Diabetes mellitus in a child: how to recognize it?

Diabetes in children is a disease that can be called a new epidemic that is prevalent not only in Poland, but also in the world. Worryingly, the number of new cases of diabetes is constantly increasing. In order for it not to cause great damage to the body, it is necessary to detect it early and treat it properly. In order to be able to diagnose diabetes in a child, it must be emphasized that there are different types of diabetes, the symptoms and course of which are different.

Types of diabetes in a child

Insulin-dependent diabetes mellitus

Type 1 diabetes, or insulin-dependent diabetes (formerly called juvenile diabetes) is a disease in which the body's autoimmune processes cause the cells of the pancreas to (Beta cells) they stop producing insulin. This type of diabetes is most common in children.

In type 1 diabetes, the pancreas does not produce any insulintherefore it must be fed from the outside. This prevents sugar (glucose) from being absorbed into the cells and circulating in the blood.

A high blood sugar in a child, which persists for a long time, is very dangerous and can lead to many serious complications. That is why it is so important to recognize your child's diabetes as soon as possible.

Non-insulin dependent diabetes mellitus

Type 2 diabetes, i.e. non-insulin-dependent diabetes, formerly referred to as diabetes mellitus of adulthood (today, unfortunately, more and more often due to the obesity epidemic at a young age), is a metabolic disease.

In this type of diabetes, insulin is produced by the pancreasbut cells are resistant to it. Obesity or overweight, poor diet and lack of exercise are the main risk factors for this disease, also at a young age. The first symptoms of type 2 diabetes in a child are not as severe as in type 1 diabetes. It is the only preventable form of diabetes in children.

Unfortunately, the times in which we live, i.e. the COVID epidemic and the related remote education, quarantine, isolation, lack of access to sports facilities, have started to result in the fact that type 2 diabetes - although not only it - is more and more common in younger and younger children .

Diabetes mellitus of the MODY type

In addition to typical type 1 and type 2 diabetes, there are also other, lesser-known types of diabetes. They include, among others MODY diabetes. It is caused by a single gene mutation that damages insulin-producing beta cells.

What are the the first symptoms of diabetes in a child?

Diabetes usually doesn't develop insidiously. When blood sugar levels rise quickly, the body begins to defend itself against it and sends out a series of disturbing symptoms. However, you have to pay attention to the fact that this the symptoms of type 1 diabetes in children develop rapidly and rapidly, even within a few weeks. Whereas the symptoms of type 2 diabetes are not very specific and may even take years to develop.

Unfortunately, there is no way to protect yourself from type 1 diabetes. However, the development of type 2 diabetes in a child can be prevented by adequate nutrition and regular exercise. What symptoms should worry you? What you should pay attention to so as not to miss the first symptoms of diabetes at your child?

The first symptoms of diabetes:

Increased thirst and frequent urination

If you notice that your child drinks or drinks more fluids than before (even those that he did not like before), and also often gets up at night, the red light should be on. Of course, if this happens once or twice and increased thirst is justified (eg it is hot and each of us then feels an increased thirst) then there is no reason to panic right away.

However, if you have noticed a change that has been going on for some time and is not justified in any way, and even bothersome for your child, make sure that it is not accompanied by other symptoms of diabetes in children listed below.

Losing weight despite normal appetite

Your baby suddenly, for no apparent reason, he loses kilos and drinks a lot at the same time? Besides, he often gets up to use the toilet at night? This could be one of the first symptoms of his newly developing type 1 diabetes.

Tiredness

Your child, suddenly from an energetic and full life, becomes constantly sleepy, tired and unable to do anything? Fun, pleasures that previously made him happy, do not enjoy him anymore? It can also be one of the symptoms of diabetes. Insulin is the hormone that carries glucose into the bloodstream and provides energy to the entire body. In the case of diabetes mellitus and the lack of insulin, the whole process is disturbed. The fatigue that occurs within 1-2 hours after eating a meal with plenty of carbohydrates is also worrying. This could be a sign that your baby has elevated blood sugar (glucose) levels after a meal.

Somnolence

Is your child falling asleep more and more during the day? Maybe he also falls asleep in situations where it was previously unthinkable? It is also one of the many symptoms of diabetes.

Dehydration

You can recognize them by the fact that your child has dry, chapped lips (of course excluding this with weather changes, because in cold, frosty or windy weather the lips can often be chapped and this is not a symptom of diabetes). Similarly, if the corners of the mouth are beginning to form, which were not there before, this, in combination with other symptoms, may indicate to the high sugar (glucose) in your baby's blood.

Learning difficulties, distraction, lack of concentration or irritability

Problems at school, kindergarten. In older children, illogical answers to questions such as: the teacher, rude behavior or aggression towards teachers, peers or difficulties in establishing relationships with peers can be noticed.

Other symptoms:

• unpleasant, "strange" sweet acetone odor from the mouth;
• cramps in the legs;
• recurrent infections, infections, inflammation of the external urogenital organs, diaper dermatitis in young children;
• decreased visual acuity.

The development of diabetes and ketoacidosis

If a child lacks insulin for a long time, and the parents do not notice or ignore the symptoms described above for a long time, then ketoacidosis, a life-threatening condition, develops.

Symptoms of acidosis include:

• increasing weakness and drowsiness;
• abdominal pain;
• nausea, vomiting;
• rapid, deepened breathing;
• disturbances of consciousness;
• coma.

Diabetes type and symptoms

The first symptoms of type 1 diabetes in a child may appear when the child is weakened. For example, they can occur soon after a recent flu, strep throat or cold.

Symptoms of type 2 diabetes They are different. They are often much more difficult to notice or may not be present at all. Type 2 diabetes occurs mainly in overweight and obese children.

The most common symptoms of type 2 diabetes include:

• hard to heal wounds, itchy skin;
• frequent recurring infections and infections;
• drowsiness, fatigue or, on the contrary, irritability.

In addition to elevated blood sugar levels in a child, sugar drops and associated hunger attacks may also appear, caused by insulin resistance and subsequent insulin surge.

Pay attention to what your child says and whenever his behavior changes, don't underestimate the symptoms. Often you just feel that something is wrong, so don't delay your visit to the doctor.

How can I check if my child has diabetes?

Blood sugar standards:

• Normal blood sugar (glucose) in a child should be in the range of 70-99 mg / dl.
• Sugar above 99 mg / dL means only elevated sugar (glucose) in a child.
• If the sugar (glucose) measured at any time of the day, regardless of the time of the meal, exceeds or is equal to 200 mg / dL and the symptoms of diabetes mentioned above are present, then diabetes is diagnosed.
• If the fasting blood sugar (glucose) is double greater than or equal to 126 mg / dl (regardless of the time of the last meal, exercise or time of day), diabetes is also diagnosed.

Diabetes diagnosis

Glucose load test (OGTT)

A diagnosis of diabetes mellitus, where appropriate, is also performed oral glucose load test (OGTT). If the sugar (glucose), after 2 hours of the oral OGTT test, exceeds or is equal to 200 mg / dl, diabetes is also diagnosed. OGGT is not performed if diabetes can be diagnosed sooner. And this is when it occurs elevated blood sugar in the child in the test performed on an empty stomach (twice) or at any time of the day.

Suspecting type 1 diabetes mellitus, the OGTT test is rarely performed in children, as in most cases the symptoms are violent and severe. And such an additional supply of sugar during the test could only do more harm than good. If it is difficult to diagnose diabetes, OGTT can be performed several times (once a year) until the diagnosis is made (in children with type 2 diabetes, or those who are overweight or obese).

Determination of diabetes markers

It may also be useful in diagnosing diabetes determination of diabetes markers, that is:

• anti-exsudative autoantibodies against glutamic acid decarboxylase,
• antibodies to tyrosine phosphotase,
• anti-insulin autoantibodies
• and / or percentage of glycosylated hemoglobin (HbA1c).

However, routine HbA1c testing is not recommended in the diagnosis of diabetes. To recognize diabetes in a child, Measurement of fasting insulin or C-peptide levels may be helpful. In type 2 diabetes, these results will be normal or increased, and in type 1 diabetes, it will be decreased.

Genetic research

To diagnose monogenic diabetes, including the aforementioned MODY diabetes, are necessary genetic research.

Stay alert 

To early recognize diabetes you need to be extremely vigilant and notice any disturbing changes in behavior in time child. Parents of children who know the problem of diabetes (because, for example, the disease has been in the family), it is much easier to recognize the first symptoms of diabetes in a child.

Type 2 diabetes may be more difficult, but it can be prevented sooner.

Pay attention to:

• that's how nourishes himself Your child;
• whether there is no bad eating habits;
• or his body weight is correct.

It is also very important regular physical activity. Idle staring at a computer or smartphone screen, combined with a poor diet, can largely contribute to overweight or obesity, and then to the development of diabetes later in life