Diabetes in Children: Symptoms and Diagnostics

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Introduction

Due to the fact that diabetes is most frequently met in people over 65, there is a common delusion that it can be classified as an age-related disease. However, more than 200,000 children and adolescents in the United States currently have the same diagnosis (Hamilton, Knudsen, Vaina, Smith, & Paul, 2017). The situation is exacerbated by the rising obesity level in American children.

Until recently, children and adolescents were mostly diagnosed with type 1 diabetes, which was supposed to be juvenile. Yet, the situation has changed dramatically during the last decade. Now, due to the problem of obesity and inactivity, children also get type 2 diabetes (the incidence of which has increased by 30,5% since 2009) (Hamilton et al., 2017). This risk is typically attributed to Hispanic, African, Asian, and other minority groups.

Children with this diagnosis are likely to enter adulthood with an increased risk of developing other conditions. The major problem is connected with researchers inability to detect the disease at an early stage. Thus, innovative diagnostic tools are required to address the problem.

Overview of the Disease

Type 1 diabetes occurs owing to the inability of the pancreas to produce sufficient amounts of insulin and accounts for 5-10% of all cases of diabetes. Although the cause of this condition has not been identified, it is believed by many scholars that it has a genetic component. The lack of insulin prevents the transportation of sugar to cells and leads to its accumulation in the blood. Children having type 1 diabetes need lifelong injections of insulin accompanied by a healthy diet and physical activity to prevent critical levels of glucose in their blood (Craig et al., 2014).

Type 2 diabetes is diagnosed when insulin production is reduced and the hormone cannot work properly. This leads to sugar accumulation in the bloodstream (Hamilton et al., 2017). Although in most grave cases medications may be required, the condition can generally be managed through proper nutrition and exercise.

Symptoms of Diabetes in Children

Both types of diabetes have practically the same symptoms in children: fatigue, excessive urination, thirst, blurred vision, and increased hunger (some girls may also get a yeast infection). However, there are certain differences. For instance, those with type 1 diabetes typically lose weight before being diagnosed. The condition develops rapidly (usually within 2-3 weeks). Type 2 diabetes has more symptoms, including but not limited to acanthosis nigricans (dark patches of skin), insulin resistance, and polycystic ovarian syndrome. The development of the disease is much slower (Hamilton et al., 2017). This is the major reason type 2 diabetes often goes undiagnosed for a long period of time (from several months to several years).

The Importance of Early Detection

According to statistics, only 10-15% of parents are capable of detecting the major symptoms of diabetes (of both types). The importance of early detection is supported by the fact that a lengthy delay in diagnosis may turn out to be fatal for children. Such kids can develop diabetic ketoacidosis (DKA), which is one of the major causes of mortality in the case of type 1 diabetes. A significant lack of insulin leads to the inability of the body to use glucose for energy, which makes it break down fat. As a result, toxic chemicals (ketones) are produced, making the body acidic, and leading to the appearance of DKA. Another factor increasing the importance of early detection is a rapid progression of the disease at an early age, which is fraught with eye and kidney complications, high cholesterol levels, and elevated blood pressure (Craig et al., 2014).

The Role of Nurses

Nurses play a crucial role in educating both children and their parents on early detection and treatment methods. That is why they must remain updated on the most relevant diagnostic tools to be able to make a recommendation. Each separate case must be approached on an individual basis. In order to choose an appropriate method of education, the nurse must take into consideration a number of factors, which include: the childs age, family support, social background, IQ level, and current awareness of the issue (Wong et al., 2017). The major purpose of education for children is to make them independent in managing their condition as their age allows. As for parents, they must be informed about diet options, physical activity requirements, and diagnostic methods.

Innovative Diagnostic Tool

The KRONUS Zinc Transporter 8 Autoantibody ELISA assay is a new diagnostic tool that makes it possible to distinguish between the types of diabetes. This is done through the detection of ZnT8 antibodies (the insulin secretory granule zinc transporters, produced by the SLC30A8 gene) in the patients bloodstream. Since these antibodies are present exclusively in those who suffer from type 1 diabetes, the test increases the accuracy of type 1 diabetes diagnosis in children. It was proven in the course of clinical studies that it managed to detect the condition in 65% of cases. The number of errors did not increase by 2% (Gomes et al., 2017). It is crucial to integrate this test into practice since it will decrease the number of children with a wrong diagnosis. This measure can be supported by care and educational institutions (kindergartens and schools) and be made a part of a required medical examination.

References

Craig, M. E., Jefferies, C., Dabelea, D., Balde, N., Seth, A., & Donaghue, K. C. (2014). Definition, epidemiology, and classification of diabetes in children and adolescents. Pediatr Diabetes, 15(20), 4-17.

Gomes, K. F. B., Semzezem, C., Batista, R., Fukui, R. T., Santos, A. S., Correia, M. R.,& da Silva, M. E. R. (2017). Importance of Zinc Transporter 8 Autoantibody in the diagnosis of type 1 diabetes in Latin Americans. Scientific Reports, 7. Web.

Hamilton, H., Knudsen, G., Vaina, C. L., Smith, M., & Paul, S. P. (2017). Children and young people with diabetes: Recognition and management. British Journal of Nursing, 26(6), 340-347.

Wong, F. K. Y., Lau, A. T. Y., Ng, R., Wong, E. W. Y., Wong, S. M., Kan, E. C. Y.,& BryantLukosius, D. (2017). An exploratory study on exemplary practice of nurse consultants. Journal of Nursing Scholarship, 49(5), 548-556.

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