The first signs you can't miss
Symptoms of type 1 diabetes in children are quite common, but they are often attributed to other causes. The child begins to drink much more than usual, including at night, and urinates just as often; in babies this is manifested by heavy diapers and the return of bedwetting. Despite a good and sometimes increased appetite, weight decreases. Fatigue, irritability, decreased performance, dry skin and mucous membranes occur, in girls - persistent itching in the genital area, in boys - inflammation of the foreskin. Sometimes the first noticeable sign is a wound that does not heal for a long time.
- Extreme thirst, especially at night
- Frequent excessive urination
- Losing weight with a good appetite
- Lethargy, irritability, decreased performance
- Dry skin and mucous membranes
- Return of bedwetting
- Persistent fungal inflammation
Why does type 1 diabetes develop?
The underlying cause is an autoimmune process: the immune system mistakenly attacks the beta cells of the pancreatic islets. Triggering factors are being studied; discuss the role of previous viral infections and the characteristics of immunity against the background of genetic predisposition. It is important to understand what is not on this list: type 1 diabetes does not arise from the fact that the child ate a lot of sweets, and is not a consequence of errors in upbringing or care. Having relatives with diabetes increases the risk, but most children develop the disease without a family history. Cell destruction occurs gradually, and symptoms appear when there are few working cells left.
- Autoimmune destruction of beta cells
- Genetic predisposition
- The role of past viral infections
- Combination with other autoimmune diseases
- Not associated with eating sweets
- Most often debuts in preschool and adolescence
Diagnostics
Confirming the diagnosis is simple and quick: just measure your blood glucose. A value of 11.1 mmol/l and above in the presence of typical complaints or 7.0 mmol/l and above on an empty stomach indicates diabetes. Additionally, glycated hemoglobin is determined, reflecting the average glucose level over 2–3 months, and urine is examined for glucose and ketones. To clarify the type of diabetes, C-peptide is used, which shows the residual production of its own insulin, and specific antibodies. If symptoms are severe, do not delay the examination: delay can lead to diabetic ketoacidosis, requiring treatment in a hospital.
- Blood glucose - the first and main analysis
- Glycated hemoglobin
- Glucose and ketones in urine
- C-peptide
- Antibodies to beta cells
- Thyroid function assessment and celiac disease screening
Treatment and daily monitoring
The basis of treatment is insulin replacement therapy, which imitates the natural production of the hormone: long-acting basal insulin plus short-acting insulin before meals, or pump delivery. The doctor selects doses individually and regularly reviews them as the child grows. Parents and the child themselves are taught how to count carbohydrates in bread units, measure glucose with a glucometer or continuous monitoring system, and the rules of behavior in special situations: during illness, physical activity, and travel. A strict diet is not required; nutrition is based on the usual principles of a healthy diet, taking into account carbohydrates.
- Insulin therapy according to an individual regimen
- Regular glucose testing or continuous monitoring
- Carbohydrate counting and meal planning
- Education for families and children at diabetes school
- Dose adjustment for stress and illness
- Regular visits to the endocrinologist and HbA1c monitoring
Hypoglycemia and living with diabetes
The most common acute problem in everyday life is hypoglycemia, a decrease in glucose below normal. It is manifested by trembling, sweating, pallor, hunger, headache, irritability; in young children - sudden lethargy or moodiness. At the first signs, the child is given fast carbohydrates: juice, glucose tablets, sugar, and then a snack with slow carbohydrates. In case of loss of consciousness and convulsions, call 103 and do not pour anything into the mouth. It is important for a child with diabetes to have fast carbohydrates with them, and for caregivers and teachers to know about the diagnosis and rules of assistance. Sports are not prohibited, but require planning.
- Recognize early signs of hypoglycemia
- Always have fast carbohydrates with you
- If you lose consciousness, call 103, do not give anything to drink
- Inform the school and coaches about the diagnosis
- Plan your meals and dose before sports
- Annual screening for complications as prescribed by a doctor
- Psychological support for family and child