Diabetes in children (type II)

Diabetes type II and one of the chronic and costly disease that affects many age groups. Accompanies this disease, including many of the complications of acute and chronic. The period of infection with the disease are important factors that determine the appearance of chronic complications of the disease.
With an increased incidence of diabetes and high rates of type II diabetes between the group of children and adolescents and the high average age of those categories, he started alarm bells ringing to warn the increased incidence of complications of diabetes and chronic, which holds our societies developing mobilized a large and challenging to control this disease at this stage in particular, as this category represents the precious spring of developing societies, where it is the primary source of workforce and productive society.
Until recently, diabetes caused by disorder of the immune system of the body (Type I) is a type known in children with diabetes, while other species are about 1-2% of the total cases.
But this picture took sharp change, noting many international reports that that image has changed a lot, as the 8-45% of cases of newly diagnosed diabetes among children belonging to the second type is caused by the disorder of the immune system.
This new concept of diabetes among children and adolescents, and place the new difficulty in the hands of therapists, and determine the type of sugar is affected by the child or adolescent.
Adopted some of the therapists on the clinical picture of the patient at the time the initial appearance of the disease, while an other resorted to in addition to complex laboratory tests.
But there are some lines that may help in differentiating between the two types:

Diabetes Type I:
1) can be observed that most patients do not suffer from overweight or obesity, but some may suffer from a lack of weight
2) Note the short period of time between the onset of illness and the clarity of the clinical picture of the disease (multiple times urination, frequent drinking of water and unexplained weight loss)
3) the emergence of objects Alasithonah the time of diagnosis (first images Alasithona acidification of the disease in about 35% of neonatal infection)
4) Note the period of traffic and lack of metabolic stability Alihujp to insulin (honeymoon period), also notes the high probability of injury Alasithona blood acidification.
5) 5% have a family history of injury to a family of class I or II diabetes.

Diabetes Type II:
1) Note that most patients are overweight or obese (85%) the time of diagnosis
2) Note diabetes and not notice Alasithona urine (33%) as in the first type.
3) the emergence of objects Alasithonah the time of diagnosis (5-25% represents the acidification of the blood Alasithona first images have the disease)
4) a family history of diabetes (45-80% suffer at least one parent from getting diabetes)
5) 74-100% of patients have a family history of sugar and that does not appear in the family of modern generations.
And, perhaps surprisingly, to be a hit children in the household is causing the detection of cases of infection among family members where a call for a child injury risk extrapolated to all family members.
6) the manifestations of increased insulin resistance such as acanthosis nigricans (a skin change is characterized by velvety smooth texture with an increase in skin pigment) and appears in some areas, such as the area under the axillary and appears, and in patients with clear-skinned black (90%). In addition to some disturbances accompanied by an increase of insulin resistance such as multiple cystic ovarian in women.
Often are diagnosed with diabetes type II diabetes among children and adolescents after the age of ten. Represent the age group 12-16 summit in periods of diagnosis among children and adolescents.

Monitoring of diabetes type II:
Perhaps the early detection of disease and one of the most important lines of prevention. Perhaps the first step of monitoring is to identify the groups most susceptible to this disease:
1) who are overweight (body mass index more than 85 percentage for age and sex, increased weight for height more than 85 percentage or weight gain of more than 120% of ideal body weight (50 C). In addition to having two or more of the :
A) family history of injury from diabetes type II among the relatives of the first or second degree
B) belonging to an ethnic group with an increase in the coefficient of risk of infection, such as the African race.
C) the existence of the manifestations of increased insulin resistance or disorders accompanied by increased insulin resistance.
Begins with early detection of sugar in this category since the age of ten and continues periodically every two years or begins at puberty, whichever is earlier.
Are relying on the examination of the level of fasting blood glucose after a meal or two hours or the work of the curve of glucose in the cases of others and clear.
Are taken into account that the duration of fasting should not be less than 8 hours of abstinence from eating the calories. Can be counted on to refrain from eating during sleep for children and do not use the fast during the day to be difficult.
Diagnosis:
1) the presence of symptoms of diabetes (frequent urination, excessive drinking of water and unexplained weight loss) in addition to the examination of sugar at any moment regardless of the time between eating and blood test more than 200 mg / dl.
Or
2) high fasting blood sugar of over 126 mg / dl
Or
3) High blood sugar two hours after eating for more than 200 mg / dl
Some therapists may depend on many complex tests such as the presence of antibodies to beta cells to secrete insulin or to determine the level of blood insulin level or smooth Albptdah "C". It is worth mentioning that the level of insulin or Albptdah series "C" may be normal or above normal in patients with type II diabetes types.

Functional disorders in patients with type II diabetes between the types of children and adolescents:
Overlap and complicated reasons that may lead to the emergence of diabetes type II in this age group. Oscillating between these factors, social factors, genetic and environmental in the emergence of this disease. The impact of genetic factor in these differences in infection rates between different races.
Supports glucose balance within the body to balance the secretion of insulin from beta cells of the pancreas and the action of insulin through the insulin receptor.
The high level of blood sugar in people with type II diabetes on the basis of impaired insulin action first and then the disruption of insulin secretion II.
The phase of growth and adolescence characterized by increasing levels of hormones of the impact of anti-insulin like growth hormone and sex hormones and to compensate for the body to increase secretion of insulin.
The failure of the body in the Eodi often to the high level of blood sugar and thus the emergence of diabetes. Perhaps this explains the increasing rates of diagnosis on this age period.
Play overweight or obesity plays an important role in Show diabetes. Where she works as a fat cell hormone secrete various substances that lead to higher blood sugar. Observed that obese children have a reduced ability to respond Balnbugraas beta cells to secrete more insulin as a result of high blood glucose by 40% compared with those who do not suffer from obesity or weight gain.
Match the proportion of internal fat, internal organs directly proportional to the beta cells in response to high blood glucose secrete more insulin and inversely with the body's sensitivity to insulin secreted.

Treatment:
Treatment aims to:
1) good control to adjust the level of blood sugar and blood sugar-related Bkhaddab
2) good control of diseases associated with diabetes or resulting from it, such as high blood pressure and blood fat disorder
3) the prevention of acute and chronic complications of diabetes
Removing the child as a unit and one of the most common errors in dealing with child diabetes. The difficulty lies in the treatment of diabetes in the child that the child victim is part of an entire sector of family members and those around the child and the treatment should be directed to them all.
The estimation of the emotional reaction of the injured child's diabetes and what the resulting reactions of the two oceans by the members of his family's refusal to diagnose and prevent the other wall is to deal effectively with the child with diabetes if they are not tear down this wall.
So the first step of treatment begin to extend the table of trust between the child and his family and members of medical team
Also, to clarify the basic facts about the disease to a private child-oceans of the most important elements of parental treatment.
The early starting age for diabetes type II among children increase the likelihood of chronic complications in the early stage of age in the absence of good control of blood sugar.



A) change the methods of daily cohabitation and intensive education:
The intensive education about diabetes and the delivery of simplified information about it from one the most important elements of treatment and the use of simplified methods and tools such as easy connectivity aids, games, comics one the most successful methods used to teach children the facts of this disease.
Education comes self-examination and follow-up of the most important priorities of the treating physician. The goal of stimulating learning methods of self-examination of the sugar is to provide a permanent method of the child to follow the level of sugar, so as to avoid sharp Alamadagvat such as low sugar or low sugar acute asymptomatic (no symptoms of feeling low sugar). All results are discussed with the patient and individuals around him in an easy and simplified.
Perhaps the role of the organization of food and quality are important elements in treatment.
When you try and put a nutrition program for children should take into account the quality of food available in the child's environment and lack of exaggeration in describing the types of foods unpalatable in an environment of the child or the child himself should also take into account the physical condition of the child's family diabetes and avoid the fatigue of material through her description of food expensive the price for food diabetics are sold in stores or some pharmacies should also be careful to modify food habits of the family in general, so that the child eating the right within the family.
Should also encourage physical activity for children and not suppressed under the pretext that he is a diabetic, but you must set the motor activity with treatment covered by the child and to avoid low blood sugar and give the child a snack before exercise motor activity.
The physical activity helps the child to avoid high blood sugar by reducing insulin resistance and the withdrawal of part of the blood glucose to the muscles active, and as a result of increased sensitivity of insulin receptors and the number of muscle tissue.
Should encourage the child to reduce the periods of sitting in front of television screens and computer and electronic games and the subsequent idle and eating high-calorie foods such as nuts, sweets and encourage physical activity outdoors.
Perhaps, it is important to clarify the importance of the role of the family in every step of the therapeutic relationship with her sick child.
Can measure the success of the modification patterns of daily life, and successfully control the Zen of the child and its stability and return to normal, stable blood sugar level over 126 mg / dl and stable blood sugar linked to Bkhaddab for less than 7%.

B) drug therapy:
Given the similarity of functional disorders valuable diabetes type II in children and adults, the real estate used by the adults in theory can be used in the treatment of diabetes in children and adolescents, but because of the lack of studies with adequate on the level of safety of these drugs in this age group and dose necessary remedial treatment, many global bodies such as the Food and Drug Administration is not permissible to use these drugs to treat diabetes type II in children and adolescents remains and various types of insulin is a safe treatment.


Follow-up:
The periodic follow-up of children with diabetes and one of the important instructions that must be addressed. These include the follow-up the following elements:
1) the annual periodic inspection of the eye
2) examination of proteinuria in a yearly
3) examination of the feet, and if this type of screening is controversial at this early stage of age, but due to the ease and low cost of such examination, the play does not affect the time of the patient or the physician or members of the treating team.
4) follow-up blood pressure and direct interaction in the case exceeded the permissible limits.
5) follow-up blood fat and immediate treatment if it exceeded the limit.
Perhaps, weight loss and follow-up food from a main line of treatment.

Prevention:
Is always prevention is the key. Should activate the role of primary prevention aimed at all members of society in general and those with high risk factors and that especially the deployment of health education and to clarify the facts about this disease and discuss the misconceptions, such as linking health and wellness obesity.
Often note the admiration of mothers taking their children with overweight and obesity, they believe that the evidence on health and wellness.
Perhaps Holaúa mothers do not teach what they do in their children and the size of the risk of providing for those children.
It also represents the early detection and early induction, either through a blood test or genetic induction and a means of early prevention.
The early intervention and a means of prevention in the secondary stage, which aims to avoid the fierce march of the disease and try to prevent or delay chronic doubled.
A final word whisper in the ears of every father and mother:
Your children loved Okbadcm Ahdoa their health and wellness at all stages of their lives
And do not judge them diabetes and obesity early