Diabetes Mellitus Management in Children
Diabetes Mellitus is a chronic illness, so it has no treatment. However, the good news is, you can manage it perfectly to the extent you can live your life normally. Additionally, you can maintain the stage where you diagnosed. More importantly, you can avoid it upon following certain precautions.
Now, let’s go through diabetes mellitus management in children’s ways.
The first step to reaching how to manage your Diabetes Mellitus is to understand the relationship between Insulin and Diabetes.
Insulin is a hormone secreted by the pancreas from the islets of Langerhans, which is an especially pancreatic cell that is also called beta cells. On the other hand, our body uses different sources of energy from food and glucose is the main source. Insulin is responsible for entering glucose into cells. Afterward, the cells breakdown glucose through a process called glycolysis.
Ways for Developing Diabetes mellitus in children
Unfortunately, there are different ways of developing Diabetes:
- when your genes are changed or mutated, they cannot synthesize or secret Insulin.
- when your body’s immune system starts to attack your pancreatic beta Islets of Langerhans, the cells are damaged and cannot produce Insulin Consequently, Glucose cannot enter our cells, and it accumulates in the bloodstream; leading to high Blood Glucose Levels. Here the chronic illness starts, when our body cannot respond by secreting insulin, this is called Diabetes Mellitus.
- Usually, we have receptors on the surface of our cells, which respond to substance, hormones, enzymes, etc… When you are overweight or obese, It means that your body fats are high. Through studies, researchers and doctors found that fats increase Insulin Resistance. At first, the body responds to high Blood Glucose Levels by increasing the amount of insulin produced by the Pancreas. By the time, the Pancreas becomes exhausted and stops synthesizing and secreting Insulin.
Thus, it is either your body is not making and secreting Insulin, or the cells are resisting Insulin.
Management of diabetes mellitus in children
Insulin injections(taken immediately before meal), in case of diabetes Type 1, and late-stage diabetes Type 2 when there is no Insulin anymore produced in the body.
Nowadays, options for Insulin treatment are developing; In trials to decrease using of needles and pain associated with injections.
You can take insulin by different methods such as:
- Needles and injections.
- A daily injection insulin pen.
- Insulin pump: It is a pump placed under the skin with the ability to control the amount of Insulin pumped through it.
- Inhaler’s for insulin: Is insulin administrated through the respiratory tract. You breathe the dose through your nose. This method has not proved efficacy over injections or pens. Unfortunately, it requires you to administer higher doses of Insulin to achieve the required effect.
- Oral insulin: It is still under study and here are the updated research results:
Oral hypoglycemics (taken by mouth before the meal by about 30 minutes) are medications used for type 2 diabetes. These are drugs of different actions and are classified into:
- Biguanides: a common group of drugs that physicians give to their patients mostly obese. They decrease the body’s resistance to Insulin and decrease liver glycogenolysis, which is breaking down glycogen to get glucose. For example, Metformin which is in the market under the name Glucophage and Cidophage.
- Sulphonylureas: a group of drugs that increases Insulin secretion from the pancreas, e.g: Amaryl.
- Other classes are Thiazolidinediones, Meglitinides, Alpha-glucosidase Inhibitors, etc….
There are recent methods and procedures which are under test or are developing such as :
- Artificial Pancreas: this is an artificial replacement of It senses blood glucose levels and responds by producing doses of insulin and Glucagon, which is a hormone that increases blood Glucose Levels in response to low glucose levels in the blood.
- Weight loss surgery which is called “Bariatric Surgery”, It’s a surgery for obese and Diabetes Type 2 patients.
- Pancreatic Islet Transplantation: this is a procedure of transplanting the cells responsible for insulin synthesis and secretion, This method is more effective in patients with Diabetes Type 1.Because their Pancreatic Islet Cells are destructed and no more functioning.
You should regularly monitor your child’s Blood Glucose Levels.
- If your child is obese or overweight, Follow with a dietician.
- Try to decrease carbohydrates and sugar in your Child’s
- If you are a breastfeeding mother make sure to feed your baby on demand. Also, avoid early weaning which happens when a mother stops to give breastfeeding. in a study published in Nursing Outlook in February 2019 that breastfeeding has benefits for the mother, as well as the baby. It decreases the risk of developing diabetes type 1 and diabetes type 2 in the future of the newborn.
- Increase your Child physical activity from crawling, walking to playing sports, the American Diabetes Association recommends at least 30 minutes of exercise for 5 days a week.
- Provide your child with healthy balanced food like vegetables, fruits, nuts, full grains, low-fat protein, unsaturated vegetable oils like olive oil, etc…..
- Control your Child’s amount of food, The recent nutrition studies suggest eating less amount of food per one portion and more than 3 small different portions daily.
- Give your Child medicines as prescribed.
In a study published in the Journal of Nutrition and Intermediary Metabolism in December 2018; It is found that vitamin B3(Nicotinamide) can protect the beta cells in the Pancreas and help patients with Diabetes Type 1. Also, it found that omega-3 decreases Insulin Resistance in the body and helps patients with Diabetes Type 2.
Complications of diabetes mellitus in children
In Children, complications happen in older ages and in case of uncontrolled blood Glucose Levels.
When glucose accumulates in the blood, it starts to damage blood vessels. If the large blood vessel is damaged, it causes macrovascular complications. In which its complications affect the heart, limbs and the brain. For example:
- The heart needs oxygen and nutrients such as sodium and potassium to stay alive and work. Also, the coronary artery is the blood vessel that delivers oxygen and nutrients to the heart. When the coronary artery is damaged during Diabetes, the heart as an organ starts to die gradually; leading to its failure to pump blood to the body. Thus, Diabetes can lead to heart ischemia; which is a state of low oxygen delivered to the heart. As well as heart failure which occurs when the heart cannot pump blood.
- Hands and feet muscles need blood to move and do any activity. During Diabetes, the nerves and blood vessels are damaged leading to decreased sensation and ability to move your limbs. Also, you easily bruise and take a long time to heal. The limbs become labile to infections. Unfortunately, in the late stages of damage, the limbs have to be amputated.
- Stroke is the third macrovascular complication. If the blood supply decreases to the brain, It dies resulting in a stroke.
On the other hand, If the small blood vessel or blood capillaries are damaged, it causes microvascular complications. These complications are including the eyes, kidneys, and neurons.
For an example of microvascular complications:
- Neurons start to damage causing the decreased sensation of pain, wounding, etc….
- The kidneys start to fail in removing toxins from the blood. Unfortunately, Kidney failure is a common complication.
- Diabetes leads to cataract, which means that the eyes start to lose vision.
In research published in Surgery(Oxford) in February 2019, Foot complication is a common cause of going to hospitals.
Prevention of complications starts by controlling Diabetes. How to control Diabetes and keep our body-safe?
Prevention of diabetes mellitus in children
- It is very important to follow your Child Blood Glucose Levels and keeping it under control, keep it between 140-200 mg/dl(follow the levels with a doctor) if you measure randomly by about 2 hours after the meal.
- Avoid food rich in carbohydrates like potatoes and rice. Also, follow with your doctor or dietician.
- It is better not giving your Child any sugar source.
- It is better to decrease the amount of salt in the food.
- Keep your Child’s feet clean and dry to avoid infections, and keep Blood Glucose Levels under control to avoid gangrene; which is tissue death due to the decrease of oxygen supply.
- Your child should always wear something in his feet, you should avoid leaving sharp objects on the floor.
- Take care to give the proper Insulin or Oral Hypoglycemics doses to your If you give a higher dose, it can lead to low blood glucose levels, and that is not good for organs especially the brain. Also, if you give a lower dose of Insulin, it can lead to an uncontrolled high blood Glucose Level.
- Lifestyle changes concerning dietary habits and encourage him/her to increase physical activity.
- Give vitamin D starting from the fourth month of your infant’s age. Because Vitamin D is important for bone growth, as well as it improves the body’s response to Insulin.
To focus on the important prevention and care points for your child: Lifestyle changes, Keep glucose levels under control and if he takes insulin or medications give the proper doses at the stated time by the doctor.
In conclusion, do not give up on having Diabetes Mellitus as a chronic illness. It is possible that at every moment a good treatment can arise saving your Child life. Additionally, keep in mind that your management to your Child Blood Glucose Level makes him in a better state.
You can check our Diabetes Mellitus articles through our blog site: