Children, along with adults, are susceptible to the development of various ailments. The parents are responsible for the child’s health. Therefore, on their shoulders lies the burden of an attentive attitude to the slightest changes in the behavior and well-being of the baby throughout the entire period of his growth and development. This will give the parents confidence that he is developing normally (both physically, mentally and emotionally).
Recently, many children are born with congenital diabetes mellitus or acquire it as they grow.
In children, compared with adults, diabetes is difficult. This is due to the intensity of metabolic processes inherent in the child’s body. The need for hormones with anabolic effect is very high. Insulin has this effect, which means that children need more insulin than adults. It is appropriate here to explain what anabolism is. This is part of the metabolism (metabolism), a set of chemical processes in the body that occur with the formation of high molecular weight compounds. In contrast to this process, catabolism is also part of metabolism – the breakdown of complex substances into simpler ones or the oxidation of a substance.
Why does the disease occur
Most children are diagnosed with the disease between 6 and 12 years of age. During this period, children experience many stresses associated with significant and new milestones in life for them: parting with kindergarten and going to first grade (in addition to stress, this is also a change in the usual regime, an increase in load and responsibility), the onset of puberty. The body of a little man cannot cope with such a “bulk”, which is why negative changes occur.
It is very important to regularly visit a pediatrician, take tests, so as not to miss the onset of an insidious disease, which will subsequently radically change the child’s life.
It is believed that diabetes mellitus in children develops when there is congenital pancreatic insufficiency. Due to the physiological characteristics of the child’s body, the content of most counterinsular hormones in children is significantly higher than in adults. By contrainsular hormones (insulin having opposite action) include somatotropin, adrenocorticotropin, glucocorticoids , thyroid hormones, epinephrine, glucagon. The content of somatotropic hormone (growth hormone) is especially high during the period of physiological accelerated growth of a child (3-4 years, 7-8 years, adolescence). It is during these age intervals that diabetes mellitus develops in children. With a full-fledged pancreas, a high level of growth hormone does not cause this disease in a child. In children with congenital pancreatic insufficiency, an increase in the level of growth hormone leads to the development of diabetes mellitus.
In childhood, there is an increased concentration of adrenocorticotropic hormone, which means that there is an increased level of glucocorticoids (hormones of the adrenal cortex), and they, in turn, have a powerful neoglycokinetic (formation of carbohydrates from proteins, fats) effect, that is, a lot of glucose is formed in the body, and with congenital pancreatic insufficiency, diabetes mellitus develops.
The child’s body is characterized by increased lability (imbalance) of the nervous system, especially its sympathetic part, which leads to excessive formation of adrenaline, which is the cause of the rapid breakdown of glycogen in the liver and muscles, which contributes to an increase in blood sugar.
Excess counterinsular hormones can significantly aggravate pre-existing diabetes mellitus. Nevertheless, in childhood, this disease develops less often, of the total number of diabetics, children make up 5%. This is due to the great compensatory capabilities of the child’s body.
Infections have a great influence on the development of diabetes mellitus in children.
The course of the disease
Diabetes mellitus in children is characterized by its rapid onset. Can be recognized for the first time in a coma. There is a high need for insulin. In the initial period, the child has:
- general weakness;
- losing weight with good appetite;
- deterioration in school performance;
All this indicates the decompensation of diabetes mellitus with an already identified disease.
In children, there is a general lesion of the pancreas, absolute insulin deficiency. A mild form of diabetes mellitus is established for a short time. A severe form is often diagnosed, less often a moderate severity.
Diabetes mellitus in children is divided into two periods:
- early (labile);
- late (stable).
The first period is due to the presence of endogenous (intrinsic, formed by beta cells) insulin. The second period is characterized by depletion of the pancreas (no endogenous insulin).
With Moriak’s syndrome, which can develop in children as a result of long-term treatment of the disease with insufficient doses of insulin, there is a severe labile course of the disease and complete depletion of the insular apparatus of the pancreas. The labile course of the disease is due to the state of the liver, namely its fatty infiltration. The lack of glycogen in the liver causes hypoglycemic reactions that aggravate fatty liver infiltration.
Outwardly, Moriak’s syndrome is manifested by a blush and roundness of the face, a disproportionate distribution of fatty tissue. With Moriak’s syndrome, hypoglycemia is frequent; the liver is significantly enlarged, it is high in fat and low in glycogen. Children are lagging behind in physical and sexual development.
The severe labile course of diabetes mellitus in children predisposes to the development of vascular lesions. They are observed in 95% of patients who fell ill in childhood, with a “length of time” of the disease lasting 20 years. In the early stages, vascular lesions are reversible.
In children, in the early stages of the disease, changes in the eyes and kidneys are detected.
Diabetes mellitus in children is treated with diet and insulin. The diet should have a sufficient amount of carbohydrates to provide the body with energy, fats are limited. Many experts recommend using easily digestible carbohydrates: sugar, honey, candies, as they have an antiketoacidotic effect. Prolonged withdrawal of them leads to ketoacidosis (a high concentration of glucose and ketone bodies in the blood). A sufficient amount of protein (meat, fish, milk, eggs) must be included in the diet of children.
Physiological norms of the main components of food for a child with diabetes mellitus
- Carbohydrates – 60%.
- Protein – 15%.
- Fat – 25%.
The dose of insulin is selected by the doctor; it must correspond to the needs of the body at this age. First, before compensation occurs, simple insulin is used, then prolonged insulin .
It is necessary to ensure adequate physical and emotional development of the child. The former depends on adequate nutrition, which is maintained by the administration of the necessary doses of insulin, prescribed individually depending on the needs. To develop emotional stability, the child’s independence and self-confidence should be encouraged from the outset.
Children are hospitalized in a medical institution at least 2 times a year, if necessary – more often.
If we consider the normal indicators of glycemia (sugar level) in children at different periods, then in newborns it will differ from adult children. In premature babies, it is much lower.
|Premature babies||1.8-2.8 mmol / L|
|1 day – 1 month||2.8-4.3 mmol / l|
|1 month – 1 year||2.6-4.8 mmol / L|
|2 years – 6 years||3.2-5.2 mmol / L|
|7 years old – 12 years old||3.2-5.6 mmol / L|
|12 years old – 18 years old||3.4-5.6 mmol / L|
From the table above, it can be seen: in infants, the values are quite low, this is medically acceptable. In the first year, the metabolism of a child is different from that of an adult. It depends on sparing nutrition, low mobility, from which the internal organs do not fully work. Every year the sugar level rises, and from the age of 7 it is already equal to the indicators typical for an adult (the child becomes mobile, spends a lot of energy, eats with his parents).
The smaller the child, the more difficult it is to notice deviations in his health during the development of diabetes mellitus. If, nevertheless, one of the signs (or several) is noted, you should urgently consult a pediatrician:
- increased appetite;
- poor sleep;
- frequent urination;
- plentiful drink;
- little weight gain or vice versa, excessive weight;
- low activity.
Under the influence of some factors, glucose values in children may change. They may be below normal if, on the eve of the test, the child was actively involved in sports, ate fatty foods, or experienced stress. Deviation from the norm does not always indicate the development of the disease – perhaps external factors played a role.
Be attentive to your child!