Diabetes mellitus is a chronic illness characterized by elevated blood glucose levels. People of various ages, including children, are affected by the condition. In infants, it is quite difficult to recognize the disease, as its symptoms are similar to the manifestations of other pathologies. What are the main signs of diabetes in children?
Causes of diabetes in children
- toxic effects on the body;
- feeding with cow's milk or inappropriate mixtures;
- the previous operation;
- stress, emotional shock.
Other diseases are also caused:
- pancreatic pathology (pancreatitis);
- endocrinopathies (diffuse toxic lizard, acromegaly, Itsenko-Cushing syndrome);
- immunological diseases (rheumatoid arthritis, lupus erythematosus, scleroderma);
- genetic abnormalities (Down, Shereshevsky-Turner syndrome, tungsten, porphyria);
- oncological diseases.
Early manifestations
There is no distinct clinical picture in the early stages of the disease, and overt symptoms are frequently ascribed to other conditions. The first signs are difficult to notice, do not bring significant discomfort, often go unnoticed.
Early symptoms of diabetes in a child:
- Excessive dryness of the skin, peeling, poor wound healing, and scratches.
- Severe itching on various parts of the body, which pediatricians often see as allergic reactions. Special testing and tests are conducted to rule out the potential of allergies.
- An increase in the amount of urine excreted, a change in the nature of the discharge. After the feces dry, white spots remain in their place, similar to traces of sugar.
- Mood, nervousness, irritability. Children are prone to mood swings, hysteria.
- Constant craving for sweets, due to impaired glucose absorption and the desire to compensate for its amount.
Common symptoms
Diabetes mellitus in children occurs due to insufficient synthesis of insulin by the pancreas. With a lack of hormones, the body cannot fully absorb glucose, leading to a violation of carbohydrate and energy balance. The following symptoms are characteristic of this condition:
- Polydipsia: the excessive thirst that cannot be quenched.
- Polyuria: frequent urination due to excessive water consumption, increased stress on the kidneys.
- Impaired glucose uptake, tissue depletion, decreased energy potential.
- Weight loss or poor weight gain due to active adipose tissue breakdown to compensate for lack of energy.
Auxiliary signs
Diabetes mellitus in children manifests itself gradually. In addition to the standard symptoms, the ancillary symptoms are characteristic of the disease:
- nightmares, restless sleep, frequent awakenings;
- constant blush on the cheeks;
- bleeding gums, premature tooth loss;
- weakness, drowsiness, increased fatigue;
- frequent colds, viral and bacterial infections caused by decreased immunity.
To maintain the normal functioning of the body, the pancreas tries to synthesize an extra amount of hormones. This leads to a sharp drop in glucose levels. Hypoglycemia is manifested by the following symptoms:
- weakness, accompanied by loss of consciousness;
- excessive sweating;
- nausea;
- a severe attack of hunger.
- low body temperature;
- slow weight gain;
- intense thirst;
- inflammation, swelling of the genitals;
- sticky urine with the smell of acetone, which after drying leaves a white mark;
- increased irritability;
- diabetic coma.
Treatment
Diabetes therapy includes medication, diet, increased physical activity.
When hyperglycemia is diagnosed, the child’s diet is primarily adjusted. Sweets, fast carbs, animal fats, fast food, practical foods are excluded from the diet. The diet should be balanced, fractional. It is important to avoid large differences between meals to avoid hypoglycemia.
To normalize sugar levels, correction is performed with tablets or insulin injections. The dosage is selected individually, taking into account the weight, age of the child, as well as degree of glycemia.
Moderate physical activity will help maintain glucose at an optimal level: hiking, swimming, cycling, yoga.
Without proper treatment and monitoring of the condition, complications dangerous to the health and life of the child develop ketoacidosis, retinopathy, diabetic foot, polyneuropathy. To avoid them, it is important to follow all the doctor's recommendations, constantly monitor your blood sugar.
Prevention
There is no single system for preventing diabetes. To reduce the likelihood of developing pathology in children with a hereditary predisposition, follow these recommendations:
- control the child's weight, not obese;
- increase physical activity;
- pay attention to your diet, limit the use of sweets, practical foods, fast foods;
- a vaccine to prevent viral infections.
The signs of diabetes in children vary in different age groups, depending on the type and stage of development. To identify pathological changes in a timely manner and begin treatment, you need to know the main symptoms of the disease, the prerequisites for its development, and also constantly monitor the condition of the child.
Thanks to its capabilities, modern medicine avoid the fatal consequences of diabetes. Diabetes symptoms in children are comparable to those seen in adults, but the therapy is different. Previously, the condition proved lethal to young children, but medication assistance allows the body to endure the disease's symptoms. What are the early warning symptoms of diabetes in children? The symptoms, diagnosis, and aspects of the disease's progress in children of various ages are given in the article below.
Types of diabetes
Often the forms of the disease do not differ, but they are completely different. Types of diabetes include:
- Type I - the reason lies in the genetic predisposition of children for the disease, sometimes caused by very strong stress. This is a congenital type of condition in which a kid is insulin dependant and requires medicine to sustain the body. Glucose in pancreatic tissue is tough to digest.
- Type II - a person in this group is insulin-independent. Diabetes is linked to faulty metabolism and, eventually, a shortage of insulin in the blood. This sort of illness is common among the older population.
Signs of diabetes in adolescents
Diabetes mellitus in puberty takes place in the same way as in adults. It is manifested by polyuria, polydipsia, drowsiness, fatigue, increased irritability. However, some features of the manifestation of the disease should be highlighted:
- itching, inflammation, swelling in the genital area;
- menstrual irregularities;
- abdominal pain, nausea, vomiting;
- skin pathologies: acne, fevers, frequent barley.
Diagnostic
If you find signs of diabetes in your child, consult an endocrinologist and take the necessary tests:
- blood count from finger;
- assessment of glycated hemoglobin;
- glucose tolerance test;
- urine sugar test.
Finger testing is given on an empty stomach. You cannot drink or eat anything, brush your teeth with toothpaste or rinse your mouth before blood sampling. Limit excessive physical activity per day, reduce the number of sweets consumed and stop taking medications. The blood sugar level in children depends on age but averages 3.3–5.5 mmol / l.
In case of doubtful results from the previous analysis, a glucose tolerance test is performed. A blood test on the voice is taken at the finger of a child. He then takes a glucose solution. After 1 and 2 hours, repeated sugar level measurements are performed.
How is diabetes in a child
Thanks to its capabilities, modern medicine avoid the fatal consequences of diabetes. Diabetes symptoms in children are comparable to those seen in adults, but the therapy is different. Previously, the condition proved lethal to young children, but medication assistance allows the body to endure the disease's symptoms. What are the early warning symptoms of diabetes in children? The article below discusses the symptoms, diagnosis, and aspects of the disease's progression in children of various ages.
The first signs and symptoms of diabetes in a child
- Thirst. When blood sugar is elevated, it eats water from the cells, causing dehydration. Children are especially thirsty in the evening.
- Frequent urination. Increased glucose has a detrimental impact on the kidneys, slows the process of reverse absorption of primary urine, and leads the child to urinate frequently, causing the body to clear itself of harmful chemicals.
- Increased appetite. When a child eats a lot but does not gain weight, and even loses weight dramatically, it is a sign that glucose is not entering the cells, she is starving.
- Feeling bad after eating. Until the pancreas returns glucose levels to normal, the child has nausea, abdominal pain, and even vomiting.
- Sudden weight loss. This symptom is manifested if the glucose does not enter the cells at all and the body must eat energy from the subcutaneous fat.
- Constant weakness. Fatigue, lethargy, apathy are associated with impaired blood glucose digestion.
- Acetone odor emanating from the mouth cavity. This condition happens as a result of the production of ketone bodies in the blood following a fat breakdown. The body must get rid of toxins, and it does so through the lungs.
- Infectious diseases. Weakened immunity does not cope with the protective functions, and the child often suffers from bacterial and fungal infections.
Characteristics of the course of the disease depending on age
Diabetes develops in children of any age. In the first months of life, this happens less often, but from the 9th month begins the period of puberty in which the first signs of diabetes appear in the child. Clinical manifestations and therapy at different age periods are different. How does the disease pass, depending on age and how to diagnose diabetes in a child?
In infants
The acute onset of the disease in infants alternates with the prodromal period, which often goes unnoticed. Diabetes is difficult to diagnose in children under the age of one because thirst and rapid urination are difficult to detect. In some children, diabetes develops abruptly, with severe intoxication, vomiting, and dehydration, followed by diabetic coma.
The second type of disease progresses slowly. Infants up to 2 years do not gain weight, although they eat well. After eating, the child may become ill, but after drinking, he is noticeably relieved. The development of infections on the background of the disease contributes to the formation of diaper rash on the genitals, the folds of skin under the diaper. The diaper rash does not go away for a long time, and if the baby's urine falls on the diaper, then it dries out and becomes starch. If the liquid from urine gets on the floor or other surfaces, they become sticky.
In preschoolers and elementary school students
- severe exhaustion, dystrophy;
- increased abdominal volume (frequent stretching);
- flatulence;
- problematic stool;
- dysbiosis;
- abdominal pain;
- the smell of acetone from the oral cavity;
- food refusal;
- vomit;
- decay of the body, complete rejection of sweets.
Children are also prone to type 2 diabetes, which is associated with malnutrition, obesity, and insufficient physical activity. More and more adolescents prefer junk food, later suffering from improper metabolism weakened hormonal background, and pancreatic work. The load on the vessels causes them to weaken, and additional complications of the disease appear. This type of disease requires a strict diet. The remaining signs of diabetes in younger children are not very pronounced.
In adolescents
In children older than 10 years, the incidence is more common than at a young age and amounts to 37.5%. Recognition of the disease, as in adult patients, is simpler, the symptoms are pronounced. The period before puberty and puberty (13 years) is characterized by the following symptoms:
- increased diabetes
- persistent fluid deficiency;
- enuresis;
- sudden weight loss;
- increased appetite.
This occurs when the disease may exist but has no pronounced signs, therefore, it is detected during a medical examination. The period of active development lasts up to six months. School is characterized by frequent fatigue, apathy, weakening of the whole organism, the transmission of many types of infections. In adolescent girls, an irregular menstrual cycle, itching in the genital area may be noticed. Stress is devastating, the disease begins to develop even faster.
Diagnostic methods
There are no significant differences in the diagnosis of the disease in children from adults, so the following detection methods are used:
- Blood test. Indicators that are particularly important in this study: the amount of protein, the amount of glucose in the blood of the voice, glucose tolerance before and after meals, glycated hemoglobin. An immunological study of blood sampling is important: it checks for the presence of antibodies, which indicates the development of diabetes.
- General urine analysis. A sign of diabetes in children is a huge amount of glucose in the urine, its increased density. This fact also indicates that it is necessary to check the kidneys, which could be affected. Presence of acetone in urine.
- Hormone test.
- Pancreatography.
- Skin study. In diabetics, flushing of the cheeks, forehead, chin, rash characteristic of the disease is noticed, the tongue becomes scarlet.
- Pancreatic ultrasound
Possible complications and consequences
To maintain the body, young patients are advised to diet, taking drugs of various specific actions, folk remedies. Parents should carefully monitor their insulin intake, proper diet, control physical activity and avoid stress. What are the consequences of the disease if left untreated?
- Coma (hypoglycemic, hyperglycemic, lactic acid, ketoacidosis).
- Damage to organs and systems.
- Development of infectious diseases.
- Fatal outcome due to severe course of the disease.
Diabetes mellitus in children and adolescents, as well as the manifestation of its symptoms and signs, are increasingly relevant in our time. Diabetes is less common than many other diseases, but it is not as rare as previously thought. The incidence of the disease is not sex-dependent. Sick children of all ages, starting from the first month of birth. But the peak of diabetes is in children aged 6-13 years. Many researchers believe that the disease is especially common during periods of increased child growth.
The appearance of this disease is most often diagnosed after infectious diseases:
- pig;
- infectious hepatitis;
- tonsillar infection;
- malaria;
- measles and others.
Syphilis as the main provoker of the disease has not been confirmed at the moment. But mental injuries, acute and long-lasting, as well as physical injuries, especially bruises on the head and abdomen, malnutrition with a lot of carbohydrates and fats - all these factors indirectly contribute to the development of latent imperfections of the pancreatic islet.
pathogenesis
The etiology of diabetes in children is not dramatically different from the pathogenesis of this illness in adults.
The growth process, which involves increased protein synthesis, is linked to insulin participation and increased tissue consumption. With a defective pancreatic islet apparatus, its function can deteriorate, resulting in diabetes mellitus.
Course and symptoms
The onset of the disease is usually gradual, but it can sometimes be quite fast and abrupt, with most symptoms being detected quickly. The following are the disease's initial symptoms:
- increased thirst;
- dry mouth
- often excessive urination, often nocturnal and even diurnal urinary incontinence;
- later as a symptom weight loss is manifested by a good, sometimes even very good appetite;
- general weakness;
- headaches;
- rapid fatigue.
Skin manifestations - Itching and associated conditions (pyoderma, furunculosis, eczema) are uncommon in youngsters.
Hyperglycemia in children is a major and persistent symptom. Glycosuria occurs almost always. Because urine-specific gravity does not always match quantitative sugar concentration, it cannot be used as a diagnostic test. Often, there is no perfect match between blood sugar and the degree of glycosuria. Hyperketonemia develops for the second time with fatty infiltration of the liver, which is caused by loss of lipotropic function of the pancreas.
Changes in the organs and systems of the body are diverse
Rubeosis and xanthosis observed in adults are rare in children. In untreated patients, dry skin and peeling are observed. Swelling may occur with severe exhaustion.
The tongue is dry bright red in color, often with smooth papillae. Gingivitis is often observed, and sometimes alviolar pyroreia, which is stronger in children than in adults. The carious process in the teeth is prone to progression.
Cardiac sounds are deaf, sometimes a systolic murmur is detected at the top, which indicates reduced vascular tone. pulse is the small, soft, palate. Blood pressure, both maximum and minimum, almost always drops. Capillaroscopy shows an intense red background and expansion of the arterial knee, the electrocardiogram shows changes in the myocardium.
In some situations, the number of red blood cells and hemoglobin levels fall.. On the white blood side, the leukocyte formula is extremely lubic:
- In mild forms of diabetes - lymphocytosis, which decreases with increasing severity of the disease.
- In severe coma and coma - lymphopenia. Neutrophil shift to the left and eosinophil deficiency.
The acidity of gastric juice is often reduced. There are dyspeptic symptoms. The liver is enlarged in most patients (especially in children with long-term diabetes.), Dense, sometimes painful.
In urine, albuminuria and cylindruria are not pronounced. In a difficult and long-lasting course, the number of cylinders and proteins increases, and red blood cells can appear. In some cases, the filtration capacity of the kidneys is impaired.
Already at the beginning of the disease appear:
- headaches;
- Dizziness
- irritability;
- emotiveness;
- rapid fatigue;
- lethargy, weakness;
- memory impairment.
Peripheral nervous system disorders are manifested by pain in the limbs, impaired skin sensitivity, and weakening or extinction of tendon reflexes.
Organs of sight
Accommodation problems are more frequent in children with diabetes than in adults, according to ophthalmology. Change in refraction according to both hyperopia and multiplicity, and in severe cases hypotension of the eyeballs.
Sometimes there is diabetic retinopathy and cataracts, prone to rapid maturation. Diabetic retinitis, paralysis of the eye muscles in children are extremely rare.
Forms of disease
Diabetes in children is practically indistinguishable from that of an adult, it is divided into three forms:
But the mild form in children is extremely rare. It is more commonly diagnosed with moderate and severe forms; with the latter, liver damage is not uncommon, especially its fat degeneration. This can be due to the loss of not only insulin but also lidocaine. Also, overproduction of growth hormone, which has adipokinetic action and causes fatty liver.
Cystic fibrosis (cystic fibrosis) in children
Diabetes mellitus in children due to cystic fibrosis is primarily due to insulin deficiency. But secondary insulin resistance in acute disease due to infectious complications and the use of pharmacological drugs (bronchodilators and glucocorticoids) may contribute to the development of impaired glucose tolerance and diabetes mellitus.
Diabetes due to cystic fibrosis tends to appear in the later stages of the disease, usually in adolescence and early adolescence. If there is cirrhosis, it contributes to insulin resistance. The development of diabetes due to cystic fibrosis is a poor prognostic sign and is associated with increased disability and mortality. Poorly controlled diabetes acts with immune responses to infections and promotes catabolism.
Recommendations for screening range from randomized glucose testing each year for all children with cystic fibrosis (cystic fibrosis) ≥ 14 years to an oral glucose tolerance test each year for children older than 10 years, but traditional measurements such as plasma glucose on the test, PGTT, and HbA1c may not require diagnostic methods for diabetes in individuals with cystic fibrosis.
Initially, insulin therapy is necessary only for respiratory infections, acute or chronic infectious episodes, but over time, insulin therapy becomes constantly necessary. Initial doses of insulin are usually small (more than complementary than completely insulin replacement therapy). In some patients, early insulin therapy before the onset of hyperglycemia symptoms leads to beneficial metabolic effects that improve growth, body weight, and lung function.
Prediabetes in children
Children are often diagnosed with latent diabetes (prediabetes), which can often be exogenously accompanying - constitutional obesity or infectious diseases:
- malaria;
- dysentery;
- infectious hepatitis and others.
Patients usually do not show complaints. Blood sugar in the voice is sometimes normal, there is no sugar in the urine, sometimes there is transient hyperglycemia and glycosuria. But, as a rule, they are difficult to spot with one examination.
Latent diabetes in a child can be detected only by calculating the blood sugar curve after glucose filling (for school-age children, a load of 50 g of sugar is sufficient). High rise with the delayed reading of the maximum level and slow descent, after 3 hours of not reaching the initial blood sugar values, are characteristic of latent diabetes.
Early detection of latent diabetes is very important because it allows treatment to be carried out in the early stages of development and prevents the transition from latent diabetes to explicit.
It is much harder than in adults, it is prone to progress. With puberty, the process normalizes, probably due to the cessation (with the onset of full development of all organs and systems) of excessive intake of the somatotropic hormone.
complications
Identified at an early stage of development and properly treated diabetes in children in 90% of cases does not give complications. With improper treatment, the clinical picture worsens and a number of complications develop:
- growth retardation, the more pronounced, the earlier diabetes developed with age;
- sexual underdevelopment;
- polyneuritis;
- cataract;
- impaired renal function;
- liver cirrhosis.
Systematic monitoring of lung condition is required in childhood and adolescence with diabetes and a predisposition to tuberculosis. Due to the earlier detection of diabetes and proper treatment, tuberculosis has become much rarer lately.
Signs of diabetes in children
It is not uncommon for children to be diagnosed with diabetes very late.
- thirst;
- dry mouth
- frequent urination
- weight loss;
weakness is sometimes considered a helminthic invasion or another disease.
Implemented in this regard, therapeutic measures: anthelmintic treatment, enhanced diet, intravenous glucose further aggravate the patient's condition. The sugar content in the urine, and even more so in the blood in these cases, will be determined very late when the patient in a coma comes to the medical facility. In the presence of most symptoms and determination of sugar in urine and blood, the diagnosis is not difficult.
Differential diagnosis
With renal diabetes, as with sugar, urine is excreted, but usually, a patient suffering from renal diabetes does not show complaints, blood sugar is usually normal, and sometimes even slightly reduced. The glycemic curve does not change. Sugar in the urine is excreted in moderation and does not depend on the number of carbohydrates received with food. Renal diabetes in adolescents does not require specific insulin treatment. It is necessary to constantly monitor the patient because some believe that renal diabetes in children is the beginning of diabetes, ie its middle form.
The main symptoms of diabetes insipidus do not differ from sugar, it is increased thirst, dry mouth, frequent urination, weight loss. Blood sugar and the glycemic curve in diabetes insipidus are not cheating.
The prognosis directly depends on the time of diagnosis. Thanks to previously performed diagnostics and constant regular treatment under frequent medical supervision, children can lead a lifestyle that is no different from healthy children and learns successfully in school.
With severe acidotic as well as complicated forms, the prognosis is less favorable. The prognosis is particularly unfavorable in families where the child does not pay enough attention to the general regimen, proper and nutritious diet, and timely administration of insulin. Children with diabetes are more prone to various diseases than healthy children. Diseases can be more severe and even fatal.
Remission or "honeymoon" phase in type 1 diabetes
In about 80% of children and adolescents, insulin requirements are temporarily reduced after the start of insulin therapy. Until recently, the definition of the phase of partial remission has not been clarified, it is now generally accepted to consider the phase of partial remission when a patient needs less than 0.5 units of insulin per kg of body weight per day at the level of glycosylated hemoglobin.
Patients need adequate physiological nutrition and insulin therapy. Each patient needs a completely individual approach in prescribing the course of treatment, depending on the condition in which he comes under medical supervision and age. In latent diabetes, only a physiological diet with the correct ratio of protein, fat, and carbohydrates is prescribed.
Diabetes is not uncommon in children in a mild form, and physiological nutrition is prescribed. In which some hyperglycemia and glycosuria may remain that do not exceed 5-10% of the value of food sugar (carbohydrates + 1/2 protein). In this case, there should be good health, complete preservation of working ability, normal weight.
Dietary insulin
Most patients are forced to receive insulin along with a physiological diet. Insulin is administered subcutaneously, based on the assumption that one unit stimulates the absorption of 5 g of carbohydrates. In some cases, this correspondence is interrupted due to the inactivation of insulin in the body. Insulin must be given in an amount that ensures almost complete absorption of carbohydrates. It is recommended to leave glycosuria up to 20 g of sugar daily, such glycosuria is not harmful and at the same time warns the patient of hypoglycemia. To reduce hyperglycemia to normal numbers should not be.
The distribution of food during the day should be done taking into account the insulin received. In order to determine the dose of insulin and its more regular distribution during the day, it is necessary to conduct a daily glycosuric profile (glycosuria in each 3-hour portion of urine and total glycosuria per day are determined).
It is recommended to inject more needed insulin before breakfast and lunch, avoiding the evening injection or making it the smallest. Food is best divided into 5 receptions: breakfast, vows, and dinner, and additional food 3 hours after ingestion of insulin, second breakfast, and afternoon snack. Such a fractional diet allows for a more even distribution of carbohydrates and prevents the possibility of hypoglycemia.
Hypoglycemia
Hypoglycemia is usually the result of a mismatch between the amount of insulin injected and carbohydrates received with food, sometimes occurring after a lot of physical activity. It is developing rapidly:
- weakness appears;
- trembling hands;
- feeling hot and light chills;
- with heavier proportions - darkened consciousness;
- epileptiform convulsions;
- complete loss of consciousness - hypoglycemic coma.
In the initial stages, you can easily remove the patient from the state of hypoglycemia, giving him easily absorbed carbohydrates: sweet tea, bread, jam. In case of loss of consciousness, glucose is given intravenously (40% solution 20-40 ml), depending on the severity of hypoglycemia. If glucose cannot be administered, for example, during convulsions, 0.5 ml of 1: 1000 adrenaline solution may be administered (as a last resort!).
Patients often come under the supervision of a physician in a state of hyperglycemic coma, which is the result of poor treatment, eating disorders, fat abuse, discontinuation of insulin. Coma occurs slowly, in a coma, patients complain of:
- weakness;
- tin pain;
- hangover;
- appetite worsens;
- nausea and vomiting occur.
- An attack of coma in children in some cases is accompanied by sharp abdominal pain.
- If the patient worsens:
- loses consciousness;
- the smell of acetone is felt in the mouth;
- blood sugar and ketone bodies rise sharply;
- glycosuria increases;
- the reaction to acetone in the urine is positive;
- decreased muscle tone and eyeball tone;
- breathing is frequent and noisy.
In such cases, it is urgent to start fractional administration of insulin subcutaneously every half hour, taking into account the patient's condition and the amount of insulin previously obtained. Simultaneously with the intake of insulin, it is necessary to enter a large number of carbohydrates in the form of sweet compote, tea, juice if the patient can drink. In the unconscious state, glucose is given intravenously (40% solution) and subcutaneously (5% solution). Intravenous administration of 10% sodium chloride solution gives a very good effect. The patient should be well warmed up. According to the indications, heart drops are prescribed.
Severe diabetes
In severe acidotic forms of fatty liver diabetes, a broad diet with fat-restricted carbohydrates, fractional administration of insulin is required. Food should be rich in vitamins. Slow-acting insulin can only be given to older children who do not have acidosis and are prone to frequent hypoglycemia.
The general way of working and school
The general regimen is the same as for healthy children. Sports activities must be arranged with your doctor.
Schoolwork is not contraindicated. Depending on the course of the disease, in some cases, an additional day off is required. Spa rest is useful as a restorative factor.
Treatment of complications and concomitant diseases is carried out in the usual way. Against the background of diet and insulin treatment, there are no contraindications for surgical methods of treatment. General strengthening measures are needed: proper nutrition without overeating. With severe heredity and the presence of diabetes in several family members, such children need to be under constant medical supervision. (systematic blood and urine tests for sugar content).
Prevention of diabetic complications is especially important. Parents of children with this diagnosis should be well acquainted with the main issues related to the treatment of diabetes, diet, insulin, etc. All children diagnosed with diabetes are advised to be hospitalized each year for a more thorough examination. With permanent deterioration, the patient should be hospitalized immediately.
Questions for discussion with school staff
Emergency Contact
- Who to call in case of acute complications?
- Another family member's phone number if you can't pass.
- Algorithm of hypoglycemia action
- What symptoms should you pay attention to and what should be done with such symptoms?
- What does the hypoglycemic emergency kit look like and where ??
- Does the school have a doctor's office? The time of his work? Is there glucagon in the office (a medicine used by medical staff to treat hypoglycemia)?
- Does the teacher have access to the office during non-working hours and can he/she ingest glucagon on his own?
Food and snacks
If a child needs to eat during strictly defined hours, how can this be organized taking into account the class schedule?
- Children bring ready meals from home or eat in the school cafeteria.?
- Does a child need adult help in counting units of carbohydrates?
- Does the child need a snack before exercise?
- Blood sugar
- When should a child have their blood sugar measured? Does he need help?
- Is the child able to interpret the measurement results or does adult help be needed?
Actions for hyperglycemia
What to do with high blood sugar? (Insulin injections!)
Should a child be injected with insulin while at school? Does he need adult help?
If a child uses an insulin pump, will they be able to use it on their own?
Is it possible to use a refrigerator to store insulin if necessary (for example, in hot weather)?
Is there a special room where you can inject insulin? You need to ensure that your child has everything they need to follow the prescribed treatment regimen during the school day. You should check your insulin regularly and replenish your supplies if necessary.
How adolescent diabetes affects siblings
Diabetes affects not only the child but also the whole family. As a parent, you can start spending more time with your child because there are so many things to talk about, especially at the beginning of the illness. Your child may feel lonely, like everyone else, frustrated or insecure about their future, and, understandably, will be surrounded by the extra care and attention. If you have several children, then this imbalance can cause tension in the family. It is important to allocate your time properly to reduce the impact of your child's diabetes on your relationship with other family members, as well as your siblings' relationship with each other.
Dictionary brothers
It is not always easy to achieve a balance in the distribution of time between children, because as a rule, a child with diabetes needs extra care and attention. Be interested in the feelings of all your children. Other children may feel abandoned, unimportant, or forgotten. Some fear for the future of their brother or sister and worry that they too may get diabetes. Either they may feel guilty for not having diabetes or blame themselves for giving sweets to their siblings in the past.
Strong attachment from parents and those close to a sick child can cause envy in other children. Do they feel they are not getting the same attention as before? Other children may also pay too much attention to a sibling with diabetes. A sick child may feel exhausted or think he is constantly watching him.
Other children may be jealous because a sick child receives more privileges or concessions. It is therefore necessary to involve siblings in an open discussion on the topic of diabetes and to talk about it with the whole family. Explain to your children what diabetes is and how it affects their daily lives. It is very important to submit information for each child individually, depending on his age and stage of development. Try to involve other family members in caring for a child with diabetes.
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