How to recognize and control ketoacidosis in children with diabetes

How to recognize and control ketoacidosis in children with diabetes

What is ketoacidosis, the alarm bells that should not be overlooked, why it occurs and how to get to the diagnosis

Great heat. Humidity sky high. In the city, in the countryside and by the sea, getting around becomes a chore. But it is obviously impossible to stop the little ones who want to play and jump. And that for this reason, thanks to the climate and the increase in sweat production with alteration of blood fluids, their blood sugar regulation systems can be altered, with repercussions when obviously they suffer from diabetes.

The danger in these cases is called ketoacidosis. Regularly checking the blood sugar with continuous monitoring devices can be of great help in these cases, obviously on the advice of the diabetologist, in order to avoid major problems. And above all, if there are any alarms, here's how to recognize them.

What to pay attention to in the child

Type 1 diabetes is linked to an alteration of the immune defenses, which can appear after a viral infection and recognizes a marked genetic predisposition. The body's defensive cells, by mistake, attack the cells of the pancreas that produce insulin and destroy them. The body no longer produces insulin and therefore has to take it from the outside. It mainly affects young people and children.

There are some important alarm bells that a parent must always keep under control, especially in the summer season. By exercising more, babies are more tired, thirsty and pee more. These are the very first suspicious signs for a diagnosis of diabetes but at the same time they are also the effects of heat and physical activity.

If action is not taken immediately, ketoacidosis appears which is a complication due to the delay in diagnosis. To avoid false alarms, it is therefore necessary to activate due checks if other symptoms occur.

“These are small tricks, easy to put into practice but absolutely predictive – explains Valentino Cherubini, Director of the Departmental Organizational Structure of Pediatric Diabetology at the Ospedali Riuniti in Ancona. In summer, it is normal for a child to drink more, pee more, and be more tired than usual, so it is unthinkable that the alarm of suspected diabetes could be triggered in this way. Instead, I suggest keeping an eye on whether there are other symptoms among the baby's changes, including severe bad breath, stomach ache, difficulty breathing, sudden weight loss and hunger. They do not necessarily have to be all at the same time, because 2 or 3 of these will be enough to better investigate. Early diagnosis of diabetes in children also protects them from a variety of adult complications. Suffice it to say that a single episode of diabetic ketoacidosis (which occurs when the pH of the blood drops below 7.30 and becomes severe when it is below 7.1) can cause permanent damage, in particular on the cognitive sphere ".

It is important to arrive at the diagnosis

If there is a suspicion of diabetes, the first response, immediate and painless, comes from simple sticks available in pharmacies. "It is clear and normal that children drink more in the summer and sometimes the increase in water demand is underestimated – reports the expert. It is even more important that parents know how to take immediate action to confirm or nullify the suspicion of diabetes. In addition, the heat and dehydration require faster intervention to restore the hydroelectrolytic balance. If diabetes is suspected, the prescription of blood and urine tests can delay the diagnosis. If in doubt, the first precaution is to go to the pharmacy for a blood glucose measurement with a stick or take a stick on the urine to check if there is glucose "

Of the 150 thousand Italians with diabetes, about 11 thousand are under 15 forced to manage a disease that will accompany them in life. This is a number to be multiplied by the number of non-stop parents who have to take charge of the disease, especially concerned about what happens and will happen outside the home (at school, in sports activities, at parties with friends). The technological evolution of very small devices, without external and waterproof tubes, is proving to be a valid support for better diabetes management from the tender age of 2.

The certainty of the data and the safety of precise therapeutic interventions have made both the continuous blood glucose meter and the insulin infuser (Dexcom G6 and Omnipod distributed in Italy by Theras) two technological successes.

This is confirmed by various data conducted by the diabetes study group of the Italian Society of Pediatric Endocrinology and Diabetology-SIEDP (1). The study, which will be presented at the next National Congress, analyzed the clinical data of children under 15 from 40 Italian pediatric diabetes centers in the period 2017-2020, for a total of 3230 children. The results indicate that the increase in the diagnosis of diabetes with ketoacidosis increased by more than 9% during the months of the lockdown and remained above 5% for the rest of 2020.

"From this worrying data it is deduced – intervenes Valentino CHERUBINI, Director of SOD (Departmental Organizational Structure) of Pediatric Diabetology at Ospedali Riuniti in Ancona – that many children have received the diagnosis of diabetes late and indicates the need to devote more energy to prevention".

"The blood glucose trend of a child with type 1 diabetes is very difficult to predict, but thanks to the latest technology of CGM (continuous glucose monitoring, that is, continuous glucose monitoring in real time) it is possible to have a very high level of prediction. high, precise and safe. This generates a reassuring effect on patients who have become more aware and ready to intervene in the face of a real need generated by the sound of the alarm.

In the case of the youngest – concludes Cherubini – the success of a measurement that is always correct also impacts the health of the parent, relieved of the fear of having to rush to give instructions or intervene directly when it is not necessary. All patients, including the youngest, will also be able to make therapeutic decisions without comparing the data with what they obtained by pricking their fingertip. This is an important step, unique up to now and recognized by the FDA ".

Tag: Children Diabetes

Category: Health
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