National Science and Technology Workers' Day | Heartbroken! I got diabetes at the age of 11

Recently, our hospital's pediatric department admitted an 11-year-old patient. This child used to drink 1-2L of water every day, eat 1 bowl of rice at each meal, and urinate 3-4 times a day, but now he drinks 3-4L of water every day, eats 2 bowls of rice at each meal, and urinates 6-7 times a day. Although the child eats more, he is not fat, and only weighs 70 pounds. Therefore, the child's mother thought that the child was growing and it was normal to drink and eat more. Until one day, the mother accidentally discovered that the child's urine was particularly sticky and felt something was wrong, so she immediately took the child to the hospital for treatment. After outpatient testing, the child's blood sugar was 30.55mmol/L, urine ketones 4+, and urine glucose 4+, so he was admitted to the hospital. After a series of subsequent examinations, he was diagnosed with type 1 diabetes.

The child’s mother was very puzzled: My child is not fat, why did he get diabetes at such a young age?

● If your child suddenly drinks and urinates more frequently, you should be alert●

Adult diabetes is mainly caused by a relative lack of insulin secretion, and most cases are type 2 diabetes. More than 90% of new cases of childhood diabetes are type 1 diabetes, which is very different from the common type 2 diabetes in adults. Childhood diabetes is caused by damage to the pancreatic beta cells, which reduces the amount of insulin secreted by the child. It is caused by the combined effects of genetic genes, immune factors, and environmental factors. The onset is relatively rapid. Once the disease occurs, almost 100% of cases will experience polydipsia and polyuria. The "little sugar man" mentioned above attracted the attention of parents only after he developed symptoms of polydipsia and polyuria.

It is important to emphasize that children with type 1 diabetes can easily go into a coma due to ketoacidosis. Ketoacidosis is one of the serious acute complications of diabetes and the leading cause of death in children with diabetes. If you find that your child is extremely weak, fatigued, has muscle aches, has anorexia, vomits, has abdominal pain, has deep breathing, and has a "rotten apple" taste in his mouth, you must send him to the emergency room immediately.

● These reasons may be the “culprit” ●

Genetics: As the number of diabetic patients surviving the disease increases, the gene pool of the population changes, which in turn increases the number of children suffering from diabetes.

Obesity: The incidence of type 2 diabetes in children is currently on an upward trend year by year. The main reason is the sharp increase in the number of obese children, resulting in type 2 diabetes, which was previously "exclusive" to adults, becoming common among adolescents and children.

Lack of exercise: Lack of exercise is the main reason why children consume too few calories. In recent years, with the improvement of living standards, children's participation in physical activities has gradually decreased, so the probability of childhood obesity has increased year by year. Once obesity occurs, children's enthusiasm for participating in sports will decrease, making it more difficult to return to normal weight, which creates a vicious cycle.

● If you don’t want to be a “sugar man”, you must change your bad habits●

The onset of type 1 diabetes in children is related to various viral infections, such as rubella virus, mumps virus, coxsackie virus, etc. In addition, chemical toxins and the lack of certain nutritional components can also damage pancreatic beta cells and cause the disease. Since the exact pathogenesis of type 1 diabetes is not fully understood, there is currently no good prevention method. Scientists are conducting research in the hope of finding a biomarker that can serve as an early warning.

Type 2 diabetes often has a family history and is often associated with obesity. Therefore, for children with a family history, especially those who have reached the obesity threshold, it is crucial to properly manage their diet and lifestyle habits.

Eating habits

Control the diet, and the nutrients and calories should be taken in in a planned way; the staple food for children should not be too fine, and they should eat a combination of coarse and fine grains, and the side dishes should be of a wide variety of vegetables, so that they can take in a wide range of nutrients; try not to give children foods containing pigments and preservatives; limit the intake of sweets and beverages.

Lifestyle

Parents should guide their children to pay attention to personal hygiene and prevent various infections; cultivate their children's good work and rest schedules, go to bed early and get up early, and avoid staying up late; at the same time, increase exercise to achieve the purpose of prevention.

● None of the five pillars of treatment can be missing●

The treatment of childhood diabetes is the same as that of adult diabetes. There is no cure at present, but blood sugar can be controlled through various means. It is mainly through five aspects, which are often called the "five horses" of treatment, namely diet control, drug treatment, exercise, blood sugar monitoring and diabetes education for patients. Each of these "five horses" is very important.

Diet control

Dietary control is the basis for the treatment of all types of diabetes and is an indispensable measure for the prevention and control of diabetes, because the key to controlling blood sugar levels is to control the "mouth". Therefore, controlling total calories and eating a balanced diet are the primary principles. Eat breakfast, lunch, and dinner at regular times and in regular amounts, and avoid increasing or decreasing food intake at will or carrying snacks with you. Suggestions:

Daily calorie requirement: total calorie = 1000 + age × (70-100)

The composition and distribution of dietary nutrients are: carbohydrates account for 50%, fats account for 30%, and proteins account for 20%.

Calorie distribution for three meals: Generally, small and frequent meals are appropriate. Two snacks can be added between meals to avoid hypoglycemia.

Drug treatment

Once diagnosed with type 1 diabetes, the "little sugar man" needs to inject insulin for life, and needs to adjust the dosage of the medicine according to the doctor's instructions based on the condition and follow up on time.

Although there are many drugs available for adults with type 2 diabetes, for minors, most parts of the world only approve metformin and insulin for use in children and adolescents aged 10 to 18. A doctor should formulate a medication plan based on the condition and take the medication as directed by the doctor.

Exercise

Children with diabetes can also exercise, and they need to exercise scientifically. Appropriate exercise can reduce the amount of insulin used, control weight, and promote cardiovascular function.

Blood glucose monitoring

Conduct self-blood sugar monitoring flexibly according to the treatment plan to avoid hypoglycemia. It is recommended to monitor blood sugar 3 to 4 times a day. If conditions limit it, 2 to 3 days a week, 3 to 4 times a day, can provide more information on blood sugar control than 7 days a week, 1 time a day. Blood sugar should be monitored in time for any sudden physical discomfort, before and after strenuous exercise, and significant changes in diet.

Diabetes Education

When treating their children, parents should not listen to folk remedies or secret recipes. They must receive scientific diabetes education to control the condition of their children and avoid high or low blood sugar.

Parents should learn how to better care for children with diabetes, help them develop healthy eating and living habits, and learn to manage and take care of themselves, so that these "little diabetes people" can thrive in a healthy and happy atmosphere!

Author: Li Lu, Chief Pharmacist, First Affiliated Hospital of Dalian Medical University

Review expert: Yang Shilei, deputy chief pharmacist of the First Affiliated Hospital of Dalian Medical University

Wei Guoyi, Chief Pharmacist, Beijing Anzhen Hospital, Capital Medical University