Diabetes, an autoimmune disease characterized by an imbalance of insulin secretion in the body, which can occur at any age, can be detected in the preclinical stage in children, which would allow the family to adapt, learning to react according to the evolution of the disease.
Detecting type 1 diabetes in the preclinical stage is important: Pixabay
“Not every hypoglycemia in the child has trivial causes ”, It draws the attention of diabetologist Anca Roman, presenting, on his Facebook page, two cases of patients, children, who arrived in the office.
“Recently, I met two children who appeared in the cabinet apparently for episodes of hypoglycemia at home. We made the full panel of specific autoantibodies for type 1 diabetes and peptide dosage C.
The results were edifying: anti-gad antibodies, the most commonly positive at the onset of the disease, came out negative; However, peptide C was low and other autoantibodies came out positive. The conclusion? If we only limit ourselves to anti-gad antibodies, we would have missed the diagnosis in a very important stage-the preclinical one, when there is still the functional pancreatic reserve and when we can offer careful monitoring, education and early intervention, ” noted the doctor.
The correct diagnosis requires complete testing of autoantibodies (not just anti-gad), the doctor said, insisting that the discovery of the disease in the preclinical stage fundamentally changes the evolution and how it can be intervened.
“Like any autoimmune disease, we have to make certain autoantibodies to detect it and see that they come out positive. In diabetes, those anti -gad antibodies, in type 1, are most common. But there are three more antibodies that are done. And if we have a positive one and one peptide C -which is another analysis that is done to see how much the insulin, They positively and peptide C decreasing or a little low, lower than it should, we can make type 1 diagnosis in the preclinical stage before installing, practically, diabetes, with symptoms, to reach the hospital in a coma, in serious condition ”explained the doctor Anca Roman, for “Adevărul”.
“It would not have been the suggestive clinical picture for type 1 diabetes”
Family doctors are usually those who send patients to the specialist’s office, either as a result of symptoms, or as a result of certain modified parameters. Type 1 diabetes diagnosed in the preclinical stage provides the patient to adapt to what follows and even allows the progress of the disease.
Symptoms that worry are usually weight loss for no reason, high water consumption and often urinated. Paradoxically, says the doctor Anca Roman, there are patients who do not have a big blood sugar. Moreover, the former standard that led the doctors with the diagnosis of diabetes, respectively the weak child, is no longer verified.
“I also had patients, children with overponents or obesity, who were sent for overponents and obesity and hypoglycemia. It would not have been the suggestive clinical picture for type 1 diabetes “, mentioned the doctor. Investigations that can confirm type 1 diabetes in the preclinical stage are quite expensive for families, not in the list of state settled.
“We must, however, do these investigations, tell parents, even if they are slightly expensive. Many parents have done them gradually, because they did not allow them all ”, said the doctor.
In the preclinical stage, type 1 diabetes (an autoimmune disease that cannot be cured, but with treatment the complications can be kept under control and the patient can have a fulfilled life) does not manifest with values that allow doctors to quickly diagnose, respectively – glycosylated hemoglobin over 6.5, blood glucose in 200. Preclinically, explains the doctor, in which the antibodies are positive, peptide C low, without blood sugar. “Patients still have a reserve of outstanding insulin. Low, but it is,” completes Dr. Anca Roman.
What allows early diagnosis is to adjust the diet, with a lower carbohydrate consumption, which will allow the patient to keep from the insulin reserve. Also, the patient could receive the recommendation to make more movement.
“The patient with obesity, the child, has diminished weight and still does not need insulin. And it’s been almost a year. Although the peptide is slightly decreasing. The preclinical stage is very important because we install blood glucose sensors, so that their parents do not sting them, and we monitor your blood sugar. And it’s no longer a shock when blood sugar begins. I mean parents know that at a time It will reach insulin, The children are prepared, we put the pump very quickly and do not go through that shock to be admitted to large blood sugar therapy, with 5-6 injections per day. The burden for parents is no longer so big, because suddenly their lives are changing, in a second. They do not have time to realize what is happening (n. Red.-when the diagnosis of type 1 diabetes comes unexpectedly) ”, said the doctor.
There have been cases in which the diagnosis fallen as clearly lowered their parents, they failed to manage blood glucose oscillations at home. This is what does not happen in the case of an early diagnosis, when the doctor will prepare the patient and the family for what is followed in the evolution of the disease.
