- Type1 diabetes mellitus is characterized by the destruction of the pancreatic beta cells,which produce insulin; this results in absolute insulin deficiency.
- Type 2 diabetes mellitus usually arises because of insulin resistance , in which the body fails to use insulin properly , combined with relative insulin deficiency.
- Complete insulin deficiency requires the use of exogenous insulin to promote appropriate glucose use and to prevent complications related to elevated blood glucose levels,such as hyperglycemia , diabetic ketoacidosis , and death.
- .Diagnosis is based on the presence of classic symptoms and an elevated blood glucose level ( normal blood glucose level is 70 to 110 mg/dl ).
- Children may need to be admitted directly to the pediatric intensive care unit because of the manifestations of diabetic ketoacidosis , which may be the initial occurrence leading to diagnosis of diabetes mellitus.
Diabetes Mellitus Symptoms
1. Polyuria , polydipsia , polyphagia
3. Weight loss
4. Unexplained fatigue or lethargy
7. Occasional eneuresis in a previously toilet trained child
8. Vaginitis in adolescent girls ( caused by candida which thrives in hyperglycemic tissues)
9. Fruity odour to breath
11. Blurred vision
12. Slow wound healing
13. Changes in level of consciousness
a. Failure to grow at a normal rate
b. Delayed maturation
c. Recurrent infections
e. Cardiovascular diseases
f. Retinal microvascular disease
3. Diabetic ketoacidosis
7. Microvascular changes
8. Cardiovascular changes
- Normal healthy nutrition is encouraged , and the total number of calories is individualized based on the child’s age and growth expectations
- As prescribed by the physician , the child may be instructed to follow the dietary guidelines .
- Dietary intake should include three well balanced meals per day, eaten at regular intervals , plus a midafternoon snack and a bedtime snack; a consistent intake of the prescribed protein, fats, and carbohydrates at each meal and snack is needed
- Instruct the child and parents that the child should carry a source of glucose to treat hypoglycemia if it occur
- Allow the child to participate iin making food choices to prevent sense of control.
1. Instruct the child in dirtary adjustments when exercising.
2. Extra food needs to be consumed for increased activity , usually 10 to 15 g of carbohydrates for every 30 to 45 minutes of activity.
3. Instruct the hild to monitor the blood glucose level before exercising
4. Plan the appropriate exercise regimen.