DIABETES MELLITUS, INSULIN-DEPENDENT |
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DESCRIPTIONInsulin-dependent diabetes mellitus is a chronic disease of the body's metabolism characterized by an inability to produce enough insulin to process carbohydrates, fat, and protein efficiently. Treatment requires injections of insulin. Insulin-dependent diabetes is often called ketosis-prone diabetes if it begins in adulthood and juvenile diabetes if it begins in childhood. Body parts involved include islet cells of the pancreas that produce insulin and all body cells that need insulin to convert food into chemicals the body can use.
Appropriate health care includes:
Self-care after diagnosis. Self-care is by far the most important part of your child's treatment.
Physician's monitoring of general condition and medications.
Hospitalization for severe complications.
Surgery for treatment of some complications, such as failing eyesight or gangrene.
SIGNS & SYMPTOMS
Fatigue.
Excess thirst.
Increased appetite and weight loss.
Frequent urination, especially noted at night.
Itching around the genitals.
Increased susceptibility to infections, especially urinary-tract infections and yeast infections of the skin, mouth, or vagina.
Deterioration of vision (advanced stages).
CAUSES
Too little insulin produced by the islet cells of the pancreas for unknown reasons.
Interference with insulin use in the body cells for unknown reasons.
Virus infection of the pancreas.
RISK FACTORS
Family history of diabetes mellitus. It often skips one generation.
Pregnancy.
PREVENTING COMPLICATIONS OR RECURRENCECannot be prevented.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory urine and blood studies to measure glucose, cholesterol, and insulin.
POSSIBLE COMPLICATIONS
Cardiovascular disease, especially stroke, atherosclerosis, and coronary-artery disease.
Kidney failure.
Blindness.
Peripheral vascular disease, with gangrene in legs and feet.
Life-threatening hypoglycemia (low blood sugar) if too much insulin is used.
Life-threatening ketoacidosis (very high blood sugar) with breakdown of body cells.
PROBABLE OUTCOME
This disease is presently considered incurable, but symptoms and progress of the disease can be controlled with rigid adherence to a treatment program. Life expectancy is somewhat reduced, but many children with diabetes have a nearly normal life span.
TREATMENT
HOME CARE
Learn all you can about controlling your child's diabetes and recognizing signs and symptoms of ketoacidosis or hypoglycemia.
Keep a vial of glucagon available at all times to use if hypoglycemia occurs.
Learn to give your child insulin injections. At an appropriate time, your doctor will give the child instructions for self-injections. They will be necessary every day for life.
Encourage your child to wear a Medic-Alert bracelet or pendant (See Glossary).
Seek medical treatment for any infection.
MEDICATION
Your doctor will prescribe insulin by injection. The dosage must be individualized and occasionally adjusted.
ACTIVITY
No restrictions. Regular daily exercise for your child is an important part of controlling diabetes. Consult your doctor.
DIET & FLUIDS
A special diet will be prescribed by your doctor.
OK TO GO TO SCHOOL?Yes, when diabetes is under control.
CALL YOUR DOCTOR IF
Your child has symptoms of diabetes mellitus.
The following occurs during the child's treatment:
-- Inability to think clearly, weakness, sweating, paleness, rapid heartbeat, seizures, or coma (may indicate hypoglycemia).
-- Orange odor on the breath, changes in breathing pattern, or stupor (may indicate ketoacidosis).
-- Several days of illness or weakness.
-- Numbness, tingling, or pain in the feet or hands.
-- Chest pain.
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