Diabetes is a condition that causes problems with the regulation of blood glucose (blood sugar). There are two forms of diabetes. Type 1 diabetes (mellitus), or insulin-dependent diabetes, is an autoimmune disease: autoantibodies cause the destruction of the pancreatic cells that synthesize insulin, leading to a deficiency in this hormone that makes sugar "enter" into the cells. Type 2 diabetes is non-insulin dependent. Insulin is synthesized and secreted normally. But there is a resistance to insulin, which does not allow the sugar to "fit" into the cells.
Children are mostly diagnosed with type 1 diabetes.
Insulin-dependent diabetes will lead to pathological changes in blood sugar. The sugar in the blood is too high (hyperglycemia). There are signs that make a HCP suspect type 1 diabetes in children:
- the child urinates a lot (especially at night);
- the child drinks a lot;
- the child is tired;
- The child may also lose weight despite a large appetite.
The diagnosis is suspected depending on the clinical signs; different tests can support this suspicion: a blood glucose test showing too much blood glucose and a urine dipstick, which highlights the presence of sugar in the urine. In case of a positive result on these two tests, further blood tests will be carried out and several days of hospitalization for diagnostic confirmation. Education of the child and his parents is essential.
The treatment consists of:
- Education of the patient and his family to the lifestyle and dietary rules necessary for a good control of diabetes, including methods of surveillance, signs suggestive of a complication, and the adjustments necessary in one's diet: avoid sweets, include more starchy carbohydrates in your daily diet ... ;
- monitoring blood glucose every day (usually morning, noon and evening). The results are recorded and kept in a notebook to keep a therapeutic history;
- insulin administered as multiple daily injections in a specific pattern or by using an insulin pump.
The type of insulin (slow, medium or fast), and the dosage is determined by the doctor. Slow Insulin has a slow action onset, whereas fast insulins act quickly. In the case of injections, careful monitoring of blood glucose is important. Indeed, insulin dosages are adjusted according to the blood glucose level found.
A multidisciplinary follow-up is essential to monitor long-term glycemic control and the prevention of complications.