Diabetes mellitus in children ( type 1 diabetes ) cause and clinical features Custom Search Diabetes mellitus is a condition in which there is abnormally high level of glucose in the blood. Type 1 Diabetes also called as immune mediated diabetes or Juvenile diabetes or Insulin dependent diabetes is the most common type found in children. Type 2 diabetes (Non- immune mediated or non insulin dependent diabetes) is common in adults. It can occur in obese adolescents. Cause: Genetic factor is suspected. If both parents are diabetic the risk of the disease in children is higher. Viral infection and dietary habits are also thought to contribute. Many infants with congenital rubella develop diabetes in later life. Some food preservatives are also suspected as those consuming foods preserved in excessive amounts of nitrates were found to have higher incidence of diabetes mellitus. There is evidence of immunologic damage to the beta cells of pancreas. Hence a combination of genetic, environmental and immunologic factors may lead to the disease. Obesity and lack of exercises predispose to type 2 diabetes. Clinical features and diagnosis: The classical features of diabetes are, polyuria (passing increased quantities of urine), polydipsia (increased thirst which is a defense mechanism to prevent dehydration) and weight loss. Occasionally the disease is diagnosed by detection of glucose in urine (glycosuria) on routine examination. Less commonly a patient of diabetes may be brought in a state of coma because of severe metabolic disturbance which affects the function of brain. The diagnosis is confirmed by estimating glucose in blood. Fasting plasma glucose level of more than 126mg/dl (7mmol/l) or random plasma glucose level of more than 200mg/dl (11.1mmol/l) is diagnostic. Glycosuria by itself is not confirmatory as some children with normal blood glucose level may have detectable glucose in urine (a condition known as renal glycosuria). It is better to repeat the blood test as transient hyperglycemia can sometimes occur particularly during some illness. The term impaired glucose tolerance is used when fasting blood sugar is between 110-126mg or 2 hours value for glucose tolerance test is between 140-200mg/dl. The diagnosis of diabetes is a child may be met with shock, denial, anger and feeling of guilt. It may be necessary to spend some time with parents to help them accept the reality. Custom Search
Page last reviewed on 17th November 2010
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