Diagnosis of diabetes in children is based on identifying the symptoms of the disease and determining the concentration of glucose and insulin in the blood. Treatment of diabetes mellitus in children includes diet, dosed exercise, treatment with insulin preparations.

Forms of diabetes in children. There are two main types of diabetes mellitus:

• Insulin-dependent diabetes (type 1 diabetes).
• Non-insulin dependent diabetes (type 2 diabetes).

While type 2 diabetes mellitus predominates among adults, type 1 diabetes mellitus (insulin-dependent) predominates among children.

Type 1 diabetes mellitus is characterized by very low levels of insulin in the blood, as a result of which the diabetic child is dependent on insulin treatment.

Features of the development of diabetes in children

A child's pancreas (an organ that produces the hormone insulin) is very small. By the age of 10, the mass of the child's pancreas doubles, reaching a size of 12 cm and a weight of just over 50 g. The production of insulin by the pancreas is one of its most important functions, which is finally formed by the fifth year of a child's life. It is from this age and up to about 11 years that children are especially susceptible to diabetes. All metabolic processes in a child's body proceed much faster than in an adult. Carbohydrate metabolism (assimilation of sugars) is no exception. Accordingly, a child needs to consume 10 g of carbohydrates per 1 kg of weight per day. Therefore, all children are very fond of sweets - this is a natural need of their body. The metabolism of carbohydrates is also affected by the nervous system of the child, which is not yet fully formed, therefore it can malfunction and also affect blood sugar levels. Contrary to popular belief, even the consumption of significant amounts of sweets in childhood does not lead to the development of diabetes.

In general, the risk of developing diabetes is higher in premature, underdeveloped children, or adolescents during puberty. Also, the risk of developing diabetes is higher in children subject to significant physical exertion (for example, in pupils of sports schools).

The main cause of diabetes in children is a viral infection that destroys insulin-producing cells in the pancreas. Among childhood infections, many can cause the development of diabetes (mumps, rubella, measles, etc.). In this regard, one of the most important measures to prevent the development of diabetes in children is the timely vaccination of the child.

The course of diabetes mellitus in children also depends on the age of the child at which the disease began. The younger the child with diabetes, the more severe it is and the greater the risk of various complications. As a rule, once having arisen, diabetes in a child never goes away. A child with diabetes will need supportive care throughout his life.

Risk factors for diabetes in children

There are a number of risk factors that contribute to the development of diabetes in children. The presence of one or more risk factors greatly increases a child's chances of developing diabetes. Risk factors for diabetes in children:

• children born to diabetic mothers
• both parents of the child have diabetes mellitus
• frequent acute viral diseases
• birth weight exceeded 4.5 kg
• other metabolic disorders (hypothyroidism, obesity)
• immunosuppression

Symptoms of diabetes in children are almost the same as in adults:

• thirst
• weight loss
• excessive urine output (more than 2-3 liters per day)
• severe infections
• fatigue, inability to concentrate

Parents do not always notice these symptoms, which makes it difficult to detect diabetes in children. Despite the difficulty in identifying the symptoms of diabetes in a child, there are characteristic signs of diabetes in children that make it easier to identify the disease. So, for example, an important symptom of diabetes is bedwetting. Children with diabetes produce 2-4 times more urine than healthy children. Also, in children with diabetes, skin lesions (furunculosis), itching of the skin, etc. often occur. In infants, diabetes mellitus is accompanied by indigestion (diarrhea, constipation, vomiting), anxiety. A diabetic child suckles a lot and greedily at the breast or drinks water. From sweet urine, linen and diapers become hard, crispy. These symptoms are often observed in moderate or severe diabetes mellitus. In mild diabetes mellitus, sick children may have little to no complaints or signs of illness, and the diagnosis is based on blood and urine sugar levels.

Treatment of diabetes in children.

Treatment of diabetes in a child includes: exercise, diet, medication.

Exercise for children with diabetes

Exercise increases the sensitivity of body tissues to insulin and lowers blood sugar levels. In this regard, dosed physical activity is an important part of the treatment of children with diabetes. It should be emphasized that only dosed physical activity is useful in diabetes, while uncontrolled physical activity in patients with diabetes mellitus contributes to the development of hypoglycemic conditions.

Proper exercise management in diabetic children necessarily includes the use of additional carbohydrates before, during and after exercise in accordance with the recommendations given by your doctor, as well as periodic monitoring of blood glucose levels.

It is important to measure blood glucose before, during and after exercise in order to correctly dose insulin with a short or intermediate duration of action.

Nutrition of a sick child plays an important role in the treatment of diabetes mellitus. The nutrition of a child with diabetes should meet all the requirements that are currently imposed on the nutrition of a healthy child: the diet should be as balanced as possible in all the most important ingredients (proteins, fats, carbohydrates and vitamins). Compliance with this condition allows children with diabetes to grow and develop normally. At the same time, a special diet eliminates the carbohydrate load and thus facilitates the course and treatment of diabetes.

In diabetes mellitus, they limit the use of such foods and dishes as bakery products made from wheat flour, potatoes, cereals (semolina, rice). Porridge is given to the child no more than once a day, using coarse grinding cereals (buckwheat, oatmeal, corn) for their preparation.

Rice, semolina and pasta should be used in limited quantities. The consumption of bread should not exceed 100g per day. Vegetables (everything except potatoes) can be offered to the child without restrictions. Moreover, dishes from various vegetables should make up a significant part of the daily diet of children.

Fruits and berries – unsweetened varieties of apples, black currants, cherries, etc. – are also widely included in the diet for diabetes. Occasionally, you can give your child citrus fruits (oranges, tangerines), strawberries, wild strawberries, raspberries. A child can eat fruits raw and in the form of compotes prepared with sugar substitutes.

Fatty, spicy and salty sauces, sweet sauces are excluded from the menu. If the child does not have liver diseases associated with diabetes, it is allowed to add a small amount of onion to food as a seasoning.

It is necessary to feed a child with diabetes 6 times a day and more often. The greatest satisfaction for the child, as a rule, brings his usual food. In view of this, when compiling a diet, the features of the family nutrition stereotype should be taken into account: the hours and volume of each meal, the child's eating habits. The composition of the child's diet should be agreed with the doctor observing the child.

Drug treatment of diabetes in children.

Almost all children with diabetes receive insulin. Thanks to the introduction of long-acting insulin preparations into medical practice, as a rule, one injection of insulin per day is sufficient.

The choice of insulin preparation, its dosage and administration schedule are also determined by the attending physician. Tablets for diabetes (Maninil, Glipizide, etc.) are quite effective in treating diabetes in adults, but very rarely give good results in children. They are used in mild forms of the disease or prescribed as an adjuvant to reduce the number of injections or the dose of insulin.

Children and adolescents who are regularly treated, adhere to the diet exactly, develop well physically and mentally.

Properly selected and organized therapy with insulin preparations and constant monitoring of the child's condition greatly alleviate the course of the disease and allow children with diabetes to lead a full life.

Material taken from the site: Cherepovets City Maternity Hospital

Diabetes mellitus in children: explain and teach

The diagnosis of "diabetes mellitus" made to a child can cause shock in the first place, not even for the child himself, but for his parents. First reaction: it can't be, it's some kind of mistake. The second - for what? Why exactly did my baby or baby suffer such a fate? .. Some of the parents, not agreeing at first with the “terrible” diagnosis, as it seems to him, are trying to find other methods of treatment, turning to alternative medicine, healers and healers for help. Such behavior will not only not help the child cope with the disease, but can also cause irreparable harm to him.

Since the patient himself, most likely, does not yet understand anything about the disease, with which he will henceforth have to coexist for the rest of his life, the responsibility for how it develops falls on the shoulders of the parents. That is why they must know in detail how to help their child and how to teach him to properly organize his life and take care of his own health.

First symptoms of disease

What symptoms in the behavior and well-being of the child should definitely alert parents?

• Feeling of thirst. The child often drinks a lot (instead of a glass of juice or water, he can drink a whole bottle).
• Increased urination (including at night).
• Despite the presence of a good appetite, the child noticeably loses weight.
• Loss of activity, feeling of weakness, desire to lie down even during the day.

In diabetic patients, due to a lack of insulin, glucose remains in the blood “without use”, while the cells of the body, meanwhile, “starve” and, out of hopelessness, begin to use their own body fat as an energy source. That is why weight loss becomes one of the symptoms of diabetes.

In the process of burning in fat cells, a large number of so-called ketone bodies are released into the blood, which eventually begin to be excreted in the urine in the form of acetone. If treatment is not started, the child may develop a condition called "diabetic ketoacidosis" .

The only medicine that can help the child in this situation is insulin injections. Receiving the required daily dose of insulin, your baby will be able to feel good and lead a completely normal life: go to school, and then at the institute, make a career, start a family, raise their own children.

Causes of diabetes in a child

No matter how far modern medicine has stepped, scientists still do not give an exact answer to the question of the causes of diabetes. However, it is reliably known that the risk of developing diabetes can be inherited. At the same time, the closest relatives themselves may be healthy, but have an increased predisposition to this disease and “give” it to their child or grandson. And then childhood infections, viral colds, stress, and other reasons can come into play.

As for the excessive consumption of sweets, there is no scientific evidence that this can lead a child to diabetes. On the other hand, it can accelerate the onset of the disease, so in families where there are patients with diabetes, children are not recommended to eat a lot of sweets.

"Honeymoon" and all life

After the diagnosis is made in the first months of the disease, some children go into remission, which is called the “honeymoon”. This happens because, having received insulin, the pancreas begins to secrete more insulin. Such a remission can last from several weeks to 1-2 years, creating a misleading impression that the disease has been curbed. Unfortunately, over time, the need for insulin always increases.

It happens that parents try to achieve remission by drastically reducing their child's intake of carbohydrates , switching to "special diets" (from raw cereals, nuts, dried fruits). It is absolutely impossible to do this! This is very dangerous for the child's body and in the future can lead to serious consequences.

At the same time, it is possible to achieve a longer remission if you do not overload the pancreas with excess carbohydrates, constantly monitor blood glucose levels, lead an active lifestyle, and play sports. And in no case do not overcool, since any infectious or viral disease can put an end to the "honeymoon".

New way of life

In order for a child to lead a normal life, he must learn the basic rules of self-control: conduct regular tests for glucose in the blood (glycemia), urine (glucosuria), follow a diet and physical activity, and, depending on the circumstances, be able to change the dose of insulin .

The dose of insulin is selected individually for each child. The task of parents is to teach the child to correctly collect the right amount of insulin and to inject correctly.

Glucose control is necessary - this is the only way to determine whether the dose of insulin is sufficient, whether to change it or nutrition before physical activity, during some kind of illness, etc. Competent self-control will allow the child not to feel like a "stranger" in a children's company or among classmates among their own. "

In the diet of a child with diabetes, preference should be given to those foods that do not increase blood glucose levels, contain few carbohydrates and a large amount of fiber: these are almost all vegetables and herbs, meat, fish, dairy products, etc. Sweets, of course, better to exclude.

But in no case should you refuse an active lifestyle, playing sports. Having diabetes is not a reason to lie in bed! There are several reasons for going to the gym regularly.

• Therapeutic effect: physical exercises lead to a decrease in blood glucose levels and, as a result, to a decrease in the dose of insulin administered.
• Physiological effect: the child's flexibility increases, muscle strength and lung capacity increase.
• Psychological effect: physical exercises help fight stress, bad mood, increase self-esteem.

Before you start playing sports, you need to consult with your doctor and decide together on the type of physical activity, its duration and intensity.

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