Type 1 diabetes is the most common form of diabetes in children - as many as 90-95% of children suffering from this disease have this type. However, world health institutions point out that the number of children with type 2 diabetes is also on the rise, and the most common reason is the increasingly common obesity and poor nutrition of children. The main symptoms of diabetes observed in children do not differ from the symptoms of adults. These include thirst, weight loss, fatigue and frequent urination. It is often stated that children are irritable, have stomachaches, have frequent headaches and that their behavior is unusual (open children withdraw into themselves, have less contact with peers, have frequent tantrums). Pediatrician Dr. Marija Lakićević talks about diabetes in children.
"When the urine analysis in children shows the presence of glucose, it must be checked as soon as possible whether the blood sugar level has also increased. This parameter is extremely important and must not be ignored, because glucose in the urine is not a normal finding and can mean two things - that the child has diabetes, or that he has a rare hereditary kidney disorder - renal glycosuria. To check this, an urgent blood glucose measurement is necessary. Because, at the same time, increased levels of sugar in the blood and urine warn that the child may be suffering from diabetes", warns Dr. Lakićević.
What is diabetes mellitus?
"Diabetes mellitus is the Latin name for diabetes, the main characteristic of which is a constant increase in the concentration of sugar (glucose) in the blood. Sugar usually "jumps" after eating (but also after stress), so the right time to control it is in the morning - "on an empty stomach". However, the increase in blood sugar concentration is only a consequence of the real cause of diabetes in children, which is an insufficient amount of the hormone insulin, which is one of the most important regulators of very complicated metabolic processes in the body. One of the main functions of insulin is to 'introduce' glucose into the cells of our body. This is extremely important because sugar is necessary for life as the main source of necessary energy for most cells, and without this "biological energy" there is no life. So, when there is not enough insulin, a paradoxical situation occurs in the body - there is an excess of sugar in the blood, and a shortage in the cells (which need it very much). That is why the essence of diabetes in children is the lack (or decrease in the amount) of insulin, which is produced and secreted into the blood by the pancreas.
symptoms
"If a child eats more and loses weight, often urinates during the night, and often drinks water, these are symptoms that parents should pay attention to and check if everything is okay. And (sudden) behavior changes, combined with the previously listed symptoms, can be an indicator that diabetes may be present".
Types of diabetes
"In most children, it is a case of the deterioration of the pancreatic cells that produce insulin, so there is not enough of this important hormone in the body. This is diabetes mellitus type 1 (the first type of the disease), which requires mandatory insulin replacement because there is an almost complete lack of this hormone very quickly. Type 2 diabetes is more common in the elderly and is characterized by a decrease (but still there) in the amount of insulin in the body. Medicines (in the form of tablets or capsules) can be used here to help use up the remaining insulin. Although it is rarer in children, it occurs in adolescents, especially when they become overweight.
More blood tests are needed for diagnosis
"When diabetes is suspected, it is always necessary to check the blood sugar level on an empty stomach." A urine test is also performed, as well as other laboratory parameters that undoubtedly confirm the diagnosis. When diabetes is suspected, the path to confirmation of the diagnosis is really fast, so the child can start treatment immediately. And the only real cure for type 1 diabetes is insulin! That's why this type of diabetes is called insulin-dependent diabetes!
How is insulin given?
"Insulin is actually a protein, and all proteins, when taken through the mouth into the stomach and intestines, are digested - they break down. That is why it is impossible to give insulin by mouth, but the only possible way is to inject the drug into the subcutaneous tissue. Specially designed 'needles' are used for this, which are very thin and pain during insulin administration is minimized.
How often to take insulin
"Standard insulin dosing involves two daily insulin applications. The morning and evening dose must enable good regulation of blood sugar levels. Unfortunately, it is not easy because the child's body is a very turbulent 'metabolic' environment where changes in blood sugar concentration are frequent. That is why it is very difficult, with two doses of insulin, to regulate glycemia. That is why modern protocols for administering insulin in children include four daily doses. It has been shown that it is easier to regulate glycemia in children this way, but it is necessary to control the blood sugar level several times.
Nutrition of a child with diabetes
Modern insulin therapy necessarily goes with proper nutrition. It is not a diet, but a proper diet, because children should lead a normal life and eat well with certain restrictions. Foods and drinks with a large amount of sugar (concentrated sugar) should be avoided. These are primarily sweets and carbonated and non-carbonated drinks that contain sugar. For example, one two deciliter glass of juice (which is sweetened with sugar during production) has about two full tablespoons of sugar. Detailed instructions for the nutrition of diabetic children are given by nutritionists, and there are also very useful brochures that help parents to feed a child with diabetes well and healthily.
What can a parent do?
There are several important tips when it comes to what a parent can do for their child, whether they are small or in the adolescent period, whether they are new to this disease or already have some experience with it.
- Learn how to give insulin injections correctly
- Find out about the symptoms of low and high blood glucose levels - how to recognize them and what to do in those situations
- Measure the blood glucose level regularly and as soon as the child grows up enough, teach him too
- Teach your child to inject himself as soon as he is old enough - usually around 9 years old
- Go to the doctor regularly, especially if the child gets sick for any reason - it is probably necessary to adjust the treatment.
- Inform school staff and the child's friends that your child has diabetes and the symptoms of low blood glucose and what to do if they notice them.
And last but not least - talk openly with your child about diabetes, his fears and dilemmas related to this disease. Teach him to become responsible for his health, that diabetes is his everyday life and that he can live normally with it.
Complications are common
Be careful how you give your child insulin - there are clear rules that must be followed. Insufficient administration of the drug leads to almost constantly elevated glucose values, so the risk of acute and chronic complications of diabetes is high. Another problem is an overdose of insulin, which leads to a dangerous complication - a sudden drop in blood sugar (which is professionally called hypoglycemia). It usually happens when children don't eat enough or when the dose of insulin is simply too high. The first signs of hypoglycemia are trembling, restlessness, feeling hungry, and if nothing is done, the child becomes drowsy, drenched in cold sweat, and with a further drop in sugar, he can "fall" into a hypoglycemic coma. That's why it's important to recognize these signs in children and measure their sugar. If it is low, you should immediately give sweetened tea, or some other sweet drink, and then a meal.
The complications of diabetes are numerous, and the basis of all of them is the fact that small blood vessels (capillaries) suffer the most from sugar. These conditions can lead to heart, kidney, eye damage... Acute complications occur after several weeks of elevated sugar values - the child becomes irritable, complains of abdominal pain, and vomits. Then the general condition of the child worsens with numbness and complete inactivity. This condition is professionally called ketoacidosis and requires urgent treatment in hospital conditions.
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