Don't be afraid of life: about type 1 diabetes in children

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November 11, 2021

Author of the article: Morozova Ekaterina Vyacheslavovna

Pediatrician, Candidate of Medical Sciences, member of the Union of Pediatricians of Russia

Experience: 15 years

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Every disease has its own root cause. Moreover, it can be either congenital or acquired. One of the most important controllable variables in the life of the body is the level of glucose in the blood or glycemia. This is the most important source of energy, which ensures the normal functioning of all organs and tissues. Deviation from the norm can become a provoking factor in the development of various diseases. Therefore, it is extremely important to control blood sugar in children and adults.

What values ​​are considered normal?

There is a certain norm for blood sugar in children. But this indicator is determined by the age of the child.

Glucose levels depend on many factors, including:

• nutrition;
• work of the digestive tract;
• the influence of various hormones (thyroid, adrenal glands, glucagon, insulin, etc.).

To understand whether children's blood sugar levels are normal, you should compare test results with the required indicators. Below is a table with the normal blood sugar levels in children depending on age (indicators are measured in mmol/l.).

Based on this table, the normal blood sugar level in children is determined.

Types of diabetes

• Type 1 – insulin dependent.
• Type 2 – insulin-independent.

The first type is most common in children. The disease is characterized by very low levels of insulin; the child requires constant monitoring.

In type 1 diabetes, the body does not produce enough insulin; it is necessary to constantly monitor its level and administer additional insulin if necessary. The cause is unknown and the disease cannot be prevented. Symptoms include thirst, constant hunger, excessive urination, fatigue, decreased visual acuity, and weight loss. Symptoms may occur suddenly.

Type 2 diabetes was previously observed only in adults, but is now appearing in children as well. The pathology is a consequence of ineffective absorption of insulin by the body. Develops against a background of physical inactivity and excess weight. Symptoms are less pronounced than with type 1. Source: A.B. Resnenko Type 2 diabetes mellitus in children and adolescents: from pathogenesis to treatment // Pediatric pharmacology, 2011, vol. 8, no. 4, pp. 125-129

Comparison table of LED types

Causes of sugar level deviations

The reasons influence whether a child’s blood sugar will be high or low. Moreover, they can be very different. But to understand all this, you should study in more detail what high and low blood sugar in a child is.

Low blood sugar in a child

If children's blood sugar levels drop below normal levels, then hypoglycemia is diagnosed. This is dangerous because with such a diagnosis, frequent feelings of hunger, trembling, sweating, weakness, confusion, and slow speech may occur. Convulsions often occur. Indicated for insufficient blood sugar in children and loss of consciousness.

The cause of low blood sugar in a child may be:

• insufficient water consumption;
• prolonged fasting;
• insulinoma;
• severe chronic diseases;
• CNS diseases;
• diseases associated with the digestive tract (including gastritis, pancreatitis, etc.);
• sarcoidosis;
• arsenic or chloroform poisoning.

All this affects the reduction of blood sugar levels in children.

High blood sugar in a child

If, when compared with the table of blood sugar norms in children, it is found that the test results are higher than the established values, this means that the glucose level is elevated. This leads, first of all, to the conclusion that the child may develop or already has diabetes mellitus.

High blood sugar in a child may be due to:

• the presence of diseases of the thyroid gland, pituitary gland or adrenal glands;
• pancreatic tumors;
• overweight (obesity);
• long-term use of anti-inflammatory non-steroidal drugs, as well as glucocorticoids.

An incorrect test can show elevated blood sugar levels in children. These are the cases when blood is donated when the child is excited, tense or has had a heavy meal.

When should you see a doctor?

Blood sugar in children should be regularly monitored, because minor deviations from the norm do not always appear externally. Identifying many diseases in the early stages allows you to prevent consequences and prevent the disease from developing. Therefore, once a year or more often, parents should take their child for a blood draw. This is how you can control blood sugar levels in children.

You should definitely contact a specialist if you notice that the child is often weak, he begins to speak more slowly, and is confused in his thoughts. You should immediately visit a doctor if your baby has seizures or loses consciousness. A pediatrician can determine the normal blood sugar level in children. And if deviations occur, then the specialist issues a referral to an endocrinologist. You can contact JSC "Medicine" (clinic of Academician Roitberg), located in the central district of Moscow. Specialists will promptly carry out diagnostic measures and prescribe the necessary treatment.

Diagnostics

To determine the normal blood sugar level in children, you need to take a routine finger prick test. If the results are elevated, then the child will be given a repeat blood draw, which will help accurately determine the glucose level.

Consequences

If, according to the table, the blood sugar level in children is low, this can lead to the development of hypoglycemic coma, which is deadly. Elevated glucose levels are the first sign of the presence or gradual development of diabetes mellitus.

Could the results be unreliable?

The risk that test results are unreliable always exists. This can be influenced by the child’s physical condition at the time of blood collection (activity, agitation, etc.), as well as the fact that the baby ate before donating blood. To exclude any errors, the doctor always prescribes a repeat test.

What is the prognosis for treatment?

With proper and well-chosen treatment, the prognosis is favorable.
There are different types of insulin. Many children use insulin pump therapy. But it is important to know that much here depends not on the treatment, but on how the child and his parents perceive the diagnosis and how they treat it. They will have to learn a lot. The first thing is to streamline your diet

and lifestyle. Please note that the diet does not change completely, it just becomes correct. And this is not just eating chips, chocolates and sandwiches.

Secondly, in childhood diabetes mellitus, blood glucose control

. Children do this often: optimally 6–8 times a day. There are now many different means to control blood glucose. First of all, these are glucometers, when for each measurement of glucose in the blood the child needs to prick his finger. But now there are systems where a sensor is placed in children for two weeks (for example, in the shoulder area). And with a special device (scanner) you can determine blood glucose every minute by bringing this scanner to the sensor. And then you don’t need to prick your fingers 6–8 times a day.

Is a full life possible, and why will you have to give up forever? And our children live full lives

. Participate in various competitions and competitions. I would say, on the contrary, they are smarter and more capable than children without diabetes. Probably because they had to grow up earlier. Learn to lead a healthy lifestyle, eat right, and maintain a proper daily routine. They count bread units (this is the amount of carbohydrates) in order to correctly inject themselves with the required dose of insulin.

However, children with diabetes and their parents should be aware that they will be faced with the difficult question of choosing a profession. The fact is that some professions are contraindicated for diabetes:

• with heavy physical activity (miners);
• with significant neuropsychological stress (air traffic controllers, transport drivers);
• with irregular working hours, at night, with an unfavorable microclimate, with contact with toxic substances (chemical production).

How to make an appointment with an endocrinologist

If you are looking for a highly qualified endocrinologist in the center of Moscow, then you can contact JSC “Medicine” (clinic of academician Roitberg). Specialists will prescribe all the necessary tests, conduct an examination and make a diagnosis.

Doctors select an individual treatment method, which increases the effectiveness of actions.

Our multidisciplinary medical center is located in the Central Administrative District at the address: Moscow, 2nd Tverskoy-Yamskoy lane, building 10 (Mayakovskaya metro station).

You can make an appointment with specialists using a special form on the website or by calling +7.

Where does the disease come from in children?

Each type of diabetes has its own causes. There are risk factors that provoke the disease:

• mother or both parents are diabetic;
• viruses;
• high birth weight (more than 4.5 kg);
• obesity;
• presence of diathesis;
• frequent colds;
• weakened immune system;
• metabolic disease.

Many people are concerned about whether the disease is transmittable. The main cause of type 1 diabetes in children is heredity. This is confirmed by the large number of family cases when the disease occurs in a child in the presence of pathology in parents, grandparents.

The autoimmune process is initiated by an external factor – viruses. Chronic insulitis and insulin deficiency are caused by exposure to the ECHO virus, Coxsackie B virus, herpes, rubella, and Epstein-Barr. The disease can be caused by enterovirus, rotavirus, measles and others. Source: P.F. Litvitsky, L.D. Maltseva Disorders of carbohydrate metabolism in children: diabetes mellitus // Issues of modern pediatrics, 2021, v. 16, no. 6, p. 468-480

In children with a genetic predisposition, the disease can be triggered by intoxication, artificial feeding, monotonous carbohydrate diet, as well as stress and previous operations.

Type 2 diabetes in children develops due to dysfunction of the pancreas - when b-cells do not produce or secrete insulin. As a result, the sensitivity of the receptors decreases.

Disease prevention

No specific prevention has been developed for children with diabetes. For people at risk, it is important to maintain a normal weight, ensure daily physical activity, improve immunity, and be examined by an endocrinologist twice a year.

Timely vaccination helps prevent the development of diseases that are caused by diabetes: measles, mumps.

It is necessary to ensure that the child drinks sufficient amounts of liquid - at least 2 liters, in addition to tea and juices.

It is necessary to protect the child from stress; if there is excessive anxiety, it is better to consult a specialist.

What do deviations from the norm mean?

To understand why the baby’s sugar concentration increases or decreases, you need to understand how it is regulated in the body. First of all, glucose serves as a universal material for saturating every tissue and organ with life-giving energy. In addition, any incoming so-called difficult carbohydrates, under the influence of certain enzymes, are converted into ordinary sugar, which quite quickly enters the blood and is delivered to the liver.

Elevated sugar is dangerous for a child’s body, as it can quickly develop into diabetes. Or sharply worsen the condition of a small diabetic with transition to a more complex form, including insulin-dependent, or even coma.

A predisposition to high sugar can be caused by a lack of vitamin D, early introduction of cow's milk into the diet, drinking water contaminated with nitrates, and viral infections (rubella, Coxsackie, for example). Diet will help normalize sugar. Strict adherence to a low-carbohydrate diet - without fatty, fried, sweet / flour - and physical activity are a good way to combat elevated levels.

If you notice a sharp increase in urine in a child, acute, frequent thirst, fatigue, abnormal appetite - this is a signal to go to the doctor and get tested. Especially if there are diabetics in the family line.

Treatment of the disease

When a diagnosis is made, the doctor, in accordance with clinical recommendations, prescribes observation and examination of the child every month. Monitoring the condition allows you to make adjustments to therapy, prevent exacerbations and prevent the pathology from becoming severe.

Treatment of diabetes in children includes medications, special exercise and diet. Source: I.I. Dedov, V.A. Peterkova, T.L. Kuraeva Russian consensus on the treatment of diabetes mellitus in children and adolescents // Pediatrics, 2010, v. 89, no. 5, pp. 6-14

• Proper nutrition. The specialist develops a balanced diet in terms of calories and nutritional supplements. A complex of vitamins is required. The diet should limit the consumption of baked goods and potato dishes. Unsweetened fruits and vegetables can be eaten in any quantity. The child needs to be provided with 6 fractional meals a day.
• Exercise helps lower glucose levels and improve insulin sensitivity. The load must be accurately dosed and selected by the attending physician. During and after exercise, you need to take carbohydrates.
• Medicines. Children are prescribed medications with insulin. In most cases, a single dose every day is sufficient. The doctor selects the dose and administration schedule. In addition to the main treatment or for mild diabetes mellitus in children, tablets are indicated.

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Diagnosis of diabetes mellitus

The first person to identify symptoms of the disease is the pediatrician who observes the child. The doctor pays attention to the classic signs: increased urination, feelings of thirst, hunger and weight loss.

During the examination, the doctor may notice diabetic blush, decreased skin turgor and a crimson tongue. If symptoms of diabetes are detected, the pediatrician transfers the patient to an endocrinologist for treatment and observation.

To make an accurate diagnosis, the child is sent for laboratory testing. It is necessary to take a blood test to check your sugar level; daily monitoring is used. They also check insulin, proinsulin, glucose tolerance, level of glycosylated hemoglobin, blood CBS.

Blood test results table

The urine is tested for glucose and ketone bodies. The criteria for identifying the disease are: glycosuria, hyperglycemia, acetonuria, ketonuria.

As part of the preclinical detection of type 1 pathology in genetically predisposed children, Abs to glutamate decaboxylase and β-cells are determined. The structure of the gland is assessed using ultrasound.

Based on the patient’s complaints, urine and blood test results, and research results, the doctor makes a diagnosis.