Diabetes.

Diabetes mellitus in children: developmental features and clinical picture

Diabetes mellitus (diabetes mellitus) is a chronic disease characterized by elevated blood sugar levels due to insufficient production or ineffective use of insulin. In children, diabetes mellitus can develop relatively acutely and have a severe, progressive course. This is due to the peculiarities of metabolic regulation, intensive growth of the body and a high level of metabolic processes.

Early signs of diabetes in children are polyuria (frequent urination) and polydipsia (excessive thirst). In young children, polyuria may be mistakenly considered to be bedwetting. After drying, the skin becomes hard, as if starched. Children excrete a large amount of urine (from 3 to 6 liters per day), its density is increased (more than 1020), and in most cases the urine contains sugar and acetone.

The tendency of children to ketosis (the formation of ketone bodies in the body) explains the high frequency of ketonemia and the rapid development of diabetic coma. One of the severe manifestations of diabetes mellitus in children is Mauriac syndrome, which is characterized by significant growth retardation, hypogonadism (insufficient development of the gonads), enlarged liver, ketosis, hyperlipidemia (increased levels of fats in the blood) and obesity.

When carrying out insulin therapy in children, hypoglycemic coma may develop more often than in adults, caused by metabolic instability, anorexia and insufficient food intake after insulin administration.

Diabetic vascular lesions, glomerulosclerosis with renal failure (Kimmelstiel-Wilson disease), retinopathy (damage to the retina) and cataracts are late consequences of diabetes mellitus that are rarely observed in children.

In children with a family history, physiological changes during growth and puberty, as well as neuroendocrine changes, can contribute to the manifestation of genetically determined metabolic disorders and the development of diabetes. Obesity, which is closely associated with diabetes, may precede the disease itself. It is important to note that diabetes in children can be either type 1 or type 2.

Type 1 diabetes in children usually develops as a result of an autoimmune process in which the body's immune system attacks and destroys the cells in the pancreas responsible for producing insulin. This type of diabetes is often di