What to do if your child has diabetes

In the first, the cells responsible for insulin are destroyed. Why this happens, no one knows. But when insulin is not produced, glucose remains in the blood, and cells starve, and this leads to dire consequences.
In type 2 diabetes, insulin is produced, but the cells do not respond to it. It is a disease that is affected by a combination of genetics and risk factors.

Typically, children have type 1 diabetes, a disease that is independent of lifestyle. But now type 2 diabetes, which used to be considered a disease of the elderly, has made its way to children's wards. This has been linked to the obesity epidemic in developed countries.

Renata Petrosyan family doctor, endocrinologist, chief physician of the Chaika clinic in Krylatskoye, Moscow

Type 1 diabetes mellitus is one of the most common chronic diseases in children in the world. It manifests itself most often between the ages of four to six and from 10 to 14 years. In children under 19 years of age, it accounts for two-thirds of all diabetes cases. Girls and boys get sick equally often.

About 40% of childhood type 2 diabetes mellitus develops between 10 and 14 years of age, and the remaining 60% between 15 and 19 years.

In Russia, about 20% of children are overweight, another 15% are obese. There have been no major studies on this topic. However, more and more often children with serious obesity come to doctors.

How to understand if a child has diabetes

Type 1 diabetes cannot be prevented or even predicted. The risks are higher if this is a hereditary disease, that is, someone from the family is sick, but this is not necessary: diabetes can manifest itself even if everyone in the family is healthy.

Diabetes mellitus type 1 is often missed in the early stages, especially in young children, because no one even thinks about this disease and the symptoms of hyperglycemia are difficult to see in babies. Therefore, for some conditions in young children, such as recurring fungal infections, it is imperative to check blood sugar or urine sugar.

Renata Petrosyan

Typical symptoms of diabetes:

Frequent urination. The kidneys try to remove excess sugar in this way and work harder. Sometimes this manifests itself in the fact that the child began to wet the bed at night, even if he has been sleeping for a long time without a diaper.
Constant thirst. Due to the fact that the body is losing a lot of fluid, the child is thirsty all the time.
Itchy skin.
Weight loss with normal appetite. Cells lack nutrition, so the body uses up fat stores and breaks down muscles to get energy from them.
Weakness. Due to the fact that glucose does not enter the cells, the child does not have enough strength.

But these symptoms do not always help to notice the disease in a small child in time. Children often drink without any illnesses, and the "drink and pee" sequence is the norm for babies. Therefore, children often first see a doctor with dangerous symptoms of ketoacidosis.

Ketoacidosis is a condition that occurs with the intense breakdown of fats. Glucose does not enter the cells, so the body tries to get energy from fat. This produces a by-product - ketones. When they accumulate in the blood, they change its acidity and cause poisoning. External signs are as follows:

Great thirst and dry mouth.
Dry skin.
Stomach ache.
Nausea and vomiting.
Unpleasant, pungent odor from the mouth.
Labored breathing.
Confused consciousness, disorientation, loss of consciousness.

Ketoacidosis is dangerous and can lead to coma, so the patient urgently needs medical attention.

Type 2 diabetes usually occurs against the background of severe obesity and can hide for a long time. It is often found when looking for the cause of other diseases: kidney failure, heart attacks and strokes, blindness.

Weight gain and decreased physical activity are most influencing the development of type 2 diabetes in children. The association between obesity and diabetes is higher among adolescents than among adults. The hereditary factor also plays a huge role. Between half and three quarters of children with type 2 diabetes have close relatives with the condition. Certain medications can also interfere with the body's sensitivity to glucose.

Renata Petrosyan

As a rule, adults who have lived with diabetes for a long time and have poor control over their condition suffer from the consequences.

How to treat diabetes and can it be prevented

Diabetes cannot be cured, it is a disease with which you will have to spend your whole life.

The first type of disease cannot be prevented, patients will have to take insulin, which is not enough in their body. Insulin is given by injection, and this is one of the main difficulties in treating children. Daily injections are a difficult test for a child at any age, but they cannot be avoided.

Patients with diabetes need to constantly measure their blood sugar level with a glucometer and inject the hormone according to a certain scheme. For this, there are syringes with fine needles and pen syringes: the latter are easier to use. But children are more comfortable using an insulin pump - a small device that delivers hormone through a catheter when needed.

For most patients, the first few months of illness are associated with an emotional storm. And this time must be used to get as much information as possible about the disease, about self-control, medical support, so that injections become just a part of your everyday life.

Despite the many risks associated with type 1 diabetes, most people can continue to be active and eat their normal meals. When planning physical activity and holidays, most children can play almost any sport and sometimes eat ice cream and other sweets.

Renata Petrosyan

Type 2 diabetes is not always preventable, but it is certainly possible to reduce the risks by leading a healthy lifestyle. However, according to Renata Petrosyan, the hobby for fitness and proper nutrition still affects more adults than children: “A busy school program leads to a complete lack of free time for children. They are busy in various circles and often spend a lot of time in a sedentary state. Gadgets also don't push teenagers to move. The availability of sweets, fast carbohydrates, chips, sweets, croutons and more is a significant contributor to childhood obesity.”

The endocrinologist recommends protecting children from excess food and in every possible way to stimulate any mobility. This is better than following a low-carb diet, drinking special medications and adhering to a regimen, as is necessary for type 2 diabetes.

What to do for parents if their child has diabetes

Diabetes is a serious diagnosis, and it is shocking at first. In life with type 1 diabetes, which cannot be corrected by diet and pills, there will always be strict discipline: you need to check your sugar level on time, count carbohydrates and inject insulin. This is especially difficult given that even the smallest children can develop type 1 diabetes. But with diabetes, you can live a full life and teach it to your child. How to do this, Lifehacker asked Maria Korchevskaya, the mother of a child with type 1 diabetes.

Usually, parents find out the child's diagnosis in the hospital, where at first they undergo diabetes therapy and school. Unfortunately, hospital recommendations are often at odds with reality, and after discharge, relatives do not know what to grab onto in the first place. Maria advises this to-do-list:

Even at the hospital, order a glucose monitoring system to meet the discharge fully armed. After detecting diabetes, it is very important to learn how to monitor the child's condition; without a monitoring system, it is much more difficult for both children and parents.
Buy an injection port. While the monitoring system can help replace continuous fingersticks, the injection port can help you deliver fewer shots when insulin needs to be injected. Children do not tolerate the very fact of the injection, and the fewer needles, the better.
Buy a kitchen scale. This is a must-have, you can even purchase a model with built-in protein, fat and carbohydrate counting.
Buy a sweetener. Many children find it very difficult to give up sweets. And sweets, especially at first, will be banned. Then you will learn to control the disease in such a way that you can afford them, but that later.
Choose a product to use to increase your low sugar. For example, it can be juice or marmalade. The child should always have it with him.
Get mobile apps for calculating carbohydrates in food.
Keep a diary. Notebooks for writing foreign words with three columns per page are best suited: time and sugar, food, insulin dose.
Don't get carried away with alternative and alternative medicine. Everyone wants to help the child and is ready to do anything, but healers, homeopaths and magicians will not save people with diabetes. Don't waste your energy and money on them.

What are the benefits for a child with diabetes?

By default, diabetic children are provided with everything they need: test strips for a glucometer, insulin, needles for syringe pens, consumables for a pump. The situation changes from region to region, but in general there are no interruptions in the supply of medicines. Families have to buy test strips, but affordable glucose monitoring technologies have appeared, and Maria Korchevskaya recommends them.

Glucose monitors are available and are often more cost-effective than buying strips and routinely taking finger samples from children. The systems send data every five minutes to the smartphones of the child and parents and to the cloud, showing the blood sugar level in real time.

Maria Korchevskaya

You can register a disability - this is a legal status that has nothing to do with medical supplies. Rather, it gives additional privileges and benefits: social benefits, vouchers, tickets.

There is a paradoxical situation with disabilities: everyone knows that diabetes is incurable, but the child must confirm the status of a disabled person every year and undergo a medical examination. To do this, you need to go to the hospital and collect a bundle of documents, even if the diabetes is compensated and the child feels fine. In some cases, the disability is removed, you have to fight for it.

A child with diabetes can attend kindergarten, but this involves many difficulties. It is difficult to imagine that a child in kindergarten will be given injections by teachers or that a three-year-old will calculate the dose of the hormone that he needs to take.

It's another matter if the child has correctly programmed devices that are designed for diabetics. Technical devices provide a different quality of life.

Maria Korchevskaya

If the child has a sugar monitoring device and a programmed pump, then he just needs to press a few buttons. Then additional infrastructure and specialized institutions are not needed. Therefore, all efforts must be devoted to technical equipment.

How to find out more

Unfortunately, there are not many resources in Russian that would explain how it is easier and more convenient to live with diabetes. But there is a lot of information on the Web about this disease: