Diabetes mellitus is a fairly serious disease that occurs in adults and children. In newborns, it is less common and is caused by a disruption in a gene that is responsible for the function of the beta cells of the pancreas. In medicine, this condition is known as neonatal diabetes.
Causes of occurrence
In infants, diabetes mellitus accounts for only 1 baby out of 200 thousand. In this case, the disease is particularly severe, poses a threat to the life of the baby and requires immediate treatment.
There are several reasons for the onset of diabetes mellitus in infants:
- genetic predisposition (transmitted from parents);
- the use of medications by a pregnant woman that had a toxic effect on the fetus;
- damage to the beta cells of the pancreas by viruses, as a result of which insulin is not produced;
- undeveloped pancreas due to the premature birth of the baby;
- smoking during pregnancy, the use of alcohol, drugs, as a result of which the formation of the pancreas in the fetus is disrupted;
- the use of cow’s milk and cereals in infancy.
Risk group
A characteristic feature to look out for is the low birth weight of a full-term baby.
Doctors identify a risk group that is more susceptible to neonatal diabetes than others. These are newborns with a genetic predisposition and with the following deviations:
- intrauterine diseases of a viral nature (chickenpox, rubella, mumps);
- toxic destruction of the pancreas;
- disturbed nutrition.
It has been proven that newborns under constant stress are very nervous or frightened, more often suffer from neonatal diabetes. Such children, unfortunately, appear in asocial families (among alcoholics, drug addicts) or in those where an unfavorable microclimate has formed. When stressed, blood sugar rises.
The main symptoms of diabetes mellitus in a newborn
Diabetes mellitus rarely bothers infants, but still, parents should know the main signs of the disease in order to seek medical help in time. Symptoms of diabetes mellitus in infants are often not taken into account, so parents find out about the problem already with the onset of a diabetic coma.
So, the main signs of diabetes in newborns are:
- insufficient weight gain with good appetite;
- constant thirst;
- frequent urine flow (daily amount can be 2 liters);
- tearfulness, constant whims, anxiety;
- diaper rash and inflammation on the skin in the genital area (girls develop vulvitis , and boys suffer from inflammation of the foreskin).
A characteristic sign of neonatal diabetes is unusual urine – it sticks, after urination, a kind of stains are formed on the diaper. If parents do not pay attention to the above signs in time, then soon the newborn will have significant toxic poisoning of the body and a coma. With neonatal diabetes in babies, the acid-base balance is often disturbed, dehydration occurs, which threatens with dangerous consequences.
Possible complications
Without timely treatment, a baby with diabetes mellitus is threatened with health and life-threatening consequences. Changes not related to diabetes mellitus are also possible (violation of the integrity of the skin and mucous membranes). Doctors identify the main complications of diabetes in newborns:
- the development of hypoglycemic coma;
- signs of diabetic ketoacidosis , in which sugar levels change uncontrollably;
- violation of visual function (up to complete loss of vision);
- violation of the physical, intellectual development of the child;
- coronary artery disease;
- trophic ulcerative lesions on the lower extremities, signs of a diabetic foot;
- renal failure;
- improper cerebral circulation;
- lactic acidosis.
Diagnostics
To detect diabetes mellitus in infants, it is necessary to pass a blood and urine test to determine the glucose level. A laboratory study is also carried out for the content of hormones. This allows the doctor to determine the degree of diabetes mellitus in a newborn and choose the most appropriate treatment.
Treatment features
The main task is to replenish insulin, which the body lacks. The baby is injected with the drug through special syringes or dispensers. Mostly the doctor prescribes urea sulfate or Glibenclamide . For each newborn, the endocrinologist prescribes an individual drug in a dosage taking into account the patient’s age and physical characteristics.
Until now, doctors have not been able to develop such drugs that would completely cure diabetes mellitus in newborns, therefore, such babies are shown lifelong therapy with a special diet.
Parents should regularly monitor the amount of sugar in the baby’s blood (you can use a glucometer at home ). In addition, newborns with diabetes should control the acid-base and water-electrolyte balance with the help of special drugs. The complex therapy also includes enzymes to normalize the work of the pancreas.
If untreated, in the second month of life, the child develops symptoms of severe intoxication, leading to a coma.
Food
Supportive therapy includes adherence to a special diet. It is strictly forbidden for babies under one year old to give cow’s milk and up to 3 months – cereals. With extreme caution, complementary foods should be introduced. Diabetic babies need special nutrition:
- egg yolk and sour cream – limited;
- children’s kefir, low-fat cottage cheese (without fillings and additives);
- meat fish;
- sweets with sweeteners;
- porridge and potatoes – in small portions once a day;
- fruits with a minimum sugar content;
- boiled or baked vegetables.
It is strictly forbidden to give your baby a banana, figs, grapes, and other fruits with a high sugar content. In the baby’s diet, salt should be in a strictly limited amount. When preparing complementary foods, it is recommended not to salt soups and cereals. You can add onions, garlic or herbs to your dishes to add flavor. But if the baby has an upset stomach or liver, then such supplements should be canceled.
Neonatal diabetes prognosis
It is customary to divide neonatal diabetes into two types, each of which manifests itself in a different way. Transient diabetes mellitus is diagnosed in 50% of cases – by the age of one year, the symptoms of the disease gradually or abruptly disappear, but with a high degree of probability they can return in adolescence. With permanent diabetes mellitus, the symptoms do not disappear, but remain for life (lifelong maintenance therapy is indicated).
If the baby is diagnosed with diabetes in a timely manner and the correct treatment is started, then the prognosis is quite favorable. In the absence of comprehensive treatment, in 25% of cases, the baby is lagging behind in development. Symptoms of epilepsy and muscle weakness are possible. Children with complicated diabetes mellitus are more difficult to learn.
How to warn?
To avoid the manifestation of diabetes mellitus in a newborn, it is necessary to exclude all risk factors. Pregnancy must be planned, which means that long before conception, a woman needs to be tested for the presence of an inherited disturbed gene responsible for the function of the beta cells of the pancreas. If there is a genetic predisposition for the appearance of neonatal diabetes in a baby, then this still does not guarantee the development of the disease. In this case, the child should be protected from childhood diseases that can disrupt the normal functioning of the pancreas. It is better to feed children who are predisposed to the development of diabetes mellitus with breast milk (it contains special enzymes that have a beneficial effect on the body). The baby should be protected from nervous shocks and stress.