Features of hypo- and hyperglycemia in children

A child with diabetes mellitus often experiences certain individual feelings when the amount of sugar in the blood rises and falls. Hypoglycemic coma occurs as a result of a sharp

and a sudden drop in blood sugar levels, an insulin overdose or an inadequate intake of food after an insulin injection.

AT HYPOGLICEMIA:

• the child becomes pale, becomes sluggish and may be on the verge of losing consciousness;

• behaves differently than usual, can quiet down, subside or, conversely, become aggressive;

• It can be shaken;

• the child sweats profusely, but his skin is cold;

• the child's breathing often becomes frequent, superficial and intermittent, but there will be no smell of acetone;

• Nausea or headaches often occur;

• the child will have some confusion - not always correctly answers the simplest questions.

If during this period the child is not given anything sweet( preferably in the form of drinking), then he can lose consciousness and develop all the signs of hypoglycemic coma.

If you notice a number of signs indicating hypoglycaemia in your child, you should immediately do the following:

• Give him a piece of sugar, a drink with glucose( or a tablet with glucose) or any other sweet food. When the condition improves, give him sweets repeatedly;

• After the condition has improved, show the child to the doctor and find out why his condition worsened, whether the dose of insulin should not be revised;

• In case of unconsciousness, first check

for the airway of the child, and if breathing stops, start making artificial respiration;

• at the same time, ask someone to call an ambulance urgently. At a call it is necessary to inform, that at the child a hypoglycemic coma;

• at the appearance of the first signs of child hypoglycemia, you can not leave one at school or at home for a minute!

HYPERGLICEMIA in a child also has its own characteristics. Diabetic coma( hyperglycemia) develops in children with late diagnosis and lack of the necessary therapeutic care at the onset of the disease. Also in its occurrence, factors such as violations of the regime, emotional overloads, and the associated infection can play a role. Symptoms of diabetic coma in the child:

• the child often visits the toilet;

• the skin becomes hot to the touch, the face "burns";

• it becomes sluggish and sleepy;

• complains of poor health;

• the child constantly complains of thirst;

• nausea and vomiting appear;

• the smell of a child's breath is like the smell of acetone or rotting apples;

• breathing becomes frequent and shallow.

If at this time the child is not helped, then he

will lose consciousness and the state of hyperglycemic coma will come.

When the first signs of hyperglycemia appear, the following measures should be taken:

• ask the child if he has not eaten what is not allowed;

• Find out if an injection of insulin is made;

• show the child to the attending physician;

• If the child is unconscious, check the airway patency and make sure that the breathing is normal;

• If breathing has stopped, immediately start mouth-to-mouth resuscitation;

• You must urgently call an ambulance. When calling, you need to say that, perhaps, the child has a diabetic coma.

Treatment of diabetes in children should be comprehensive, with the mandatory use of insulin and diet therapy. Treatment should provide for not only facilitating the course of the disease, but also ensuring proper physical development. Food should be close to the age physiological norm, but with the restriction of fat and sugar. The use of full-value carbohydrates should be limited. With an increase in the liver from the diet of the child, it is necessary to exclude all sharp and fried dishes, the food should be cooked for a couple. The daily dose of insulin is determined strictly individually, taking into account daily glycosuria. The daily dose of insulin, prescribed for the first time, can easily be calculated by dividing the daily loss of sugar in urine by five. All changes in the appointment of insulin dosage should only be done by an endocrinologist.

After the disappearance of the symptoms of coma, appoint coffee, tea, rusks, broth, mashed apple, minced meat, fruit juices. Gradually switch to a full-fat diet with a restriction of fat. With the

clinical compensation, one can transfer the patient to a combined treatment with the use of prolonged-action insulin.

When hypoglycemia, the patient is given sugar syrup, tea with white bread. If the symptoms of hypoglycemia do not disappear, the patient should be administered intravenously a 40% solution of glucose.