Saturday, April 8, 2023

Diabetes in children: everything you need to know


Signs, symptoms, causes, diagnosis, treatment... Diabetes in children must be distinguished from diabetes in adults in many ways.

Type 1 and Type 2: Diabetes mellitus:

When it comes to discussing childhood diabetes, it's important to remember that there are two types of diabetes, type 1 and type 2, which are basically two different diseases that share only a name.

Type 1 diabetes, which is the type we're interested in here, results from a hormonal deficiency: It occurs when the pancreas stops producing insulin. In other words, the pancreas can no longer secrete insulin. We are talking about insulin-dependent diabetes.
On the other hand, type 2 diabetes is caused by insulin resistance. This is why we talk so much about insulin resistance.

Either way, these insulin problems lead to hyperglycemia, which is excess sugar in the blood. A phenomenon not without danger to the body.
Type 1 diabetes is a chronic autoimmune disease in which the immune system mistakenly attacks insulin-producing cells (specifically the beta cells of the islet of Langerhans in the pancreas).

Signs and symptoms to watch out for:

Signs and symptoms that should warrant a consultation can be difficult to spot, especially in infants:

  • urinating frequently We're talking about frequent urination, with heavier diapers and/or getting wet more quickly, or more frequent visits to the toilet in a clean baby.
  • You feel thirsty often, due to lack of water or even dehydration.
  • Later signs may appear later, such as weight loss and fatigue.

These symptoms are explained simply by a chain reaction. When hyperglycemia becomes severe and persistent, glucose appears in the urine (normally there is no glucose in the urine): this is called glycosuria. When this by itself becomes very large (several hundred grams per day), the kidneys have to remove a lot of water to dilute the glucose in the urine. As a result, the child urinates a lot and often. He becomes dehydrated, which leads to extreme thirst, weight loss, and fatigue.

Complications in case of delayed diagnosis and treatment:

If the treatment is not given quickly, an increase in the acidity of the blood may occur due to the alternative use of fats. We are talking about ketoacidosis. Symptoms of ketoacidosis include abdominal pain, nausea, vomiting, and rapid breathing. This is clearly a life-threatening emergency, and can lead to ketoacidosis coma or even death.

At what age can you get diabetes?

Keep in mind that type 1 diabetes occurs suddenly in a child's life. It's not something that just takes off.
Type 1 diabetes has, on average, around age eight, but it can start as early as six months.
The autoimmune reaction that occurs in type 1 diabetes is still a mystery. Several hypotheses have been put forward. There may be a genetic predisposition, but this does not explain all cases, because it often happens that a child is affected without his relatives being affected by this diabetes. But this will only be a "genetic ground", and not a systemic transmission of the disease.
We also talk about environmental causes: previous viral infections, air pollution, or food, are all mentioned without certainty. But beware of shortcuts, type 1 diabetes cannot be caused by just one viral infection.

How is the diagnosis made in young children?

First of all, the general practitioner or pediatrician, faced with the warning signs of type 1 diabetes, must think about this disease and carry out the necessary preliminary examinations.
Either a blood glucose test with a finger or ear blood sample, along with a blood glucose meter, or a urine test using a strip to measure the presence of sugar in the urine.

Ideally, these first tests should be done quickly, without going through the lab, to save time. If the result confirms abnormal blood sugar levels, the child is immediately referred to the pediatric emergency room to confirm the diagnosis and start treatment without delay.

Then the diabetic or pediatrician will do a complete initial evaluation that includes:

  • A blood test, in particular with a dose of glycated hemoglobin, that is, the fraction of hemoglobin that stabilizes the sugar present in the blood.
  • An autoimmune test, which looks for the presence of autoantibodies to insulin-secreting pancreatic cells.
  • Other tests and examinations may be added, especially with the idea of diagnosing comorbidities (autoimmune thyroiditis, celiac disease, etc.).

How to avoid diabetes in children?

Unfortunately, as of now, there are no things to do or not to do in hopes of preventing the onset of type 1 diabetes in children, as it is an autoimmune disease with unknown causes. In other words, there is no need to feel guilty afterwards once a child has been diagnosed with type 1 diabetes. It should also be noted that gestational diabetes is not currently associated with an increased risk of developing diabetes in the fetus.

On the other hand, a healthy and active lifestyle, with a varied and balanced diet, can reduce the risk of obesity and type 2 diabetes, which can go hand in hand.
Once diagnosed with diabetes, the child and his family are most often treated by the pediatric diabetology department at the nearest hospital. There, medical teams that specialize in managing the disease generally give parents the tools and resources to learn how to deal with the situation.