The number of cases of diabetes type 1 (insulin-dependent diabetes) varies greatly in children from one country to the other. The incidence is of 0.1 per 100 000 children in China and 36.8 per 100,000 in Finland. In France, this disease is one in 1,000 births. Nearly 10,000 children under 15 years are diabetic.
More and more children affected
Between 1988 and 1997, there was a surge of cases of insulin-dependent diabetes in children: 75% increase in less than 4 years and 30% for those aged 4-14. Conversely, the impact does not seem to grow among 15-19 years old.
This development is not without consequence, it instead represents a challenge for medicine. Indeed, with diabetes starting in childhood, the length of follow-up is longer and therefore the risk of complications is more important.
In addition, generally reserved to the adult type 2 diabetes affects more and more adolescents due to the increasing number of children with obesity.
Causes still blurry
To explain this increase in incidence of type 1 diabetes in children, several hypotheses are advanced.
Hand, it criminalizes environmental and feeding factors. There as well as the number of diabetes cases is inversely proportional to the rate of breastfeeding.
On the other, hygiene factors, the sanitization of the environment of infants could be capable of altering the general immune ground through the digestive system.
Remember that type 1 diabetes is an autoimmune disease that is a reaction of the body attack against its own cells. In this case, the victims are certain cells in the pancreas that secrete insulin, necessary to the good assimilation of sugars by our Organization.
Diabetes apart more than one title
Although he had many points in common with the adult-onset diabetes, several items make this particular childhood illness. The precocity of occurrence and evolution in the long term increase the risk of complications. In addition, the child goes through different key stages. Thus, puberty is a sensitive period of the disease requiring treatment adjustments. Finally, the child not being himself his own therapist, its sociocultural environment plays by elsewhere an important role in the good management of the disease.
As for other diseases, the risk of emotional and psychiatric problems in these children is higher than in the rest of the population. However, studies evaluating the increased risk of psychological difficulties in young diabetics are not concordant. We observe sometimes in adolescence a denial of the disease that gives rise to a poor adherence to treatment, voluntary injection of excessive doses or absence of insulin injection. The major emotional conflicts can be accompanied in diabetic children of hospitalizations for hypoglycemia or Ketoacidosis (hyperglycemia).
From symptoms to treatment
Lack of insulin will induce an intense thirst. The child will drink and urinate much more than usual. He sometimes suffers again from bed-wetting while the cleanliness of night was acquired. At the discovery of the disease, abdominal pain is present in about a quarter of the cases (23%). The oldest present a great fatigue and weight loss. When there are suggestive signs in a child or a teenager, a determination of the level of glucose in the blood is usually sufficient to confirm the diagnosis.
In Pediatrics, insulin has fast and intermediate action, with typically two injections per day. Easy injections, they nonetheless require a rigorous technique. The age at which the diabetic child can perform the injections himself is very variable. Between 8 and 12 years of age, it can be encouraged to become self-sufficient in the management of his illness.
From a nutritional point of view, normal growth and development inputs are similar in diabetic children and well children. The regularity of dietary intakes and the stability of the amount of carbohydrates should however be monitored.
Physical activity should be encouraged in the diabetic child. However parents need to know that intense physical activity can lead to Ketoacidosis if glycemic control is bad.
The ways of researches are to improve existing techniques in miniaturization techniques of injections, sensors for the measurement of glucose or insulin pumps. Immunotherapy (to counteract the body’s immune response) and cell therapy (which consists in grafting new pancreas cells) are all tracks that medicine now explores.
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