If children drink a lot and have to go to the bathroom frequently, parents and doctors should ring the alarm bells because the children could have diabetes. The disease is often recognized very late.
Berlin – It is an unsolved riddle: In Germany, more and more children and adolescents are suffering from type 1 diabetes mellitus, the form of diabetes that is not associated with an unhealthy diet or lack of exercise.
According to the German Diabetes Society (DDG), the incidence rate increases by three to four percent every year, especially small children are affected. “We don’t know why that is,” says Andreas Neu, DDG President and Acting Medical Director of the Department of Neuropediatrics, Developmental Neurology and Social Pediatrics at the Tübingen Children’s Clinic.
Diabetes is often associated with old age, obesity and lack of exercise. Many people do not realize that completely healthy, active children and adolescents can get diabetes. Suddenly the body stops producing enough insulin, which is essential for life, and young patients are dependent on insulin syringes or pumps for the rest of their lives. According to the DDG, an estimated 30,000 to 32,000 children and adolescents between the ages of 0 and 19 live with the autoimmune disease in Germany.
The Berliner Anne Adam would not have thought that her son Oskar could be affected at just 14 months. “After a protracted ear infection, he suddenly drank up to three liters of water a day,” recalls the mother. The ear, nose and throat doctor had put them off by saying that the boy was probably recovering from the long healing process. But one day when Oskar slept for 15 hours at a stretch, was hardly able to wake up, was apathetic and powerless, she drove with him to a clinic. “We were diagnosed with type 1 diabetes very quickly there,” recalls the 38-year-old, who also shares her experience on Instagram.
“The symptoms can also occur with other illnesses or depending on the season. That is why it often takes some time for parents to realize that their child could have the disease, ”says Andreas Neu. If the symptoms are recognized too late, it can lead to a dangerous metabolic imbalance, diabetic ketoacidosis. The lack of insulin creates ketone bodies – metabolic products that acidify the blood and can lead to coma. “That is potentially life threatening. Hours count, ”says Neu.
In the pandemic year 2020, more parents than usual went to the doctor with their children late – with dangerous consequences: According to a study, the number of ketoaizodoses has increased significantly compared to previous years. The Gießen pediatrician Clemens Kamrath and other researchers first compared the data of 532 children and adolescents who fell ill with type 1 diabetes between mid-March and mid-May with those of 2018 and 2019.
In 2020, the proportion of children who had a metabolic imbalance at the time of diagnosis was around 45 percent during the period, 25 percent in 2019 and 24 percent in 2018. One can only speculate about the causes. One possible reason is that parents, fearing a corona infection, went to doctor’s offices and hospitals later than they did before the pandemic, Kamrath said.
“Diabetes is a 24-hour job, seven days a week.”
Oskar is now almost four years old and has been receiving a regular basic amount of insulin from a pump for almost three years now. A sensor measures the blood sugar level for this. During meals, Oskar has to get the hormone in addition, depending on the amount of food. Parents and daycare educators then each have to calculate how much insulin Oskar needs and set the amount for the pump using a remote control.
Everyday life is now much more complicated. “Diabetes is a 24-hour job, seven days a week. We always have to be present and attentive, even at night when the pump sounds the alarm because the blood sugar levels are unfavorable, ”says Adam. In the day care center, she trained the educators in matters of diabetes and still remains approachable. According to the daycare manager, Oskar would not have got the daycare place with the diagnosis, said the mother. “I don’t even like to think about school yet”.
Getting a place at school is not as problematic as getting a daycare place, reports Sandra Neumann, head of the Berlin self-help group “Diafüchse” and employee of the German Diabetes Aid. “State schools have to admit children with diabetes because schooling is compulsory,” says Neumann. But even in schools, the care of the children by school helpers or integration specialists is not always guaranteed.
Inadequately treated, type 1 diabetes can lead to serious complications. “They are the same ones that we know from the widespread disease type 2 diabetes,” says Neu. Over time, the sugar attacks the eyes, kidneys, blood vessels and nerves. “In the worst case, blindness and heart attacks occur later, and amputations and dialysis can also be necessary”. Precisely because of the long lifespan that the young patients still have ahead of them, good treatment is necessary right from the start. dpa
