Your Child has Type 1 Diabetes. What
you should know
"Your child has diabetes." Many parents who hear these words
feel dazed, shocked, afraid, or guilty. It's natural to have
Children with diabetes usually have type 1 diabetes, in which
the pancreas doesn't make insulin. They need daily insulin shots
to help their bodies to use food. Type 1 diabetes is one of the
most common chronic diseases in children. Nearly one child out
of every 600 develops it. Diabetes can run in families, and
researchers are still studying how and why it happens.
Although diabetes cannot be cured, it can be treated. With
family support, daily care and treatment, your child with
diabetes can lead a healthy, active, and fun-filled life.
High Blood Sugar (hyperglycemia)-
When blood sugar levels get too high, the body gets too little
insulin or too much food.
Symptoms of high blood sugar are:
· excessive thirst
· frequent urination
· blurred vision
High blood sugar is treated by checking sugar levels and giving
your child insulin. Untreated, high blood sugar may develop into
ketoacidosis, a very serious condition.
Ketoacidosis is caused by very high levels of ketones in blood
and urine. Ketones are waste products that build up when the
body burns fat for energy. Check with your doctor about when to
do ketone tests, especially when your child is sick.Call your
doctor immediately if your child has ketones in their urine or
any of the following symptoms:
· drowsiness, labored breathing
· abdominal pain
· fruity smelling breath
Unless treated promptly Ketoacidosis can lead to a diabetic
coma. Ketoacidosis should be treated in a hospital
Low Blood Sugar (hypoglycemia)
- When blood sugar levels get too low - the body gets too much
insulin or too little food. It is the most common problem in
children with diabetes. Symptoms include:
· pale skin
Low blood sugar can be treated by giving the child
carbohydrates, such as sugar cubes, a chocolate bar, hard candy,
fruit juice, regular soda, followed by a snack of crackers with
cheese or peanut butter, half a sandwich, cereal with milk.
The goals of diabetes treatment for children are:
1 to maintain normal growth and development
2 to keep blood sugar levels within a target range (not too
high, not too low) as much as possible
3 to promote emotional well-being
Keeping blood sugar levels in a target range means balancing
insulin, food, and exercise. Remember: food raises blood sugar
levels, while insulin and exercise lower them.
A good diabetes treatment plan includes:
· eating healthy and on schedule
· checking blood sugar levels regularly
· adjusting insulin as blood sugar levels and activities
· exercising regularly
Ideas about how to treat diabetes have changed a lot in recent
years. Diabetes treatment plans are more flexible than they used
to be. Treatment is geared to the needs of the individual child
and his or her family.
Most children manage diabetes with two or three insulin shots a
day. However, some need four or more shots. Insulin is usually
given at regular times each day. Different kinds of insulin work
harder at different times. Most children take more than one kind
of insulin. The kinds of insulin your child takes and the times
it is taken will depend on your child's needs. There is no
strict rule about when (ie. what age) children can give their
own insulin injections. It depends on the child. Some children
and teenagers with diabetes use an insulin pump. The pump
delivers a continuous flow of insulin to the body. Working
closely with an expert team of health care providers helps to
ensure safe pump use.
Blood Glucose Checking
Regular checking of blood sugar levels gives information about
how well the diabetes care plan is working. Checking is done by
taking a drop of blood, usually from a finger (a "fingerstick").
The blood is placed on a special test strip in a glucose meter.
Blood sugar levels are measured in mM. A normal blood sugar
level is between 4 mM and 8 mM.
However, keeping blood sugar levels within the target range
isn't always possible. Especially in children, blood sugar
levels may be out of range for no apparent reason. It's
important that children are never made to feel it's their fault
if their blood sugar level is out of range.
Meals and Snacks
Eating meals at about the same time every day helps keep blood
sugar levels in the target range. Children with diabetes often
need to eat snacks during the day and before, during, or after
exercise, for example crackers with peanut butter or cheese,
pretzels, or apples.
You will want to know in advance about any special activities
that will change your child's usual meal times. Meal planning
for children with diabetes is fairly flexible these days. A
schedule change can usually be dealt with by adjusting your
child's meal plan or insulin dose.
Many party foods are high in sugar and fat. Generally, children
with diabetes need to limit eating these foods. A child with
diabetes can occasionally eat birthday cake or other special
foods. He or she may need to take more insulin than usual to
prevent high blood sugar. Playing an energetic game can also be
a good way of lowering blood sugar levels after eating sweets.
Discuss special events with your health care team.
Sports and Exercise
Children with diabetes can -- in fact, they should -- play games
and sports with their friends. Exercise helps to lower blood
sugar levels. In addition, taking part in gym class and team
sports can help your child make friends and feel like "one of
the gang." Getting regular exercise is important for children
with diabetes because of the need to balance the effect of
exercise with food and insulin. Because children's lives involve
a lot of unplanned activity, it's a good idea for your child to
always carry snack foods like pretzels or crackers with cheese
or peanut butter. Youngsters should also carry sugar cubes, hard
candy, glucose tablets, or another form of carbohydrate to treat
low blood sugar. The timing of exercise may affect your child's
meal plan and need for insulin. It's a good idea to ask your
child's school to notify you in advance if a game or sports
event will change your child's meal time.
Your child should not exercise if he or she is having symptoms
of low blood sugar.
Age related issues
children with diabetes often have not learned to recognize the
symptoms of low blood sugar, or they aren't able to tell
others when they are feeling "low." For this reason, it's
important that they have frequent blood sugar checks.
Preschoolers who are frightened by fingersticks and insulin
shots often try to avoid or delay them. If this happens with
your preschooler, it can help to say: "Yes, I know it hurts"
and "You're being very brave." Stickers and stars can help to
encourage a child to have a fingerstick or a shot.
Young children with diabetes can go through the same fussy
eating phases as other children. It's usually best not to
force a fussy child to eat. Have a variety of foods available.
If the child rejects one food, offer something else, or offer
juice or milk instead.
School-age children want to be like their peers. It's not
unusual for children with diabetes to feel "different" because
they need insulin shots, check blood sugar regularly, and use
a meal plan.
Talk with your doctor about how to help your child. Some
children are comfortable openly talking about their diabetes
care while others prefer to keep it private.
Teenagers. For the
teenager with diabetes, having to take insulin, check blood
sugar, and use a meal plan is bothersome. Diabetes often adds
to the normal difficulties of growing up. It is not unusual
for a teen with diabetes to ease up on diabetes care and try
to act "like everyone else." Many teenagers rebel.
Staff at your child's school need to know about your child's
diabetes. At the beginning of the school year, ask for a
conference with your child's teachers, the principal, and
other school staff. This way, everyone hears the same
information at the same time and questions can be answered.
Work with your child's school to prepare a written plan. it
should include information such as:
when to check blood sugar and take insulin
meal and snack times
preferred snacks and party foods
usual symptoms of low blood sugar
preferred treatment for low blood sugar