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Childhood diabetes
Sunday, 19 April, 2015 06:24pm  
Childhood diabetes
Bangladesh Time: The term diabetes mellitus describes a metabolic disorder of multiple etiologies characterised by chronic hyperglycemia (excess blood sugar level) with disturbances of carbohydrate, fat and protein metabolism resulting from defects of insulin secretion, insulin action or both.

Type 1 diabetes mellitus is the most common endocrine metabolic disorder of childhood and adolescence, with important consequences for physical and emotional development.

10% of all diabetes are childhood diabetes. Globally 15 million children suffers from the disease. Polyuria, polydipsia, polyphagia, fatigue and weight loss are the predominant features of diabetes in children.

Sometimes they may present with diabetic ketoacidosis (a life-threatening problem that affects people with diabetes when the body cannot use sugar i.e. glucose as a fuel source because there is no insulin or not enough insulin; fat is used for fuel instead — when fat breaks down, waste products called ketones build up in the body).

Fasting plasma glucose >7 mmol/L and 2 hours after breakfast >11.1 mmol/L; RBS > 11.1 mmol/L are diagnostic. Interestingly it has been seen that only 10% of the diabetic children having the family history of the disease in identical twin 25-50% suffers from diabetes.

Autoimmune destruction of beta cells of pancreas has been demonstrated in Type 1 DM. Environmental factors and some viral infections (Mumps, Coxasakie virus, Cytomegalovirus) trigger the onset of autoimmunity in genetically susceptible individuals.

Acute complications are hypoglycemia (low blood glucose level), ketoacidosis and chronic complications are irreversible micro and macrovascular pathology, which includes retinopathy, nephropathy, neuropathy.

Management of diabetes in children is a challenging task as they do not always like to obey the given instruction. Diet, discipline and drug are the mainstay of management. Here insulin is the drug to be used to keep blood sugar in control. Help of parents, relatives and teachers are very crucial in proper management of diabetes in children. Long, active, healthy, comfortable normal life can be enjoyed with proper management.

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