As in adults, the cause of diabetes in children is not fully understood. It is probably a combination of genetic and environmental factors, although most children with type 1 diabetes do not have a family history of the disease.
Type I diabetes
Formerly known as insulin-dependent or juvenile diabetes, type 1 diabetes is the most common of all types of the disease in children (95 percent of children under the age of 16).
Signs and symptoms
There are a number of early symptoms that indicate that a child may have type 1 diabetes:
- frequent urination of large amounts of urine
- increased thirst, dryness of the mouth and throat
- weight loss
- increased appetite
- feeling tired
- diaper rash in infants, which does not pass with usual care
- sometimes more severe symptoms: weight loss, abdominal pain, nausea and vomiting
- headache
- fatigue
- behavior disorder
When eating, food is broken down and during digestion, sugar is released, which goes into the blood and reaches the cells. But the pancreas is unable to respond by producing insulin, so the sugar cannot reach the cells.
The child therefore becomes tired, because the cells have no energy. Meanwhile, blood sugar levels rise.
Sugar attack - tired child
When the kidneys sense a high level of sugar in the blood, they begin to eliminate it in the urine. With excess sugar, the water in which the sugar is dissolved is also eliminated, and the result is that the child urinates more often and in larger quantities just to get rid of the sugar (polyuria). The higher the level of sugar in the blood, the more often the child urinates, and this usually leads to dehydration, so the body needs more water. The child becomes extremely thirsty and drinks a lot of water and other liquids. Increased urination and thirst are often the first indicators of hyperglycemia (high blood sugar) and diabetes.
Symptoms in infants and young children can be vague, as it is very difficult to identify thirst. Regular growth spurts can lead to changes in appetite, and in this case children can show more serious symptoms more quickly before the disease is detected. One of the symptoms in infants can be diaper rash, which does not show improvement even after using medical creams.
In older girls, the symptom may be fungal vaginal changes or itching.
Establishing a diagnosis
The diagnosis is usually made on the basis of several clinical symptoms and analyses:
- excessive thirst
- frequent urination
- urine analysis, which shows a lot of sugar and the appearance of ketones
- blood sugar higher than 11,1 mol/l at any time of the day, regardless of what the child eats.
Most children have diabetes type 1. The symptoms usually start dramatically, because the pancreas does not secrete insulin. Ketones appear more often in the urine in type 1 diabetes, but their appearance does not necessarily indicate that type. Unfortunately, early diagnosis does not mean that diabetes will be milder or that treatment will be easier. In rare cases, it is difficult to determine whether it is type 1 or 2, so additional tests are resorted to, which include insulin levels, genetic testing and the use of immune markers for type 1, in which antibodies are found in the body.
The first step is for parents to learn how to give insulin injections, measure blood sugar and create a meal plan. Parental knowledge is the basis of diabetes control.
Treatment
There are two goals in the treatment of diabetes: that the blood sugar level is as close to normal as possible, so that complications do not occur in the future, and that the child can live with diabetes in a healthy and productive way. It implies the following:
- giving insulin injections several times a day or giving insulin with extra doses during meals monitoring blood sugar several times a day
- compliance with the diet plan
- increased physical activity, which is accompanied by the addition of food or sometimes a decrease in insulin.
Type II diabetes
It is difficult to diagnose type 2 in young people, because it starts with mild or even no symptoms. It is not known exactly how common type 2 diabetes is in young people, it is only known that the number of patients is increasing.
Signs and symptoms
Compared to type 1 diabetes, type 2 usually starts with mild or no symptoms:
- frequent urination in large quantities
- increased thirst
- increased hunger
- loss of body weight
- blurred vision
- fungal infections
- prolonged wound healing
- weakness and exhaustion
Treatment
Type 2 diabetes is controlled by a combination of healthy diet, physical activity, weight reduction, and for many young people, medication.
Treatment certainly involves many lifestyle changes. When diet and exercise fail to control sugar levels, medications are prescribed to help insulin work better.
Some adolescents also need to take insulin injections, but neither insulin nor drugs can replace a healthy diet, regular exercise and maintaining an optimal weight.
Nutrition of sick children
Nutrition is extremely important for children with diabetes, especially in terms of complex carbohydrates and fiber.
For infants and young children, maintaining stable blood sugar levels is critical for brain development. It is necessary to be careful with sweet food, but it should not be completely excluded. The daily meal schedule includes:
- Three main meals
- Two or three snacks
- The whole family should eat the same food
What parents need to know
- learn how different foods affect blood sugar levels
- teach the child to drink water whenever he is thirsty
- choose carbohydrates with plenty of fiber
- limit: sweets, thick juices, pastries, jams, honey
- limit saturated fat and cholesterol
- establish a daily routine of physical activity
- include vegetables of different colors (spinach, broccoli, cauliflower, carrots, eggplant)
- use whole grain bread,
- integral rice and pasta
- replace meat with legumes two or three times a week
- remove the skin from the chicken before thermal processing.
Children with diabetes basically need the same food for growth and development as other children. A healthy diet includes plenty of fresh fruits and vegetables, whole grains, lean meat, fish and dairy products
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