Dr. Komarovsky claims that diabetes in children is most often insulin-dependent, in which the pancreas stops producing a hormone that converts glucose into energy. This is a chronic autoimmune progressive disease, during the course of which the beta cells of the islets of Langerhans are destroyed. It is worth noting that during the period of the onset of primary symptoms, most of these cells have already undergone destruction.
Often, type 1 diabetes is due to hereditary factors. So, if chronic hyperglycemia was among someone close to the child, then the probability that the disease will be detected in him is 5%. And the risk of developing the disease 3 identical twins is about 40%.
Sometimes in adolescence, a second type of diabetes, which is also called insulin-dependent, can develop. Komarovsky notes that with this form of the disease, ketoacidosis appears only because of severe stress.
Also, most people with acquired diabetes are overweight, which often causes insulin resistance, which can contribute to impaired glucose tolerance. In addition, the secondary form of the disease may develop due to a malfunction of the pancreas or an excess of glucocorticoids.
Signs of diabetes in children
Talking about the symptoms of chronic hyperglycemia in a child, Komarovsky focuses parents' attention on the fact that the disease manifests itself very quickly. This can often lead to the development of disability, which is explained by the peculiarities of children's physiology. These include instability of the nervous system, increased metabolism, strong physical activity, underdevelopment of the enzyme system, due to which it cannot fully fight ketones, which causes the onset of diabetic coma.
However, as mentioned above, a child sometimes has type 2 diabetes. Although such a violation is not common, because most parents try to monitor the health of their children.
The symptoms of type 1 and type 2 diabetes are similar. The first manifestation is the consumption of copious amounts of fluid. This is due to the fact that water is transferred from the cells into the blood to dilute sugar. Therefore, a child drinks up to 5 liters of water a day.
Also one of the leading signs of chronic hyperglycemia is polyuria. And in children, urination often occurs during sleep, because the day before a lot of fluid was drunk. In addition, mothers often write on the forums that if a child’s laundry dries before washing, then it feels like starched to the touch.
Many more diabetics lose weight. This is because when the glucose deficiency the body begins to break down muscle and fatty tissues.
If there is diabetes, the symptoms in children Komarovsky claims may manifest vision problems. After all, dehydration is reflected in the eye lens.
As a result, there is a veil before the eyes. However, this phenomenon is no longer considered a sign, but a complication of diabetes, which requires an immediate examination by an ophthalmologist.
In addition, a change in the behavior of a child may indicate endocrine disorders. This is explained by the fact that the cells do not receive glucose, which causes energy hunger and the patient becomes inactive and irritable.
Ketoacidosis in children
Another characteristic sign of diabetes is refusal to eat or, on the contrary, constant hunger. This also happens against the backdrop of energy starvation.
With diabetic ketoacidosis, appetite disappears. Such a manifestation is quite dangerous, which requires an immediate call for an ambulance and the subsequent hospitalization of the patient, because this is the only way to prevent the development of disability and other serious consequences.
In type 2 diabetes, frequent fungal infections often become a typical manifestation. And with an insulin-dependent form of the disease, it is even difficult for a child’s body to fight with ordinary ARVI.
Diabetics may smell like acetone from the mouth, and ketone bodies are sometimes found in the urine. These symptoms, in addition to diabetes, may be accompanied by other serious diseases, such as rotavirus infection.
If a child has only acetone breath, and there are no other signs of diabetes, then Komarovsky explains this by a deficiency of glucose. A similar condition occurs not only against the background of endocrine disorders, but also after active physical activity.
This problem is solved simply: the patient must be given a glucose tablet or offered to drink sweet tea or eat candy. However, the acetone odor in diabetes can be eliminated only with the help of insulin therapy and diet.
Moreover, the clinical picture of the disease is confirmed by laboratory tests:
- elevated blood glucose;
- the presence of antibodies in the blood that destroy the pancreas;
- rarely immunoglobulins are detected for insulin or enzymes involved in the production of a hormone.
The children's doctor notes that antibodies can only be detected in insulin-dependent diabetes, which is considered an autoimmune disease. And the second type of the disease is manifested by elevated blood pressure, high blood cholesterol and dark spots in the armpits and between the fingers.
Another hyperglycemia in the insulin-dependent form of the disease is accompanied by blanching of the skin, tremor of the limbs, dizziness and malaise. Sometimes diabetes develops covertly, which is dangerous late detection of the disease and the development of irreversible effects.
Occasionally, diabetes appears in the first year of life, which makes diagnosis much more difficult, because the child cannot explain what symptoms he is worried about. In addition, it is quite difficult to determine the daily volume of urine on diapers.
Therefore, parents of newborns should pay attention to a number of such manifestations as:
- increased appetite, because of what weight is not gained, but rather lost;
- the appearance of diaper rash on the surface of the genitals;
- the formation of sticky spots on surfaces where urine has got.
Komarovsky draws the attention of parents to the fact that the earlier a child becomes ill with diabetes, the more difficult the disease will be in the future.
Therefore, in the presence of a hereditary factor, it is important to control the blood glucose level from birth, carefully monitoring the behavior of children.
How to reduce the likelihood of developing diabetes and what to do if the diagnosis is confirmed?
Of course, it is impossible to cope with a hereditary predisposition, but to make life easier for a child with diabetes is real. Thus, as a preventive measure, infants in the risk category should be especially careful to select complementary foods and use adapted mixtures when breastfeeding is impossible.
At an older age, the child must be taught to active life with a moderate load. It is equally important in preventive and therapeutic purposes to teach children to adhere to a special diet.
The general principles of proper nutrition are that the ratio of nutrients to calories in a child’s menu should be such that he can compensate for energy costs, grow and develop normally. Thus, 50% of the diet should be carbohydrates, 30% is given to fats, and 20% - to proteins. If a diabetic has obesity, then the goal of diet therapy is to slowly lose weight and then keep the weight at the same level.
In the insulin-dependent form of food, it is important to coordinate with the introduction of insulin. Therefore, it is necessary to eat at the same time, while the ratio of proteins, carbohydrates and fats should be constantly observed.
Since insulin flows from the injection site, in the absence of additional snacks between the main meal, the patient may develop hypoglycemia, which will intensify with physical activity. Therefore, children who are given 2 injections per day should definitely have a snack between breakfast, lunch and dinner.
The child’s menu includes 6 basic types of products that can be replaced by each other:
It is noteworthy that diabetics often develop atherosclerosis. Therefore, the daily dose of fat in this disease should be no more than 30%, and cholesterol - up to 300 mg.
Preference is given to polyunsaturated fatty acids. From meat it is better to choose fish, turkey, chicken, and eating pork and beef should be limited. Dr. Komarovsky himself in the video in this article will talk about diabetes and sugar in children.