Pediatric diabetes - symptoms - treatment
Of course, the term diabetes has nothing to do with the geometric organ. It came from the Greek word "pass" when Aretaeus from Cappadocia noticed that large amounts of fluid passed into the urine, "passing" the whole body. It took 20 centuries since then to understand that this phenomenon was due to high blood sugar.
What is diabetes?
The abnormal rise in blood sugar (glucose), most commonly expressed in milligrams of glucose per deciliter of blood (mg / dl). Normal fasting glucose levels range from 70-110 mg / dl, while 1 hour after a meal glucose can normally rise to 140 mg / dl. When fasting glucose exceeds 126 mg / dl we have Diabetes. Of course, this definition covers several different forms of diabetes.
The pancreas and insulin and glucose
All living organisms, from bacteria to mammoths, need energy to grow and reproduce, for life itself. The main source of energy has always been glucose, which in order to be used as fuel, must be transported inside the cell.
The key to this transport is insulin, produced by pancreatic β-cells that form the islets of Langerhans, according to the German medical student who discovered them in the 19th century.
It is therefore important that blood sugar is neither too high (hyperglycaemia) nor too low (hypoglycaemia).
Diabetes mellitus - treatment
No! Not everyone has the same type of diabetes. There are diabetics who are initially treated with insulin and those who at first manage with pills, but in the end they also end up on insulin. This differentiation together with other characteristics in heredity, the mechanism and the intensity of diabetes led to the classification into two major categories (of course there are other types of diabetes and many times the boundaries between the categories are to be removed ...):
Type 2 diabetes
When you become obese, you develop resistance to the action of insulin. Simply put, he needs more insulin to do the exact same job that a much smaller amount of insulin would do if he were thin. Thus the pancreas overworks and after years gets tired. It is like a car engine that constantly works in the red of the tachometer and in the end of course burns ... Somewhere there are the anti-diabetic tablets, which aim to increase the production of insulin by the β-cell, to reduce the production of glucose by the liver, in reduction of insulin resistance and delayed absorption of sugars from the intestine are no longer enough, so the diabetic needs insulin.
Type 2 diabetes is much more common, has a much stronger inherited predisposition than type 1, and for the time being usually occurs in adults, mainly obese elderly people. And we say for the time being, because the new scourge of world health is unfortunately childhood obesity. Almost 40% of children and adolescents are overweight or obese. Our country -World champion here too ...- is 1st in the world in overweight boys, 2nd in obese boys, 3rd in overweight girls and 6th in obese girls. Thus, type 2 diabetes, metabolic syndrome and their complications begin to appear more and more in childhood and adolescence.
Type 1 diabetes
It is due to the destruction of β-cells by the body itself by an autoimmune mechanism. Insulin is almost completely absent, and this often happens at a young age, hence the term "juvenile diabetes". Immediate and lifelong insulin administration is absolutely necessary and allows a practically normal survival expectancy.
Diabetes mellitus - psychology
No, it's not your fault that you had type 1 diabetes. Not many sweets or sugar are to blame. Nor is the manner in which it is inherited clear. As long as a relative - and not necessarily siblings or parents - has type 1 diabetes, there is just a greater chance of "winning" the lottery ...
Diabetes mellitus - symptoms
If I am under 30 years old, in the last few weeks I have polyuria and I am constantly thirsty, I have lost weight without effort (!) And I am constantly tired, these are symptoms that should lead me to my doctor. He with two simple tests will find very high blood sugar, sugar and ketones in the urine. If I am a small child again, I hope my parents understand quickly all these strange things that happen to me .. Because as my immune system progressively destroys more and more β-cells and some "autoantibodies" circulate freely in my blood, my body , although I continue to eat normally, he can no longer use glucose, which is his favorite "gasoline", since he can hardly find any insulin. So it has to break down fat to make ketones, which is an alternative source of energy, but probably not so ecological ... These ketones are acidic, they drop the pH in the blood, they cause pain in my muscles and in my abdomen, they make me to get more and more thirsty, to breathe fast ... Eventually my head and abdomen hurt a lot, I can not eat anything and I vomit, like when I had appendicitis! If someone does not find what I have I may fall into a coma!
Diabetes mellitus - treatment
I can travel and go camping. I will normally get a diploma and drive when I grow up. My doctor will teach me what I need to be able to deal with each case. I will always have a little juice with me in case my blood sugar drops. I will understand because I will sweat sharply, maybe my hands will shake a little and I will feel tired or irritated. In case I suffer from severe hypoglycemia and lose consciousness for a while, my teacher or parents will give me an injection called glucagon and it will benefit me in a few minutes. Maybe I did not eat after the insulin injection or did a lot of exercise without eating anything for a long time, or I accidentally did more units. My friends know I have diabetes. The teacher and the doctor have explained in class what diabetes is and why I need insulin. I normally even go to a restaurant with my parents. Just before I eat I will make my insulin with my pen. I'm not ashamed of that. I learn to live by doing what I have to do to protect my body. So I know that after many years I will not suffer any of what I have heard that diabetics who do not pay attention suffer: problems with vision and kidney function, problems with the legs, heart and large blood vessels. After all, every three months we measure the glycosylated hemoglobin in the microbiological laboratory, which also shows us if my regulation is good. Once a year, of course, I do some blood tests and I also go to the ophthalmologist for a dredging. But shouldn't all people do a little check-up once a year?
With the new treatment regimens and the newest insulin analogues I am now completely free from the schedules. Every night I take a new insulin - called glargine - which maintains consistently low levels in the blood for 24 hours, covering my basic needs without the risk of hypoglycemia at night. As for meals, 3 or 4 times a day, I use just before eating the pen with fast insulin. In fact, it is so fast that I can - if necessary - do it immediately after eating. If I ever get bored of pens and injections, or my doctor thinks they are better for my adjustment, I can put on an insulin pump. But again I have to measure my blood sugar as before. I know that in a few years we will have the smart pump that can constantly measure sugar and decide for itself how much insulin I need at any given time, in addition to the large dose I will need for meals - which I will be able to do, as I do today. pump, to program it with a remote control! I also know that I may be able to use inhaled insulin at some point and no longer need to inject.
Doctors and researchers around the world are looking to find the definitive cure for diabetes. They are already evolving the islet transplantation, which is not done with surgery, but with some kind of injection! They try to reveal the secrets of the immune system and the differentiation of β-cells. Maybe one day we can order other stem cells to become β-cells, and then my insulin will start coming out again. That is why I am optimistic and I do what I have to do to be in the best possible health until then and for as long as I live. I do not do it for my parents or my doctor. I have diabetes and I do it for myself ...