs.

One of the most striking manifestations of diabetes. Adults need to control the child's fluid intake. In children with diabetes, there is a constant feeling of thirst. A sick baby can drink more than 3 liters of water per day, but his mucous membranes will remain dry, and the feeling of thirst will not dull.

2. Polyuria, or frequent and increased urination.

Due to the constant thirst and the large amount of liquid they drink, children suffering from diabetes go to small necessities more often than their healthy peers.

A large amount of urine excreted is associated with the amount of fluid consumed. In one day, the child can go to the toilet about 15-20 times, at night the child may also wake up because of the desire to urinate. Parents confuse these signs with a problem associated with frequent urination - enuresis. Therefore, for diagnosis, the signs should be considered in the aggregate.

Even in spite of increased appetite and consumption of sweets, children with diabetes may experience weight loss. Although initially the weight, on the contrary, may increase slightly. This is due to the physiology during a lack of insulin. Cells do not have enough sugar to form energy, so they look for it in fats, breaking them down. So the weight is reduced.

You can also understand that a child has diabetes on this basis. Even minor abrasions and scratches heal very slowly. This is due to impaired functioning of the vascular system due to a steady increase in blood glucose levels. In this critical situation, an appeal to an endocrinologist is inevitable.

5. Dermopathy, or skin lesions.

Because of diabetes, children often suffer from skin diseases. Rash, sores, and spots can occur on various parts of the body. This is due to a decrease in immunity, disturbances in metabolic processes and blood vessels.

No energy - the child has no strength for games and movement. He becomes weak and anxious. Diabetic children lag behind their friends in school and are not as active in physical education classes.

After coming home from an educational institution, the child wants to sleep, looks tired, does not want to communicate with anyone.

Another characteristic sign of the onset of diabetes. The air next to the child smells of vinegar or sour apples. This is clear evidence that the number of ketone bodies in the body has increased. It is worth immediately going to the doctor, otherwise the child may fall into a ketoacidotic coma.

Knowledge is your strength. If you are familiar with the symptoms of diabetes in children, you can avoid the severe consequences of the pathology and alleviate children's pain.

The clinic of the disease differs in children of different age categories. We offer you to get acquainted with the differences in the development of diabetes in accordance with age-related changes.

Signs of diabetes in the baby

In children who have recently been born, it is not easy to detect the disease. It is very difficult to understand whether the baby is experiencing polyuria (increased urination) or polydipsia (thirst) from his usual well-being. Pathology can be accompanied by other signs: vomiting, intoxication, dehydration, and even coma.

If diabetes develops slowly, the baby weakly gains weight, sleeps poorly and does not want to eat, often cries, suffers from stool disorders. For a long time, babies can suffer from diaper rash. Skin problems begin: prickly heat, allergies, pustules. Another point that should attract attention is the stickiness of urine. After drying, the diapers become hardened, and when it hits the surface, the stain sticks.

Causes of diabetes in young children

The development of diabetes occurs at an accelerated pace in children older than 1 year. The onset of a precomatose state will be preceded by the following signs:

Type I diabetes mellitus in children of this age is associated with genetic disposition and heredity.

Cases of type II diabetes in preschool children are observed more often than type 1 diabetes. This happens due to the uncontrolled use of harmful foods, fast food, rapid weight gain, and inactivity.

How does diabetes manifest itself in schoolchildren

The detection of diabetes in school-age children will be preceded by signs:

All these physical factors are combined with psychological, so-called atypical manifestations of diabetes:

Anxiety and depression;
Fatigue and weakness;
drop in academic performance;
Unwillingness to interact with peers.

If you notice at least one of these signs, do not leave the situation unattended.

At first, parents attribute diabetic symptoms to study fatigue. Moms and dads, love your children, do not ignore their problems and worries.

The first signs of diabetes in adolescents

Adolescent diabetes is a phenomenon that occurs after the age of 15. Symptoms of diabetes mellitus in adolescents are typical and worsen if left untreated.

The most common symptoms of diabetes in adolescents are:

The clinical picture of teenage diabetes is as follows: a high level of glucose in the blood provokes thirst, which does not decrease even after drinking a large amount of liquid; and frequent visits to the toilet for small needs - both during the daytime and at night.

Diabetes mellitus in girls in adolescence is manifested in menstrual irregularities. This serious violation is fraught with infertility. With the development of type II diabetes in a girl, polycystic ovaries may begin.

Diabetes mellitus of both types in adolescents goes away with symptoms of vascular disorders, pressure may increase, and there is an increase in blood cholesterol. Blood microcirculation is disturbed in the legs, the teenager experiences a feeling of numbness, suffers from convulsions.

With late diagnosis of diabetes mellitus in adolescents, the clinic of the disease is associated with the accumulation of ketone bodies in the blood. This happens due to a significant excess of blood glucose levels and a simultaneous energy deficit.

The body strives to fill this deficiency by the formation of ketones.

The primary signs of ketoacidosis are abdominal pain and nausea, the secondary ones are weakness and vomiting, frequent shortness of breath, and the smell of acetone on exhalation. A progressive form of ketoacidosis is loss of consciousness and comatose coma.

Causes of ketoacidosis in adolescents include:

In the first place among preventive measures is the organization of proper nutrition. It is necessary to maintain water balance all the time, because in addition to insulin, the pancreas produces an aqueous solution of bicarbonate, a substance that stabilizes the process of glucose penetration into the cells of the body.

Children suffering from diabetes should make it a rule to drink a glass of clean drinking water before each meal. And this is the minimum requirement. Coffee, sugary drinks, sparkling water do not count towards the liquid consumed. Such drinks will only harm you.

If your child is overweight (most often with type II diabetes), cut calories as much as possible in food. Calculate not only carbohydrates, but also vegetable and animal fats. Your child needs to eat more often, but not much. Follow the recommendations for proper nutrition with your child. For the company it is easier to overcome difficulties.

Include vegetables in the children's diet, cook original dishes from them. Let the child fall in love with beets, zucchini, cabbage, radishes, carrots, broccoli, onions, garlic, beans, swedes, fruits.

Treatment of diabetes in children

The main areas of treatment for childhood diabetes include:

Self-medication of diabetes can lead to an unpredictable scenario. The influence of traditional medicine is not fully understood. Therefore, you should not conduct experiments with your child, you should not seek help from traditional healers. Treatment of the disease in adults and children is different.

Many of the advertised drugs contain a large amount of hormones, when they enter the body, they can behave in any way. A large number of side effects will only aggravate the condition of a sick child and adversely affect the function of the pancreas.

If your child has been diagnosed with diabetes, don't despair. The situation you and your baby are in is a serious one. Do not expect magic from medicines.

Diabetes mellitus in children - the main symptoms:

Metallic taste in the mouth
Weakness
Skin itching
Nausea
Sleep disturbance
Frequent urination
The smell of acetone from the mouth
sweating
Dry mouth
Dry skin
Fast fatiguability
Double vision
Constant feeling of hunger
Pale skin
intense thirst
Decreased vision
Weight gain
reduced immunity
Weight loss
Feeling disgusted with food

Diabetes mellitus in children is a metabolic disorder, including carbohydrate metabolism, which is based on pancreatic dysfunction. This internal organ is responsible for the production of insulin, which in diabetes mellitus can be excessively low or complete immunity can be observed.

The incidence rate is 1 child per 500 children, and among newborns - 1 infant per 400 thousand.

The main predisposing factors influencing the development of the disease are genetic predisposition and previous severe infections. Clinicians have identified other, both pathological and physiological, sources of the disease.

Symptoms and signs of diabetes mellitus in children are non-specific - fatigue, weight loss or increase, constant thirst and severe itching.

Only the results of a laboratory study of blood and other biological fluids can confirm the diagnosis with accuracy. Instrumental procedures and manipulations of primary diagnostics play a secondary role.

Treatment of diabetes mellitus in children includes conservative methods - taking medications. The tactics of therapy will differ somewhat depending on the form of the course of the disease.

Causes of the disease

The essence of diabetes in children 5 years old, as in any other age, is a violation of the functioning of the pancreas, which secretes insulin. With a disease, a disorder in the production of a hormone occurs or a complete immunity of the body develops to it. In the second case, insulin is within the normal range or slightly exceeds the allowable values.

In any case, sugar cannot be converted into glucose, as it happens under normal conditions, which is why it is concentrated in large quantities in the blood. Normal sugar levels in children under 2 years old range from 2.78 to 4.4 mmol / l, in a child from 2 to 6 years old - 3.3-5 mmol / l, in those who have reached school age - no more than 5.5 mmol / l l.

The main factor in the development of diabetes is genetic predisposition. If one of the close relatives has been diagnosed with a problem, from an early age, parents should monitor the child's regular blood donation for appropriate tests.

Other causes of diabetes in children:

pathological influence of pathogens - Epstein-Barr virus, cytomegalovirus, rotavirus, enterovirus, Coxsackie virus, mumps, measles, rubella, chicken pox, herpes, whooping cough;
the course of autoimmune diseases, when the immune system destroys the pancreas, releasing aggressive antibodies that attack the organ;
the formation of malignant neoplasms;
viral damage to the liver;
infection of the urinary system;
injury or inflammation of the pancreas;
a history of malignant hypertension.

The causes of diabetes can also be the presence of other diseases in the child:

Itsenko-Cushing's syndrome;
diffuse toxic goiter;
acromegaly;
pheochromocytoma;
pancreatitis;
systemic lupus erythematosus;
rheumatoid arthritis;
scleroderma;
Down syndrome, Klinefelter and Wolfram;
chorea of Huntington;
Friedreich's ataxia.

Among the predisposing factors that do not have a pathological basis, there are:

obesity;
frequent overeating;
lack of physical activity;
uncontrolled intake of medicines - without the appointment of the attending physician, in case of non-compliance with the daily dosage or duration of administration;
irrational nutrition;
chronic stress.

Additional causes of diabetes in infants:

artificial or mixed feeding;
monotonous diet, which is based on carbohydrates;
feeding on cow's milk;
surgical interventions.

It is important to note that not in all situations it is possible to establish the etiology. In such cases, a diagnosis of "idiopathic diabetes mellitus in children" is made.

Disease classification

Depending on the source, the pathology is:

true or primary;
symptomatic or secondary - diabetes develops as a result of endocrine or other diseases.

For the primary form, the following types are characteristic:

Type 1 diabetes mellitus in children. It is called insulin-dependent, since the hormone is either not produced by the pancreas at all, or is secreted in insufficient quantities.
Type 2 diabetes in children is known as insulin resistant. This is due to the fact that the concentration of insulin is within the normal range or exceeds it, but the body remains immune to it.

According to the degree of compensation of carbohydrate metabolism disorders, the following forms of the disease are noted:

compensated - treatment makes it possible to normalize glucose levels;
subcompensated - the content of sugar in the blood and urine with competent therapy is quite a bit different from the norm;
decompensated - extremely dangerous, since even complex treatment cannot restore the process of carbohydrate metabolism.

Diabetes mellitus in a child has several degrees of severity:

mild - clinical signs may be completely absent, and the fasting blood glucose level does not exceed 8 mmol / l;
moderate - there is a deterioration in the general condition, the sugar concentration is less than 12 mmol / l;
severe - the likelihood of complications is high, because the glucose level exceeds 14 mmol / l;
complicated - children suffer from the consequences of diabetes that are not amenable to therapy, the sugar concentration rises to 25 mmol / l.

Diabetes mellitus in newborns is:

transient or transient - diagnosed more often, symptoms gradually disappear by 3 months of age, and complete remission occurs at 1 year, but the possibility of relapse at an older age is not excluded;
persistent or permanent - children need lifelong insulin therapy.

How does diabetes occur

Symptoms of diabetes in children

Symptoms of diabetes mellitus in children depend on the form of the disease. The disease begins with the appearance of such symptoms:

fluctuations in body mass index up or down;
constant feeling of hunger;
the need to consume large amounts of fluid;
frequent emptying of the bladder, especially at night;
sleep disorder;
fast fatigue, lethargy;
weakness and general malaise;
skin itching of varying severity;
increased sweating;
decrease in visual acuity.

The first signs of diabetes in a child will be observed in both insulin-dependent and insulin-resistant forms.

The clinical picture of type 1 diabetes includes the following external manifestations:

increase in the amount of fluid consumed per day;
increased urge to urinate;
dryness of the oral mucosa;
decreased physical activity;
fluctuations in temperature and blood pressure;
rapid physical fatigue;
metallic taste in the mouth;
bifurcation of the picture before the eyes;
increased fragility of bones;
decreased immunity - children are often exposed to colds, inflammatory and fungal diseases;
long-term healing of even the most minor wounds or abrasions;
persistent skin itching, most clearly localized in the groin and anus;
weight gain;
bouts of nausea and vomiting;
severe diaper rash in the genital area;
the smell of soaked apples from the mouth;
decreased appetite or complete aversion to food.

Symptoms of diabetes in a child with type 2 disease:

dryness, pallor and peeling of the skin;
intense constant thirst;
release of a large amount of sweat;
increased appetite;
increased fatigue and weakness;
weight loss;
the smell of acetone from the mouth;
frequent urge to empty the bladder;
decreased resistance of the immune system;
the appearance of "goosebumps" before the eyes;
migraines and abdominal pain;
frequent mood swings;
itching of the skin;
alternating insomnia and drowsiness;
flabbiness of the muscle layer.

It is extremely dangerous if diabetes mellitus is noted in an infant, since the newborn cannot verbally express complaints. Parents should pay attention to the behavior of the child, the frequency of urination and the amount of fluid drunk.

Symptoms of Diabetes

Diagnostics

The signs of diabetes mellitus in children are non-specific, but quite pronounced, so an experienced pediatric endocrinologist or pediatrician does not have problems in establishing the correct diagnosis.

The disease requires the implementation of a whole range of diagnostic measures. The clinician must personally:

get acquainted with the medical history of both the child and his close relatives - to search for the etiological factor;
collect and analyze a life history - for the possible identification of the physiological sources of the disease;
conduct a thorough physical examination;
measure temperature and blood tone;
interview parents in detail about the first time of onset of symptoms of diabetes in children at 3 years (or older) and the intensity of their severity.

Laboratory research:

general clinical blood test;
hormonal tests;
immunological tests;
blood biochemistry;
general analysis of urine.

Instrumental diagnosis of diabetes mellitus in children is aimed at finding possible complications and is represented by the following procedures:

ultrasonography of the liver and kidneys;
rheoencephalography;
duplex scanning of vessels of the lower extremities;
rheovasography;
ophthalmometry;
EEG of the brain;
CT and MRI.

Children's diabetes mellitus must be differentiated from the following pathologies:

acetonemic syndrome;
diabetes insipidus;
nephrogenic diabetes.

Treatment of diabetes in children

Therapy is limited to the use of conservative methods, which are based on oral medication and adherence to the rules of a sparing diet.

Medical therapy:

lifelong insulin replacement therapy using an insulin pump is the main treatment for type 1 diabetes in children;
hypoglycemic agents - sulfonylurea drugs, biguanides, meglitinides, thiazolidinediones and alpha-glucosidase inhibitors are indicated for the insulin-resistant form.

The presence of symptoms of diabetes in children can be eliminated with the help of diet therapy:

complete rejection of refined carbohydrates;
frequent food intake, but always in small portions;
daily calculation of consumption of bread units, cereals, liquid dairy products, vegetables, fruits and berries;
exclusion from the menu of any sweets and fats of organic nature.

Nutrition for diabetes

One of the effective methods of treatment is regular physical activity. Children are recommended to go in for sports three times a week, and the training should last at least 1 hour.

Possible Complications

The most common complications of diabetes in children are:

early atherosclerosis;
stroke;
lactic acidosis;
cardiac ischemia;
ulcerative lesions of the lower extremities;
hyperglycemic or hypoglycemic coma;
diabetic nephropathy, retinopathy, neuropathy, polyneuropathy, encephalopathy, angiopathy, foot;
chronic renal failure;
decline;
growth retardation.

Prevention and prognosis

To date, specifically targeted prevention of diabetes mellitus in children has not been developed. To reduce the risk of a problem, parents should monitor the child's compliance with such simple preventive rules:

active lifestyle;
proper and nutritious nutrition;
taking medication strictly according to the prescription of the attending physician;
maintaining body weight within the normal range;
permanent strengthening of immunity;
early detection and complete elimination of pathologies that lead to the appearance of symptomatic diabetes in a child aged 5 years and older;
regular examination by a pediatrician - will make it possible to identify the symptoms of diabetes in children in the initial stages and start therapy as early as possible.

Diabetes mellitus in children has a favorable prognosis, but only if complex therapy is started in a timely manner and conscientious adherence to preventive recommendations.

Diabetes mellitus in children Komarovsky

If you think that you have Diabetes mellitus in children and symptoms characteristic of this disease, then an endocrinologist can help you.