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Awaiting moderation 2418 Article |
Diabetes mellitus in children DIABETES MELLITUS IN CHILDREN
Diabetes mellitus is a condition in which the body does not properly process carbohydrates (sugars and starches). In children, it occurs when the pancreas does not produce enough insulin. Sugars and starches are the body's main sources of energy. When the body cannot properly turn sugars and starches into energy, unusually high amounts of unused sugars are found in the blood and urine. The body then burns more fats for energy in place of sugars. The process of breaking down fats into energy produces an end product called ketones. Thus higher amounts of ketones are also found in the urine.
Diabetes can occur at any age. It appears in one in 2,500 children by the age of 15. The disease usually runs in families. The parents may or may not be diabetic. There may be other family members who are diabetic, or there may have been diabetes in the family in the past.
Signs and symptoms
The earliest signs of diabetes are increased hunger, increased thirst, and increased urination. The child will both urinate more often and produce greater amounts of urine. Other symptoms then appear, including weight loss, fatigue, and irritability. Most cases are detected by this stage. If diabetes is not detected and corrected, deep, rapid breathing followed by unconsciousness (diabetic coma) eventually develops.
If you notice any of these symptoms, see your doctor. An exact diagnosis can be made only through laboratory tests.
Home care
Do not try to treat a diabetic child on your own. Your doctor must diagnose diabetes and prescribe treatment. The doctor will tailor the treatment to your child's exact needs. Then you must carefully follow the doctor's instructions for caring for the child at home.
You and your child must learn as much as possible about diabetes. The doctor will give instructions for making necessary changes in the child's diet, giving insulin, and testing the urine. You will learn how to recognize and treat insulin shock (caused by too little sugar in the blood) and diabetic coma (caused by too much sugar in the blood).
Precautions
• Bedwetting that suddenly occurs regularly (after your child has been toilet-trained for some time) may be a sign of developing diabetes. Have the child's urine tested for diabetes (and urinary tract infection) if bedwetting continues.
• If there is diabetes in your family background, try to keep your children from becoming overweight. If a child already has an inherited tendency toward diabetes, being overweight increases the possibility of diabetes developing as the child grows older.
• Untreated and uncontrolled diabetes may lead to dehydration (a serious loss of body fluids) caused by increased urination. Complicating this situation is the fact that a decrease in urination is not a reliable sign of dehydration in a diabetic child.
Medical treatment
To properly diagnose diabetes, the doctor will order several laboratory tests. A urinalysis will test for extra sugar and ketones in the urine. A blood test can check for higher amounts of sugar in the blood. In a glucose tolerance test, the child drinks a known amount of glucose sugar; then the level of sugar in the blood is measured from time to time over several hours.
If diabetes is found, your doctor may hospitalize your child to regulate the diet and determine the amount of insulin the child will need to take. If the child is dehydrated or shows excess amounts of ketones, these conditions will also be treated in the hospital. Before discharging your child, your doctor will make certain that you and the child understand how insulin should be given and how the child's diet should be changed. Most diabetic children require insulin daily and are instructed - from as early as four years of age - to give themselves injections.
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