Juvenile Diabetes

Definition

Juvenile diabetes is a type of diabetes characterized by high blood sugar level due to insufficient insulin. It usually affects children and young adults, however, it can occur in age group. It is also known as type 1 diabetes and insulin-dependent diabetes mellitus (IDDM). There are various reasons why the insulin-producing cells may be destroyed thereby reducing the insulin present in the body.

Common symptoms are increased thirst, hunger and increased urine production. Long-term patients may develop number of complications due involvement of various organs like heart, peripheral nerves, kidney and eyes. Insulin is the main drug used for treatment. Regular exercise and dietary modification is also recommended. Juvenile diabetes is not curable.

Symptoms

The classical symptoms of diabetes mellitus, type 1 or 2, includes :

  • Increased hunger (polyphagia)
  • Increased thirst (polydipsia)
  • Increased urination (polyuria)

Other common symptoms that may be seen includes :

  • Extreme lethargy
  • Sudden weight loss despite increased appetite
  • Blurred vision
  • Diminished sense of taste, smell and touch

Untreated juvenile diabetes may progress to a coma (diabetic ketoacidosis) due to high blood sugar levels. Symptoms include :

  • Rapid, deep breathing
  • Fruity odor in breath
  • Flushing of face
  • Abdominal pain
  • Nausea and vomiting
  • Dryness of skin
  • Confusion and disorientation may first arise before it progresses to a coma.

Long term complications of untreated juvenile diabetes are :

  • Heart diseases like angina pectoris (cardiac chest pain), ischemic heart disease,  heart failure or a heart attack (myocardial infarction) due to narrowing of blood vessels by lipid deposits.
  • Brain stroke may occur due to poor supply to the brain.
  • Peripheral neuropathy is impaired function of nerves due to narrowing of blood vessels supplying the nerves. Common symptoms are gradually upward progressing tingling, numbness, pin pricking sensation in the hands and feet.
  • Reduced sensation at foot may lead to unnoticed injury and ulceration. Again raised blood sugar level may lead to persistent infection of the ulcer, ultimately the ulcer become chronic and non-healing (diabetic foot). Severe cases of diabetic foot may require amputation of the limb.
  • Kidney failure (diabetic nephropathy) may occur due to compromised filtering capacity in long standing cases.
  • Frequent oral infectiona by bacteria and yeasts.
  • Weakening of bones (osteoporosis).
  • Blindness may occur due to inadequate blood supply to retina (diabetic retinopathy).

Causes

Insulin, secreted from the pancreatic beta cells, is the main hormone in glucose metabolism. It facilitates glucose absorption in the digestive tract, enhances utilization of glucose by various cells, enhances storage of glucose as glycogen in liver and muscles and inhibits production of glucose in liver (neoglucogenesis). Simple it reduces blood glucose levels when it is too high in the bloodstream.

In type 1 diabetes the pancreatic beta cells are destroyed by :

  • Viral infection.
  • Autoimmune reaction, when the immune system of the body wrongly attacks the pancreatic beta cells and destroys it.

Risk factors

  • Family history of type 1 diabetes.
  • Viral infection by Coxsackie virus or cytomegalovirus (CMV).
  • Timing of introduction of cereal in a baby’s diet.
  • Jaundice immediately after birth.
  • Respiratory infection immediately after birth.

Treatment

Insulin is the drug of choice for treating juvenile diabetes. There are number of different insulin preparations that are used, such as :

  • Rapid acting
  • Intermediate acting
  • Long acting

Insulin is given via subcutaneous injections for regular use and for emergency purpose like in diabetic ketoacidosis it may be given via the intravenous route. Dietary modification and regular exercise are the other options for treating juvenile diabetes.

 

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