DIABETES

MELLITUS
TYPE 1
Definition
Type 1 diabetes mellitus is disorder that involves an absolute or relative
deficiency of insulin, which is contrast to type 2, where insulin production is
only reduced. Type 1 is equal to both sex (boys and girls) about 1 out of 500
children or adolescents in the united states.
The disease apparently results from immunologic damage to islet cells in
susceptible individuals. Why autoimmune destruction of islet cell occurs is
unknown, but children with the disorder have a high frequency of certain
(HLA).
Signs And Symptoms:

Increased thirst
Frequent urination
Bedwetting in children who previously didn't wet the bed
during the night
Extreme hunger
Unintended weight loss
Irritability and other mood changes
Fatigue and weakness
Blurred vision
In females, a vaginal yeast infection
Diagnostic Test:

Fasting blood glucose

Random blood glucose

Other Diagnostic Test may include:

Analysis of blood samples for pH

Partial pressure of carbon Dioxide
Sodium and potassium levels
White blood cell count
Gycosylated hemoglobin
Therapeutic Management

Therapy for children with type 1 diabetes involves

five measures:
Insulin administration
Regulation of nutrition and exercise
Stress management
Blood glucose monitoring
Urine ketone monitoring
 Insulin administration

Types of insulin vary as to their time of onset.

The most common mixture of insulin used in the children is

the combination of an intermediate-acting insulin and a
regular insulin.

The advantage of using two different types of insulin is that

the peak effects occur at different times. Because the peak
time of short acting insulins is 3 to 4 hours, the child who
takes insulin before breakfast will notice a maximum effect
between 10am and 12noon. The peak effect period of the
intermediate-acting insulins is 8 to 14hours, or late
afternoon, just before dinner.
 Regulation of nutrition and exercise

In order to know how much insulin to give before a meal,

parents need to learn to count the total carbohydrate
amount in food by carefully reading food labels.

Exercise is also a requirement for it reduces the amount of

sugar in the body which we use as a energy, if exercising is a
habit it would help the consumption of sugar in the
bloodstream.
 Stress management

Whenever children with diabetes undergo a stressful situation, either emotionally or

physically, they may need increased insulin to maintain glucose homeostasis

Blood glucose monitoring

Children as young as clearly school age can learn the techniques of finger puncture and
reading a computerized monitor.
 Urine ketone monitoring

Urine testing is not used routinely but is used to test for ketonuria if the child develops a
gastrointestinal flu and is not able to eat. Acetone revealed by a test strip is a sign fat is
being use for energy, or that the child is becoming acidotic.
Complications:

If infection occurs the temperature arises

therefore there are increase of insulin
resistance. Additional insulin is needed.

If a child with diabetes is scheduled for surgery,

careful regulation on the day of surgery and
immediate postoperative period is essential,
especially if oral fluids will be restricted.