Children with Diabetes

However, it is becoming increasingly common for children and adolescents to also develop type 2 diabetes. As a rule, this form of diabetes only appears after the age of 40. Since children increasingly eat insufficiently and suffer from obesity and lack of exercise, type 2 diabetes is also becoming more common in young people. About 200 children between the ages of 12 and 19 are estimated to develop type 2 diabetes.

There are even rarer cases of diabetes in adolescence. These include MODY (Maturity-Onset Diabetes in the Young). There are currently no reliable estimates of the number of children and adults with the disease.

• Frequent and nocturnal urination up to and including enuresis.
• Intense feeling of thirst and the associated large amount to drink
• Weakness in performance and general tiredness
• Weight loss despite permanent ravenous appetite (underage diabetes type 1 patients are usually slim)
• Intense abdominal pain
• In advanced stages, exhaled air may have a typical acetone odour (similar to that of nail polish remover)

Symptoms develop more slowly in children with type 2 diabetes. Although they are similar to those of type 1, children with type 2 diabetes often suffer from severe obesity.

Both the causes and the risk factors depend on the type of diabetes.

Unlike type 1, type 2 diabetes develops over years. Over time, the body’s cells begin to react less and less sensitively to the hormone insulin. Eventually, a relative insulin deficiency occurs. The amount of insulin produced by the pancreas is still sufficient, but its effectiveness decreases. For this reason, the pancreas begins to produce more and more insulin. This leads to an overload of the organ and eventually to complete exhaustion. In many cases, an absolute insulin deficiency develops.

Concrete causes of type 2 diabetes are still unknown to scientists. However, there are a number of risk factors that favour insulin resistance. These include, for example, lack of exercise or an unhealthy diet. These risk factors apply equally to children and adults.

There are a lot of rumours and falsehoods about diabetes. Which are true and which are not? You can read about this and more here with us:

Not true. Only people with type 1 diabetes need to inject insulin. To keep blood sugar levels under control, it is usually enough for type 2 diabetics to pay attention to their diet and overall lifestyle. For them, insulin therapy is the last alternative.

This is not entirely true either. However, people who eat an excessive amount of chocolate, jelly babies or other sweets gain weight more easily. Being overweight is more likely to lead to type 2 diabetes, whereas eating sweets is not a risk factor for type 1 diabetes.

This used to be the case. Nowadays, however, diabetics are recommended to eat the same balanced diet as healthy people. This includes fruit and vegetables as well as carbohydrates, fibre, animal proteins and little sugar. For diabetics, however, it is important to pay attention to the amount of carbohydrates.

This is nonsense. Diabetics do not need special foods. These can even be counterproductive. Especially if they contain a lot of fat and thus calories. Moreover, these diabetic products are often completely overpriced.

If their blood sugar is well controlled, diabetics can very well consume sugar, although only in a very limited way. As an alternative, diabetics can use sweeteners such as aspartame, Stevia or acesulfame. They are all virtually calorie-free and do not affect blood sugar levels.

After the doctor has examined your child, a new appointment is usually made for the morning blood sample. It is especially important that your child comes to the blood test fasting, i.e., that he or she has not eaten anything eight hours beforehand. Otherwise, a reliable result of the fasting blood glucose value cannot be guaranteed. A single blood sugar measurement is not sufficient for a diagnosis. Repeated measurements ensure that measurement errors and fluctuations can be excluded. If all results are above 126 milligrams per decilitre of blood, diabetes mellitus is likely.

The long-term blood glucose value indicates the average blood glucose level over the last two to three months. If the blood glucose level is repeatedly too high or remains too high for a long time, “sugared” haemoglobin is formed. Circulating sugar molecules attach themselves to the red blood pigment. The exact proportion of total haemoglobin is determined in the laboratory and given as a percentage. Diabetes is very likely to be present if the value is more than 6.5 percent.

The oral glucose tolerance test or sugar load test checks how well or poorly the body can process sugar. The first step is to determine the fasting blood glucose level. Next, the patient must consume a specific sugar solution (75 grams of dissolved sugar). The blood sugar is then measured both after one and two hours. If the values exceed set limits, there are many indications that the patient has diabetes.

The OGTT is also usually only carried out in cases of doubt in minors. If diabetes type 2 is suspected, however, the test is part of routine diagnostics. To avoid mistakes, it is often carried out twice.

In order to make a definite diagnosis, doctors often also do a urine test for glucose. Under normal circumstances, the sugar that enters the primary urine is transported back into the bloodstream by certain cells in the kidney marrow. So, no sugar should be detectable in the blood of a healthy person. However, if the blood sugar level is too high, the kidney may no longer be able to reabsorb it. In this case, the sugar is excreted in the urine. This can be an indication of glucose intolerance or diabetes.

The body of a type 1 patient is dependent on the injection of insulin for life. The pancreas is no longer able to produce the hormone itself. Nowadays, insulin is usually administered as part of intensified insulin therapies or with the help of insulin pumps. This can be controlled particularly quickly and, above all, flexibly.

In training, type 1 diabetes children learn at what time the body needs which amount of insulin. This is essential, as otherwise life-threatening hypoglycaemia or hyperglycaemia can occur. The children are also taught how to use the insulin syringes correctly.

Therapy goals as well as the type of diabetes therapy are determined individually for each patient. An example of this is the HbA1c therapy. Here, values below 7.5 percent are usually preferred.

This therapy model involves injecting insulin once or twice a day. This is to balance the basic insulin requirement (baseline). Diabetes patients have to measure their blood sugar level before each meal and then inject themselves with normal or short-acting insulin (bolus). The required bolus amount depends on the time of day as well as the composition of the respective meal.

An individual therapy plan and therapy goals are set as for type 1 diabetes.

Regular physical activity, sport and a change in diet form the basis of the treatment. The diet should be rich in fibre and include plenty of fruit and vegetables. It reduces the risk factors for concomitant or secondary diseases, especially high blood pressure and cardiovascular diseases. It also helps diabetes patients to reduce their weight and lower their blood sugar.

Diabetes children receive tips and help, individual dietary advice and an exercise programme in diabetes training courses.

There are type 2 diabetes patients who can get their diabetes under control through more physical exercise, weight loss and a diabetes diet. However, the tendency to diabetes persists and therefore blood glucose levels need to be checked regularly.

The main goal is to achieve blood glucose levels that are as constant as possible in order to avoid secondary diseases. In principle, the younger the age of the patient, the higher the risk of secondary diseases later in life.

Acute complications can occur with varying frequency in both type 1 and type 2 diabetes. These are primarily hypoglycaemia and hyperglycaemia. Especially in type 1 diabetes, hyperglycaemia can lead to diabetic ketoacidosis in severe cases.

In type 1 diabetes children, the absolute lack of insulin means that sugar (glucose) can no longer be absorbed from the blood into the cells. The blood sugar continues to rise if the body is given no insulin at all or too little. In acute infections such as a urinary tract infection or pneumonia, such hyperglycaemia occurs in insulin-dependent diabetics. Even if the patient eats little, the body then needs more insulin than normal. As a result, the blood sugar rises excessively because the normal insulin dose is not sufficient.

There is a glucose deficiency in the cells and thus a lack of energy when there is excess glucose in the blood, because there is a disproportionate amount of glucose there. The brain, which depends on glucose for energy, needs a particularly large amount of energy. The body begins to break down more fat to compensate for the energy deficit. This produces ketone bodies, which leads to acidification of the blood, which is called diabetic ketoacidosis.

Very deep breathing, the fruity acetone smell of the exhaled air are typical symptoms. The body tries to reduce the high blood sugar level by excreting sugar together with a lot of fluid.