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Hello,
I am Dr. Jagruti Parikh practicing Endocrinologist, concentrating on diabetes and thyroid in Mulund and Thane at Om Diabetes Research Centres.
Today I am going to talk on diabetes in childhood, there are two types of childhood diabetes in childhood one is Type 1 and one is Type 2. Previously we thought Type 1 is the only or the most commonest variety of diabetes in childhood well the presentation is normally excessive hunger, excessive thirst, excessive urination children going to washroom very frequently in the school that is the commonest complaint. Bedwetting ends around child sleeping area or ends around child playing area, falling frequently sick or requiring medical attention very frequently are the commonest presentation of Type 1 Diabetes in children. The other variety that is what we see now very often in last 10 to 15 years is the Type 2 variety which was not seen 15 years back. Why sudden change, the changes because of change in Lifestyle in last 10 to 15 years and as a change in Lifestyle that means there is a change in eating habits children are eating more junk food, a fast food they need to make they need to serve food with a lot of preservatives and food with a lot of processing. In addition to that there is lack of daily routine exercise, increase in sitting timing or increase in the tuition timings, lack of external sports activity, more concentration on TV, television, computer games, mobile games all that reducing the regular activities or exercise in day to day life of children resulting into the insulin resistance, obesity and resulting into Type 2 diabetes or term which we face diabesity. Many times in Type 2 diabetes presentation is not similar to Type 1 diabetes that means very often, it is very very difficult for parents or doctors to suspect that because most of the time the investigations are done are CBC, urine routine or subjective relation testing. However, if blood sugar fasting post lunch is also including in the children who are having a frequent sickness, frequent illness or acquiring medical attention very regularly then possibilities said that this Type 2 diabetes can be detected earlier in absence of classical symptoms of diabetes. How to differentiate whether a child is having Type 1 Diabetes or Type 2, there are some special investigations done which can rule out whether the child is having Type 1 Diabetes or type 2. This investigation is C peptide, serum insulin testing, anti-insulin antibody test and Islet Cell antibody test, these are the test which is very common in Type 1 Diabetes and sometimes you can extract history of childhood measles, mumps rubella or somewhere infection in early childhood. So if a child is a sonography or CT scan of the abdomen is normal and one of this parameter that is C- Peptide or serum insulin levels are abnormal then the possibility of Type 1 Diabetes is there and it can be confirmed by doing additional testing. But if a sonography or a CT scan of the abdomen is normal and blood sugar fasting, PP are abnormal and C peptide levels are normal then in that situation we usually label that child to having Type 2 Diabetes and this Type 2 Diabetes can be treated with Lifestyle modification and if required oral antidiabetic drugs and sometimes even insulin can be given for a short period. However, if a diagnosis is Type 1 Diabetes then probably these children are required insulin lifelong at least as on today. So today I have discussed the presentation of Type 1 Diabetes and type 2 diabetes in early childhood, how to investigate and diagnose and what are the different modalities of treatment.
If you wish to know further you can log on to Lybrate.com or you can contact me through lybrate.com.
read moreDoctor in Om Diabetes Research Centres& Clinics (Thane)
Services
Prevention & Treatment of Diabetes
Treatment of Thyroid Disorders
Treatment of Sexual Dysfunction
Diet Planning
Management of Obesity and related Disorders
Diabetic Diet Counseling
Adult Diabetes Treatment
Nutritional Assessment
Treatment Of Foot Infection
Treatment of Metabolic Disorders
Treatment Of Childhood Diabetes
Gestational Diabetes Management
Treatment of Maturity Onset Diabetes of the Young
Treatment of Ketosis-prone Diabetes Mellitus
Childbirth Education
Treatment of Hyperlipidaemia
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Cushing’s syndrome occurs due to abnormally high levels of the hormone cortisol. This can happen for a variety of reasons. The most common cause is overuse of corticosteroid medications.
Causes:
Your adrenal glands produce cortisol. It helps with a number of your body’s functions, including:
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regulating blood pressure and the cardiovascular system
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reducing the immune system’s inflammatory response
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converting carbohydrates, fats, and proteins into energy
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balancing the effects of insulin
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responding to stress
Your body may produce high levels of cortisol for a variety of reasons, including:
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high stress levels, including stress related to an acute illness, surgery, injury, or pregnancy, especially in the final trimester
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athletic training
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depression, panic disorders, or high levels of emotional stress
The most common cause of Cushing’s syndrome is the use of corticosteroid medications, such as prednisone, in high doses for a long period. High doses of injectable steroids for treatment of back pain can also cause this syndrome.
Other causes include:
-
a pituitary gland tumor in which the pituitary gland releases too much adrenocorticotropic hormone, which is also known as Cushing’s disease
-
ectopic ACTH syndrome, which causes tumors that usually occur in the lung, pancreas, thyroid, or thymus gland
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an adrenal gland abnormality or tumor
Symptoms of Cushing’s Syndrome:
The most common symptoms of this condition are:
- weight gain
- obesity
- fatty deposits, especially in the midsection, the face and between the shoulders and the upper back (causing a buffalo hump)
- purple stretch marks on the breasts, arms, abdomen, and thighs
- thinning skin that bruises easily
- skin injuries that are slow to heal
- acne
- fatigue
- muscle weakness
- increased thirst
- increased urination
- bone loss
- depression
- an increased incidence of infections
Women may also notice extra facial and body hair, as well as absent or irregular menstruation.
Men may also have:
- erectile dysfunction
- a loss of sexual interest
- decreased fertility
Children with this condition are generally obese and have a slower rate of growth.
Diabetes is a chronic condition where glucose level of your body rises too high. There are two types of diabetes type 1 and type 2. In case of type 1 diabetes, the body fails to produce insulin and people suffering from this condition have to depend on insulin injections for the rest of their life. In case of type 2 diabetes the body produces less amount of insulin which is not enough for the proper functioning of the body. This type of diabetes can be kept under control by following a healthy diet and practicing exercise regularly.
Why diabetic wounds can cause severe problems?
Diabetes can cause a number of complications that makes it harder for certain wounds to heal. These include:
- Nerve damage: Until a cut or blister worsens and becomes inflamed, in case of neuropathy, you will not experience the pain. Diabetics often suffer from neuropathy, making it difficult for wounds to heal.
- Weak immune system: A minor wound may even get severe and become infected if your immune system fails to exercise its natural defenses.
- Narrow arteries: Blocked arteries may cause severe wounds which becomes difficult to heal. Clogged arteries make it difficult for the blood to flow to the affected area which slows the process of wound healing.
Treating a diabetic wound
You can follow the methods mentioned below to avoid getting infected:
- Taking care of the wound immediately. If the wound is not cleaned and taken care of, letting bacteria to build up, it can lead to infection.
- Avoid using soaps and hydrogen peroxide to irritate the injury. Use antibiotic lotions to prevent infection and use a sterile bandage to keep the affected area covered.
- Consult your doctor before any minor problems turn to larger ones
- Since the bottom of the foot is a common place for developing blisters and calluses in case of diabetic people, try to keep pressure off the wound as it slowly heals
Preventive Diabetology:
Health care is not just about telling patients what to do, it is about truly engaging them.
Providing them smart communication so that they can closely monitor them selves - this will unable early diagnosis of health issues through constant monitoring, before they become more serious.
The idea of maintaining people's well being rather then reacting to an episode makes sense.
It is not communication for sick care but it is communication for care so that you don't fall sick.
These communications will help in better continuum of care, further bridging the gap between the patient and doctor. The aim is to proactively keep people well rather than react when they become ill.