Monthly Archives: May 2014

Could my child have Diabetes ?

Diabetes in Children

     signs

Diabetes Mellitus (DM); name itself is  fearful and more so if in context to children. It is a metabolic disorder with high blood sugar level. Major Symptoms are increased urination, increased thirst and hunger. Insulin is the only way by which body can use sugar. If insulin decreases sugar rises.

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4 types: three most common types are type 1, type 2, and gestational diabetes. 4th is due rare genetic disorders

Most common in children is DM type 1 (Insulin dependent, IDDM or Juvenile diabetes).

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Type 1DM:

 

It is an autoimmune disorder in which body starts to destroy its own cell (beta cells of pancreas that makes insulin). Pancreas loses its ability to produce Insulin.

Type 1 is less common than type 2 DM.

2 main factors: genetics and the environment (certain viruses, toxins which can trigger autoimmune response).

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Type 2 DM:

 

More common in adults but nowadays seen in children too.

Pancreas still makes insulin but is not effective (Insulin resistance)

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It is hard to diagnose in adolescent; as some cases are asymptomatic.

Lifestyle changes (which are leading to unhealthy gain in weight) like

  • Decrease physical activities
  • More screen time
  • Fast food

It can be managed with Exercise and change in diet but in some cases medicine or Insulin injections are needed.

Gestational DM is diabetes that develops during pregnancy.

 

SYMTPOMS:

symptoms-of-diabetes

 

Chart is depicting few signs and symptoms of adults too.

Early

  • frequent peeing (urination) in large amounts (polyuria)
  • increase in thirst (polydipsia)
  • dry mouth or throat
  • weight loss
  • increase in appetite (polyphagia)
  • feeling tired or weak
  • diaper rash that doesn’t improve with medicated cream

s,s

Late

  • weight loss
  • stomach aches
  • nausea and vomiting
  • heavy, rapid breathing (Kussmaul breathing)
  • drowsiness

 

Diagnosis:

Random Blood sugar level > 200mg/dl

Urine test for ketones

It will need further evaluation under guidance of child specialist or Pediatric endocrinologist.

Complications:

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Life changes full circle at the time when diagnosis is confirmed. 

Coping with the diagnosis is also difficult to start with as parents are in denial /shock. It usually is followed by sadness/fear/anxiety. Some will have feeling of guilt and some will have anger.

diabetespic

Parents (and children as well):

  • Need to learn the skills needed to take care of child (injection insulin, measure blood sugar at home etc)
  • Face Emotional Disturbance
  • Life style changes (dietary changes, need to count calories.)

 

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Treatment

Aim:

  • Maintain the blood sugar level as close to normal as possible at all times to avoid complications.
  • Coping well with disease and trying to have a healthy and productive life.

 

Basic treatment of type 1 diabetes:

  • Insulin ( via injections or pump)
  • Balanced meal with help of dietician
  • Monitoring of blood sugar levels
  • Regular check up

Nursing Intervention Nursing Care Plan for Children with Diabetes Mellitus

 

Basic Treatment Type 2 diabetes:

What-causes-diabetes

  • Healthy Lifestyle
  • Increased physical activity
  • Balanced food
  • Weight loss
  • In some cases medications

 

Dietician: Proper Meal plan is needed to have a calorie count.

Guidelines_for_Treating_Type_2_Diabetes_in_Kids_

Growth and Development should not be affected and child should be able to live a healthy life.

prevention at school

School life should also be not affected.

For any queries refer to your child specialist or Pediatrics endocrinologist. Feel free to contact Maya Clinic .

Regards

Dr Rahul varma

“Healthy Kids, Happy Family”

  

Thalassemia in children

Thalassemia

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Overview:

It is genetic disorder of blood in which abnormal Hemoglobin is made leading to decrease in oxygen carring capacity of red blood cell.  RBC (red blood cells) are destroyed at faster rate leading to anemia and need for repeated blood transfusion.

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This inherited disorder is carried in genes and passed on from one generation to next generation. People who are Carrier may have no disease but when both parents are carrier, it can pass on to children.

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2 types of Thalassemias are there: Alpha and Beta.

We will discuss beta thalassemia in detail.

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There are 3 types of beta thalassemia.

  1. Beta thalassemia minor, or beta thalassemia trait, happens when one of the beta globin genes is mutated. Milder form, usually needing no treatment
  2. Beta thalassemia major (Cooley’s anemia) happens when both of the beta globin genes are mutated. Most Serious and can be life threatening if repeated blood transfusion not given
  3. Beta thalassemia intermedia may also occur when both of the beta globin genes are mutated, but less severe. Usually moderate symptoms and sometimes need blood transfusion.

Symptoms:

13Beta Thalassemia Signs Symptoms Treatment

Common symptoms of beta thalassemia include:

  • fatigue, weakness, or shortness of breath
  • a pale appearance or a yellow color to the skin (jaundice)
  • Anemia
  • Poor growth
  • irritability
  • deformities of the facial bones
  •  abdominal swelling (liver and spleen enlarged)
  • Delayed puberty
  • Repeated infections

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Diagnosis

CBC, Hb Electrophoresis

Prevention:

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Both parents should be tested for Thalassemia before or during early pregnancy. If both parents are carriers of the beta thalassemia disorder, doctors will need to conduct more tests on a fetus before birth(CVS / Amniocentesis).

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People who carry beta thalassemia genes should seek Gentic counseling, if they’re considering having children.

 

Treatment

Children with Thalassemia major require life-long , ongoing medical care which include blood transfusions.

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Standard Treatment:

  • Repeated Blood Transfusions
  • Iron Chelation Therapy
  • Floic acid supplements

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Cure:    Stem cell Transplant with HLA matched donor

Future:  Gene Therapy

Research is going on. It may be possible to insert normal hemoglobin gene into stem cells in bone marrow. This will allow children with thalassemias to make their own healthy red blood cells and hemoglobin.

get-yourself

Regards

Dr. Rahul Varma

www.mayaclinic.in

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