Children with diabetes: symptoms and therapy at a glanceType 1 diabetes often creeps up on children slowly. But there are clear symptoms that point to diabetes. Head physician Guido Laube explains what parents should look out for in their child.
Diabetes has many faces. Because it is a myth that only the old and overweight are affected by diabetes. The chronic disease also occurs in children. The body does not manage to transport the sugar from the blood into the cells. Left untreated, it leads to a life-threatening condition.
Children are almost exclusively affected by type 1 diabetes (see below). Only children are affected. Adolescents up to the age of 20. Year of life. This type of diabetes is an incurable autoimmune disease. The patient's own immune system destroys cells in the pancreas that produce the hormone insulin. Because the body cannot transport the sugar in the blood into the cells without insulin, blood sugar rises sharply.
Diabetes mellitus type 2: Affected persons are mostly older than 40. Your pancreas is still producing insulin, but the cells in the body are losing their sensitivity to the hormone and/or the secretion of insulin is disturbed. Therefore, the blood glucose level increases. The reason is often severe overweight. A reduction in weight usually already brings improvement. Otherwise, medication helps.
The most common causes of type 1 diabetes in children and adolescents are predisposition and autoimmunological processes, i.e. the presence of certain antibodies. Guido Laube, head physician in pediatrics and adolescent medicine, says: "It is not always clear which of these reasons applies and what really causes the disease."
If you eat a lot of sweets, you get diabetes – is that true??
It's not completely wrong, but it's not completely right either. Because: while the causes of type 1 diabetes cannot be influenced, in type 2 it is often obesity. Sugar itself does not cause diabetes, but it does promote excess weight on the ribs. That's why sweet-toothed children are only more at risk if they are overweight, eat an unhealthy diet and get too little exercise.
Signs are clear
The symptoms on the other hand are mostly clear. Laube speaks of the "three P's": polyuria, polydipsia and polyphagia. This means: extremely frequent urination, intense thirst and ravenous appetite. "Important: Just drinking a lot is not yet a clue. In summer you drink more – but you also sweat more. Therefore does not have to go to the toilet more often. Signs of diabetes are different: those affected feel an insane thirst, but also have to constantly dissolve water."
Symptoms in diabetes
In diabetes, the body cannot transport the ingested sugar into the cells. That is why sugar accumulates in the blood. To lower blood sugar, the body wants to dilute and eliminate sugar. The consequence: great thirst.
The organism does not lack fluids. But he demands water to get rid of the sugar. Except it doesn't work. This is why frequent urination is a symptom of diabetes. The urine is also transparent because it is very diluted due to frequent drinking.
The body cannot supply the cells sufficiently with sugar because of the lack of insulin. It therefore draws on the fat reserves, and those affected lose a lot of weight in a short time.
Fatigue and weakness
The body can no longer absorb the sugar in the blood. Therefore it lacks energy. Affected people are tired, flabby and weak.
Breath smelling of acetone
The acidic, acrid smell of acetone is reminiscent of nail polish remover. Acetone is formed in diabetics when the body breaks down fat reserves for energy production.
Type 1 diabetes therapy begins immediately
By means of a blood test, doctors examine the children for the corresponding symptoms. This requires several measurements of blood glucose to rule out natural fluctuations. If the suspicion is confirmed and the measurements show that the body cannot absorb enough blood sugar, therapy with insulin begins immediately. In most cases, the so-called basic bolus system is used. Laube explains: "With a basic dose of insulin, we lay down a carpet, so to speak. This also supplies the child at night. The bolus, on the other hand, covers the peaks in blood glucose, i.e. it is used during meals."This system is adapted to the child's eating behavior, not the other way around. The two Canadians Frederick Banting. Charles Best made a breakthrough in insulin research. It was known that the hormone of the pancreas plays a major role in diabetes. But no one had yet succeeded in isolating insulin. In 1921, the two experimented with the pancreases of dead dogs and unborn calves. In the same year, they succeeded in lowering the blood sugar level of an animal from which they had previously removed the pancreas. To do this, they injected him with insulin from another animal. From 1922, doctors successfully used the hormone to regulate blood glucose levels in diabetic patients. Initially, insulin was obtained from the pancreases of cattle and pigs. Since the 1980s, pharmaceutical companies have been producing the hormone with the help of genetically modified intestinal bacteria.
Learning to use the syringe
"As soon as the child's age allows, he or she learns to inject the right amount of insulin on his or her own."To do this, the patient must first learn to measure blood sugar: prick the finger with a kind of pen, put a drop of blood on a test strip, read the value from the test device and inject insulin accordingly. In order to learn this procedure, the child stays in the hospital with one of the parents for about two weeks after the diagnosis is made. During this time, patients and parents also receive support from the nutritional counseling service and nursing experts. Laube: "It is important that at the beginning the affected child itself and the parents, as well as any siblings, learn how to deal with the chronic disease diabetes type 1. Although diabetes entails only a few limitations, it requires lifelong therapy."
"It is important that the affected child and the parents, as well as any siblings, learn how to deal with the chronic disease of type 1 diabetes."
Laube stresses that it is important to teach children how to prick and inject the syringe. "The children need to get an understanding of their disease. This often also makes it easier for them to cope."Later, an insulin pump can also be used for therapy. This involves using a patch to fix a fine needle in the skin. A connected device, about the size of a smartphone, uses them to automatically measure blood glucose levels and trigger insulin delivery when necessary.
Type 1 diabetes in children and adolescents
If your child shows the above symptoms? Or would you like to have another condition clarified by the pediatricians? In the pediatric consultation, specialists take care of preventive examinations, vaccinations, emergencies, but also make clarifications and give second opinions.
Text: Tamara Tiefenauer – Reviewed by: Prof. Dr. med. Guido Laube, Head Physician Pediatrics and Adolescent Medicine, spez.