Stress and infectious disease can cause diabetes in a child!
Diabetes mellitus is an endocrine and metabolic disease. It is based on an absolute or relative deficiency of insulin, which determines the violation of all types of metabolism.
Most often, the development of the disease is predetermined by heredity, acute childhood infections, mental and physical factors, and malnutrition. Diabetes mellitus is a hereditary disease. Transmission is possible both for the dominant and for the recessive type. From childhood infections, the development of diabetes can be caused by mumps, chicken pox, measles, scarlet fever, flu, tonsillitis. Mental and physical injuries also belong to factors that contribute to the onset of diabetes, but, apparently, psychic injury only provokes the early manifestations of diabetes, the course of which was hidden. When physical and mental injuries often increases blood glucose levels (hyperglycemia), urine (glycosuria), but the disease does not develop.
The state of the insular apparatus of the pancreas is adversely affected by excessive power. It should be noted that diabetes begins in those who consume a lot of fat. It is fats, not carbohydrates, which, if overproduced, can lead to B-cell depletion. If children abuse sweets, it also predetermines the overload of the functions of the insular apparatus. Diabetes mellitus can occur at any age, but most often it occurs in children 6–8 and 11–13 years old, since during these years children grow intensively and the insular apparatus of the pancreas works with great tension.
The main role in the development of diabetes mellitus is played by insular insufficiency, in which all types of metabolism in the body are disturbed. The basis of these changes is the incomplete utilization of carbohydrates by the tissues, which leads to an increase in the level of glucose in the blood (hyperglycemia). Prolonged high blood glucose levels that exceed the maximum inverse threshold . vsmoktuvannyain renal tubules, glucose leads to an increase of losses in the urine (glycosuria). Under these conditions, the body’s need for energy is provided by the combustion of fats. Tissues cannot completely oxidize those fatty acids that enter the body in large quantities. That is why non-oxidized products of fat metabolism – ketone bodies (B- hydroxy butyric and acetoacetic acid, acetone) accumulate . This is howketoacidosis, which is characteristic of diabetes decompensation, develops . In addition, glycosuria causes polyuria. For each gram of glucose, 20-40 ml of liquid is released, while the loss of sodium and potassium electrolytes increases. Ketoacidosis, Mexican, dielectrolischemia, deepen metabolic disorders, the phenomenon of insular insufficiency.
In children, diabetes mellitus develops mostly suddenly. In a short time all the symptoms appear: polydipsia, polyuria, polyphagia, weight loss, dryness and itching of the skin and mucous membranes, hyperglycemia, glycosuria. This is different from adult diabetes, in which the disease develops gradually. In the initial period of the disease in children, the thirst is mild , but then it quickly increases, polyuria, bedwetting develop. Polyphagy in diabetes is manifested as a sharp increase in appetite, and an increase in the amount of food. Despite this, there is a weight loss that is progressing. One of the main symptoms of diabetes is glycosuria. In the daily urine of patients, it is possible to detect different amounts of glucose – from traces to several tens of grams. Its excretion with urine throughout the day is uneven, therefore, it is recommended to investigate the daily glycosuric profile. Urine is collected at certain hours: from 9 to 14, from 14 to 19, from 19 to 23, from 23 to 6, from 6 to 9 hours. In each portion of urine, the total amount, the percentage of glucose, and then the absolute amount of glucose in grams, which is allocated with each portion, is determined. It is necessary to establish the dose of insulin.Studies end up counting the daily amount of urine and daily glycosuria.
Hyperglycemia is also one of the main symptoms of diabetes. In sick children, the amount of glucose in the blood on an empty stomach exceeds 5.6 mmol / l, and with the development of coma or theprecomatose state rises to 22-30 mmol / l. In order to properly assess the state of carbohydrate metabolism in diabetes, it is necessary to determine the fluctuation of blood glucose levels throughout the day (constructing the daily glycemic curve). For diabetes mellitus, an increase in the blood of ketone bodies up to 860-1377 μmol / l is characteristic.
When ketonemia usually appears the smell of acetone from the mouth, acetone is detected in the urine.
However, the content of ketone bodies can also increase during fasting, infectious and other diseases. Complication. The most serious complication of diabetes mellitus is diabetic, or hyperglycemic, coma, which can develop if late recognition of the initial symptoms of the disease. In this case, after a few weeks or months, and with accompanying infections, even after a few days, severe acidosis and coma develop. In childhood diabetic coma happens more often and comes faster.
Increased diuresis, rapid weight loss and dehydration, the smell of acetone in the air that is exhaled, poor health, vomiting, thirst, lethargy and drowsiness are symptoms of a metabolic catastrophe. In a diabetic coma, consciousness does not fade away immediately: at first, gradually increasing lethargy develops, drowsiness increases, and the patient loses consciousness.
Coma is a life-threatening condition that can be prevented by starting treatment on time. In addition, there is a distant, but imminent danger, which ultimately shortens the life of the patient, the diabetic changes of the vessels. If the onset of diabetic coma is mistakenly diagnosed, then in such cases with intensive insulin therapy the blood glucose level (hypoglycemia) decreases sharply.
Hypoglycemia is characteristic of the initial, labile period of diabetes with a certain diet and insulin therapy, increasing the insulin dose, after fasting or physical exertion. The initial signs of it are pale skin, lethargy, dizziness, sweating, tremor, and disturbances of consciousness and convulsions soon appear. Important signs that distinguish hypoglycemia from hyperglycemic coma are: the absence of toxic respiration, pale moist skin, increased muscle tone, the normal concentration of glucose in the blood. Long, often repeated hypoglycemic states can cause brain damage.
In the treatment of patients with diabetes, the most important are: 1) proper nutrition; 2) insulin therapy; 3) compliance with hygienic regime. In the diet, the ratio of proteins, fats and carbohydrates should be respectively 1: 0, 75: 3.5. It is necessary to limit the consumption of sugar and other sweets to 30-35 g per day.
The food of sick children must include cheese, oatmeal and flour, lean lamb, that is, products that should have the ability to remove fats from the liver, preventing its fatty infiltration. You need to feed the child five times: breakfast, lunch, half a bed, dinner and additional meals 3 hours after the introduction of insulin, that is, the second breakfast. Unlike adult patients, diet alone is not enough.
For the treatment of diabetes in a child, you need to prescribe insulin. Insulin preparations are used with different duration and efficacy of action at different times of the day (insulin B, suinsulin , zinc insulin suspension) and others. Treatment is recommended to start with short-acting insulin preparations . Usually, the daily dose of short-acting insulin is divided into three or more injections, which are made 20-30 minutes before a meal.
The need for insulin on subsequent days, as well as daily doses, depends on the level of glucose in the urine and blood. In the first half of the day, it is advisable to prescribe most of the daily dose of insulin. If there is a need for night or evening injections, the amount of insulin should not exceed 10% of the daily. When insulin therapy for children with diabetes mellitus, it is not necessary to achieve a state of aglycosuria (no glucose in the urine), it is enough if up to 5-10% of the daily glucose is excreted in the urine.
The United States belongs to the countries with the highest incidence of diabetes. According to experts, the prevalence of diabetes in the United States has become pandemic. “The data for 2007 shows that the incidence in our country is 23-24 cases per 100 thousand population. At the same time , their number is growing every year in the USA , by the way, as well as throughout the world. Children with diabetes mellitus increases by 70 thousand every year .
C diabetes is a very serious and serious disease, especially in children. “Diabetes in children has different symptoms from adults. Its peculiarity is that it can occur “under the mask” of an acute abdomen, infectious diseases, adenoviral infection.
If parents are not physicians, they may not even think that these manifestations are evidence of a child having such a serious disease as diabetes, ”the children’s endocrinologist said.
She drew attention to the fact that the symptoms of diabetes children are growing very fast, especially if it is diabetic ketoacidosis (which is usually confused with the flu). According to her, it is for this reason that last year in the United States with a diagnosis of diabetes 10 children died. “98% of children with diabetes have type 1 diabetes mellitus: when the pancreas does not release insulin and, if children are in a state of ketoacidosis for a long time , this can lead to a serious condition, reanimation .
Therefore, she believes, medical services should prescribe not only common tests, but also a blood test for sugar. This way you can prevent the complications of diabetes, and stressed the doctor and. They insist that such an analysis should be done several times a year. “Parents should be alerted that their child drinks a lot, loses weight or often visits the toilet, especially at night. It is also necessary to take a blood test for sugar every time after a child has had an infectious disease (rubella, measles, etc.), pneumonia, flu, or stress — these factors can trigger diabetes . The children’s endocrinologist noted that the earlier a child has diabetes mellitus, the more chances to protect him from diabetes complications .