Diabetes mellitus (pediatrie)

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Diabetes mellitus (DM) is a set of symptoms that includes multiple nosological units.

Characteristic symptoms include: hyperglycemia, glycosuria, absolute or relative lack of insulin, risk of late complications due to chronic hyperglycemia.[1]

Diagnostic criteria of DM
  • typical symptoms of diabetes (polyuria, polydipsia, weight loss) and at the same time venous glucose ≥ 11.1 mmol/l at any time during the day;
or
  • fasting blood glucose ≥ 7.0 mmol/l;
or
  • blood glucose ≥ 11.1 mmol/l at the 120th minute oGTT (oral glucose tolerance test).[1]
Main symptoms of diabetes

The most serious acute complication of diabetes is diabetic ketoacidosis - as a result of an absolute or relative lack of insulin, fatty acids are used as a substitute source of energy (ketogenesis):

  • pH < 7.30 or HCO3– < 15 mmol/l with hyperglycemia > 12 mmol/l and ketonemia/ketonuria.[1]


Types of diabetes in children and adolescents[edit | edit source]

Milder forms of the disorder:

  • impaired glucose tolerance: blood glucose 7.8 – 11.0 mmol/l at the 120th minute oGTT;
  • increased fasting blood glucose': fasting blood glucose 5.6 – 6.9 mmol/l.


Polygenically determined types of diabetes:

  • diabetes mellitus type 1 – autoimmune destruction of β-cells;
    • the most severe form of diabetes;
    • vitally dependent on insulin treatment (insulin-dependent);
    • the predominant type of DM in children, adolescents and young adults.
  • diabetes mellitus type 2
    • typical disease of adults and elderly;
    • associated with excess weight and rising insulin resistance (insulin-independent), which the own insulin secretion cannot overcome.


Monogenically determined types of diabetes:

  • MODY (maturity-onset diabetes of the young)
  • neonatal diabetes
  • diabetic syndromes
  • diabetes mellitus associated with cystic fibrosis


Secondary diabetes: It is caused by the overproduction of certain hormones or pharmaceuticals; rare in children.[1]



References[edit | edit source]

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References[edit | edit source]

  1. ↑ a b c d LEBL, J – JANDA, J – POHUNEK, P, et al. Clinical Pediatrics. 1. edition. Galen, 2012. 698 pp. pp. 208-215. ISBN 978-80-7262-772-1.
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