Diabetes In Children

When we talk about diabetes, we are talking about a metabolic disease in which the pancreas produces too little insulin or none at all. Diabetes is also known colloquially as diabetes. In Germany, there are currently 7 million people with diabetes. The most common form of diabetes in infants, children and adolescents is type 1 diabetes, with around 30,000 to 32,000 minors currently suffering from the disease. Approximately 2,300 new cases are diagnosed each year.

People with type 1 diabetes must supply their bodies with the blood sugar-inhibiting hormone insulin for the rest of their lives. More and more frequently, children and adolescents are also diagnosed with type 2 diabetes. Otherwise, this often only appears after the age of 40. Nowadays, many children and adolescents have a typical risk profile. This includes lack of exercise, being overweight, and a diet high in fat and sugar. It is estimated that 200 children between the ages of 12 and 19 develop type 2 diabetes each year.

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In children with type 1 diabetes, the first symptoms often appear only when more than 80% of the insulin-producing beta cells of the pancreas have already been destroyed. Before this happens, the remaining insulin is sufficient to prevent a complete derailment of the sugar metabolism. However, within a few weeks, the symptoms of type 1 diabetes in children may develop and become apparent. Symptoms and complaints include Large amounts of urine, wetting, or urinating at night. Extreme feelings of thirst and drinking several liters per dayWeakness and lassitudeWeight loss although there is constant craving. Children with type 1 diabetes are usually very slim or even underweight. Severe abdominal pain and advanced stage, a typical acetone odor (nail polish remover) develop when exhaling. Type 2 diabetes, which occurs much less frequently in children and adolescents, develops very slowly. The symptoms and complaints are similar to those of type 1 diabetes, but these children are usually very significantly overweight.

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Cause And Risk Factors

In children and adults, the causes depend on the form of diabetes.

Diabetes Type 1

This is an autoimmune disease. Antibodies attack the insulin-producing beta cells in the pancreas and destroy them. As a result, the body is no longer able to produce insulin. Various such antibodies are now known to occur in type 1 diabetes. These include, for example, autoantibodies that are against cytoplasmic islet cell components (ICA) and against insulin (IAA). It is not yet clear why the immune system acts against its own tissue. Genetic factors seem to play a role, since type 1 diabetes sometimes occurs in several family members. Researchers have now identified several gene mutations that appear to be associated with type 1 diabetes.Other factors are also suspected of being involved in the development of the autoimmune form of diabetes. These include infections such as mumps, measles and rubella.

Type 2 Diabetes

This form of diabetes develops over years, with the body’s cells becoming increasingly insensitive to the blood sugar-lowering hormone insulin. This insulin resistance thus leads to a relative insulin deficiency: initially, sufficient insulin is still produced by the patient’s body, but its effectiveness is not delivered to the cells. To compensate, the pancreas increases insulin production. After some time, however, it is exhausted due to overload and insulin production decreases. The exact causes of type 2 diabetes are still unknown. However, in both children and adults, an unhealthy lifestyle such as lack of exercise and obesity can promote insulin resistance. Genetic factors can also play a role in the development of the disease.

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Examination And Diagnosis

If you suspect diabetes in children, the right person to contact is a pediatrician or a specialist in internal medicine and endocrinology. During the initial consultation, you may be asked the following questions:

  • Has your child often been noticeably tired lately?
  • Does he or she wet at night or have to urinate frequently?
  • Does he drink more or complain of thirst often?
  • Does it complain of abdominal pain ?
  • Have they noticed a breath odor similar to nail polish?
  • Does another family member have diabetes?

Physical Examination And Fasting Blood Glucose

The doctor will then examine your child and schedule another appointment with you for a morning blood draw. For this blood sample, your child must be fasting, which means that he or she must not have eaten anything or had any sugary drinks for 8 hours before the blood sample is taken. This is the only way to reliably determine the fasting blood glucose value. In order to exclude measurement errors and fluctuations, one blood glucose test is not sufficient. At least 2 measurements are necessary to be able to give the diagnosis of diabetes in children.

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Antibody Screening Test

An antibody search test brings clarity if diabetes type 1 cannot be clearly determined in children. In this test, your child’s blood is examined for antibodies that are typical for type 1 diabetes. In diabetes type 2, these autoantibodies cannot be detected.
An antibody screening test can give a very early diagnosis of type 1 diabetes. The autoantibodies can be found in the blood years before the onset of the disease.

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