Tag Archives: lifestyle modification in children

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.

diabetes-mellitus-type-1

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).

1

Type 2 DM:

 

More common in adults but nowadays seen in children too.

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

patho

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:

comp

 

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”

  

Overweight and childhood Obesity

food         Obesity-Cycle  

Childhood Obesity is a major health problem these days. Initially it was supposed to be disease of western countries and affluent class, but data clearly shows that it is very rampant in middle class families. Main reason as we all know are changing lifestyle with lots of junk food and minimal physical activity. It is important to be in touch with your pediatrician.

Definition: Simplistically, Obesity results from an imbalance of caloric intake and energy expenditure.

BMI (Body Mass index): BMI charts are available which can be used in children > 2years old,

BMI= Weight (in kg)/ Height (in meter)2

Obesity:  BMI more than or equal to 95th percentile

Overweight:  BMI between 85th and 95th percentile

Factors leading to obesity:

child-obesity

  • Enviornmental factors:
    • calorie dense food
    • consumption of processed foods
    • limited physical activity
    • sedentary interests: computers, TV, video games

 

  • Genetics factors also play important role in some cases

Co-Morbidities associated with childhood obesity:

  • Cardiovascular: Dyslipidemia, Hypertension
  • Endocrine: Type 2 Diabetes Mellitus, Metabolic syndrome, polycystic ovary Syndrome
  • Gastrointestinal: Gall bladder disease, Non Alcoholic fatty liver disease
  • Psychosocial effects and stigma
  • Orthopedic complications:  joint pain etc.
  • Respiratory: Sleep Apnea
  • Neurologic:  Pseudotumor cerebri

 

Interventions:

Successful intervention for obesity is challenging and is best accomplished using multimodal approaches to accomplish lifestyle change. In children we do not want rapid weight loss as child is in growing phase and adequate nutritious diet is needed. So it is best to try to retain the same weight or very slow weight loss.

  • Catch them young – school age children must be targeted
  • Do not skip meals especially Breakfast
  • Increase awareness: media; school teachers; governmental and NGO effort
  • Minimise advertising pressure for  “junk foods”
  • School play grounds; “Games periods”
  • Health food in school canteens

Traffic light Diet Plan:

Features Green light food Yellow light food Red light food
Quality Low -calorie, high –fiber, low-fat, nutrient-dense Nutrient-dense, but higher in calories and fat High in calories, sugar and fat
Types of food Fruits, vegetables Lean meats, dairy, starches, grains Latty meats, sugar, fried foods
Quantity Unlimited Limited Infrequent or avoided

  

Conclusion:

  • India is in the midst of an escalating epidemic of life style disorders associated with childhood

obesity.

• The important causes of the epidemic in India appear to be:  unhealthy eating pattern, reduced

physical activity, increased sedentary pursuits .

• Prevention must begin early in the form of a public health campaign directed towards lifestyle

changes of the family / society as a whole. The campaign requires strong social and political will.

• Health professionals must think `prevention of obesity’ at all visits, monitor BMI and ensure that

‘nutrition messages’ are not conflicting and confusing.

• Special strategies for different ages and channels of interventions for prevention of obesity have

been outlined.

• Clinic based individual assessment of the obese child and principles of therapy are provided.

 

For any queries consult your child doctor or feel free to contact Maya Clinic. we will be more than happy to answer all of them.

Regards

Dr Rahul Varma

“Healthy Kids, Happy Family”