How many people get diabetes? How do you explain diabetes in a vivid way? What is diabetes in children? What are the clinical manifestations and dangers of diabetes mellitus? Can diabetes be inherited?
Author: Guangzhou Women and Children Medical Center ? Pediatric Crayon
Source: Pediatrics in Medicine
Type 2 diabetes in adults is a household name, but diabetes in children is less known and receives little attention. Diabetes in children is mostly type 1 diabetes, which requires lifelong insulin injections. Clinically, parents of children with diabetes often find it difficult to accept the disease at first, followed by often blaming themselves for their poor care that led to the diabetes, and may avoid, become frustrated, fearful and even have conflicts with their families. Pediatricians occasionally encounter diabetes in children, but it is not easy to explain it clearly to the children and parents in an easy-to-understand way.
How many people have diabetes?
The purpose of knowing the prevalence is to let children and parents know that they are not alone, but that there are many “sugar friends” who are fighting alongside them to achieve a good state of acceptance and active participation in diabetes management. Currently, diabetes has become the third most common non-communicable disease in developed countries after cardiovascular disease and tumors. In recent years, the incidence of diabetes is becoming younger and the incidence rate is increasing year by year, and it is predicted that by 2030, the number of people with diabetes will reach 366 million worldwide. The prevalence of diabetes in China is above 3%, and the total number of patients is over 40 million, ranking second in the world. It brings heavy social and economic burdens to both individuals and society, seriously affects the living standards and health of patients, and even threatens lives, and is a worldwide public health problem that seriously threatens human health. The prevalence of diabetes among adults in China was 3.21% in the 1995-1996 survey; the incidence of type 1 diabetes among children under 15 years of age varied significantly from region to region in the 1990-1994 statistics, with the highest incidence rate of 4.6/100,000 per year in Wuhan and the lowest of 0.1/100,000 per year in Zunyi, a difference of more than 40 times, and the average incidence rate of 0.52/100,000 per year in 1980-1994. 0.52/100,000 per year from 1980 to 1994. There is a clear age difference in the onset of type 1 diabetes in children: it is rare up to the age of 1 year, with a peak at the age of 4-6 years and a large peak after puberty (10-14 years). there is no significant gender difference in the onset of type 1 diabetes.
How to explain diabetes in a vivid way?
Diabetes is a group of metabolic diseases characterized by chronic elevated blood glucose levels and is caused by defects in the secretion and/or action of insulin. Diabetes is not a single disease, but a syndrome caused by a combination of etiologies, including abnormalities in protein and fat metabolism in addition to abnormalities in glucose metabolism. Simply put, the root cause of diabetes is the inability of the human body to make good use of the glucose in the blood. What is glucose? Glucose is an indispensable energy substance for our life activities, I like to compare it to the “fuel” of our body, “fuel” is equivalent to the gasoline of a car, which plays a role in driving the operation of life. Glucose is the basis for all life activities in the human body. The source of glucose is mainly the digestion and absorption of food, but in case of hunger, liver glycogen and muscle glycogen can also be converted into glucose for use by the body. If energy is not replenished in time, when sugar is depleted, non-sugar substances such as fats and even proteins can be converted into glucose for use by the body. Glucose needs the cooperation of insulin to enter the body’s cells from the bloodstream and to be used. So, what is insulin? In short, insulin is the “key” that allows glucose to enter the cells and be used, and insulin allows glucose to enter the various cells in the body. After that, glucose can be used as “fuel” to “charge” the body, and with energy, people can move, study and work normally. In the human body, insulin is mainly synthesized and secreted by the islet B cells of the pancreas. Therefore, when glucose utilization is impaired, diabetes is produced. This makes it easy to understand that diabetes can be caused by either insufficient insulin production (insufficient amount of keys) or impaired insulin utilization (poorly matched keys and locks).
What is childhood diabetes?
Diabetes in children is defined as diabetes that occurs before the age of 15. There are three broad categories of childhood diabetes: type 1, type 2, and specific. Diabetes in adults that occurs in adolescents (MODY) and diabetes with mitochondrial gene mutations, for example, are special types of diabetes. Although there are many classifications of diabetes, in terms of the proportion of people with diabetes, type 2 diabetes is predominant in adults, while type 1 diabetes is predominant in children.
What are the clinical manifestations and risks of diabetes mellitus?
Diabetes is a chronic disease that causes disorders of sugar, fat and protein metabolism in the body due to long-term elevated blood glucose, which can cause multi-system damage, resulting in chronic progressive lesions, hypofunction and even failure of the eyes, kidneys, heart, nerves, blood vessels and other tissues and organs; sometimes, asymptomatic children with diabetes can develop acute severe metabolic disorders or even threaten their lives without being aware of it, such as diabetes Ketoacidosis (DKA), diabetic hyperglycemic hyperosmolar state, etc., are common in children with type 1 diabetes. Children with diabetes often present with easy hunger and excess food, excessive drinking, polyuria and weight loss. Due to impaired utilization of glucose, although the child’s blood sugar is high, the body does not use it properly, resulting in the child feeling hungry and eating more. The amount of food is increased compared with the original, there is always a feeling of not being full, and also easy to be hungry. Some patients do not eat much, but the side dishes are increased, and there is a tendency to prefer sweet food. At the same time, the lack of energy in the body also promotes the conversion of other substances into blood sugar, and the stored fatty tissue in the body starts to be consumed to provide energy, thus the body loses weight. The increase in blood sugar increases the osmotic pressure of the blood, and the loss of glucose from the urine takes away a large amount of water, so the child feels thirsty and drinks a lot. When the blood glucose is high enough to exceed the limit of glucose reabsorption by the kidneys, glucose is lost from the urine and a large amount of water is taken away, resulting in excessive urination. Due to the lack of energy, the child’s body is tired and weak, with mental fatigue, low energy and weakness of the waist and knees; sometimes he feels weak in the legs when going up the stairs and thinks of sleeping after meals. While glucose is used as a source of energy for people, bacteria and fungi can also use glucose to reproduce, and thus body fluids containing large amounts of glucose are a natural culture medium for bacteria and fungi. For example, increased sugar in the urine may increase vulvar infections in affected children, especially in girls, who often have perineal itching. ketoacidosis or non-ketotic hypertonic coma may occur in type 1 diabetic patients with improper diet, infection, interruption of insulin therapy, and delayed diagnosis. It manifests as fatigue, loss of appetite, nausea and vomiting, polyuria, dry mouth, headache, drowsiness, deepened and accelerated breathing, exhaled breath smelling like rotten apples, and even coma. In addition, diabetes can lead to a number of complications, various infections, diabetic nephropathy, diabetic retinopathy, neurological complications, diabetic foot and so on. Therefore, children with diabetes often need to have their eyes and kidney function checked regularly. In addition, it is worth noting that the younger the age of onset of the disease, the less typical the clinical manifestations are. In 9 cases, the symptoms were exacerbated by the infection and even diabetic ketoacidosis. Therefore, children with sudden onset of ketoacidosis due to infection during the neonatal period should have their blood glucose, biochemical electrolytes and urinary routine checked promptly to avoid aggravation of ketoacidosis due to misdiagnosis.
Can diabetes be inherited?
The onset of diabetes is related to many factors, including immune factors, infections (especially viral infections), environmental factors, etc. Diabetes in children may not be caused by genetic factors, but by other factors, or by genetic mutations.