Diabetes has become a real epidemic of the 21st century.Therefore, the Spanish Diabetes Society (SED) wants to take advantage, which today is celebrated on World Diabetes Day, to attract attention to a disease that increasingly affects children.The motto chosen for this occasion has been eye with diabetes, a slogan with which they report on the impact of this pathology on the risk to develop in the future diseases such as diabetic retinopathy (RD) or diabetic macular edema(EMD).
The Spanish Diabetics Federation (FEDE) indicates that, currently, in our country there are around 15,000 children below 15 years with diabetes and about 30,000 cases between 15 and 25 years, figures to which the 1,200 new new ones joincases that are declared every year.Although 90% suffer from type 1 diabetes, caused by a mechanism of the organism itself that causes the destruction of cells that produce insulin, which worries experts is the increase in type 2 diabetes at these early ages.
Diabetes is a chronic disease that occurs when the pancreas does not generate sufficient insulin (hormone responsible for regulating blood glucose level) or the body does not use it effectively.If it is not controlled, the consequence will be hyperglycemia, that is, a disproportionate increase in blood sugar.Sedentary lifestyle, overweight and genetic component are the three key factors in the appearance of diabetes.Spain is among the first countries with the most overweight or childhood obesity, already affecting 25% of children, which entails an increased risk of suffering from type 2 diabetes and all associated cardiovascular problems.
Jesús Argente, researcher and head of the Pediatric and Pediatric Endocrinology Service of the Niño Jesús University ChildrenWith insulin.This data is very important to differentiate it from type 2 diabetes, which suffers above all the adult, but not exclusively, and that develops due to a problem of insulin resistance that is essentially treated with diet, exercise and when necessary with treatmentsoral hypoglycemic. ”
Argente adds that now, in addition, two new forms of diabetes have appeared on stage: Modly type diabetes (Matury Onset Diabetes of the Young) or diabetes of the mature age that is presented in the young man and neonatal diabetes.In relation to the first, according to Argente, “it is a type of diabetes that, in principle, would resemble type 2 diabetes that starts in maturity but appears below 25 years.In this case, seven different types of diabetes are differentiated associated with mutations in 7 specific genes. ”As for the second, Jesús Argente continues, “appears in one in every 400 thousand births and is presented in the first six months of life.Its duration is brief, it does not usually exceed 15 days, and it is important to highlight that it is insulin-dependent, that is, it must necessarily apply insulin to the baby to achieve its control.This diabetes appears due to the mutation of two specific genes and has the particularity, according to the recently carried out research, which can be treated with oral hypoglycemicas instead of insulin. ”
Raquel Barrio, Vice President of the SED and coordinator of the Pediatric Diabetes Unit of the Ramón y Cajal University Hospital, indicates that “there is a clear symptomatology in children and young people who are diagnosed with diabetes, such as: start drinking a lot (Polidipsia), urinating a lot (polyuria), even at night (Nicuria), frequent changes in appetite in general, increasedsame (polyphia) and weight loss.That is why it is called the disease of the four P. At the same time, the child usually feels more tired.If the diagnosis is done late, the patient is very bad, with increased frequency and intensity of breathing, nausea and vomiting, dehydration and can alter consciousness until falling into a coma. ”
Given the diagnosis of diabetes in a child, Dr. Barrio advises that parents receive, from the first moment, a diabetological education in several phases, “so that parents can know how to assess the content of carbohydrates (rations) (portions), to adjust insulin to intake, and know how the exercise in the treatment adjustment influences.This training is taught by pediatric diabetes adapted to each family.It is also necessary to inform the school (teachers and schools).In the case of older children you have to educate them so that they can participate in the control of their diabetes. ”
The role of diabetes educators is essential to teach both children suffering from this disease and their families to achieve adequate metabolic control.In this sense, therapeutic education in diabetes (ETD) is an interactive and progressive process that aims to facilitate the essential knowledge and ability for the patient's self -care, by supporting the person and his family, in order to self -manageHis life with this pathology and achieve the best possible results.
Graciela Porres, nurse in diabetes of the Niño Jesús University Hospital of Madrid, explains that, “when a child debuts (diabetes is diagnosed and initiates insulin treatment), parents express a very large feeling of guilt before the appearance of thedisease.In most cases, within a few weeks they have normalized the new situation without any problem. ”Porres endorses the words of a Swedish author who says that "diabetes must be allowed to enter home like a friend, it must be one more in a day -to -day basis and always go behind the activity that the child develops."
In relation to the role that educational centers must fulfill so that the child who suffers from this disease does not feel "discriminated" by being diabetic, the vice president of SED insists that "the school must facilitate that the child and theTeen with diabetes can keep control of your diabetes.In this way, the collaboration of teachers is required, which must be instructed, and of the schools that exist in Madrid in 20% of the centers ”.This group has just presented its "action guide to type 1 diabetes in pediatric age."Among the actions collected in the manual it is pointed out that “the child with diabetes can and must carry out all the activities similar to those of his classmates but always safely.Therefore it is very important that they can monitor their glycemia, adapt the meals and value the exercise. ”Raquel Barrio recalls that "the treatment of type 1 diabetes requires collaboration between the patient, parents, school, the rest of the family, friends and society, in general."
