The goal of your child's treatment
type 1 diabetes is to always keep his or her blood
sugar levels within a
target range. A target range reduces
the chance of diabetes complications. Daily diabetes care and regular medical
checkups will help you and your child accomplish this goal.
Your child's daily care
Some problems you may encounter include:
- Changing appetite and "picky eating." A
registered dietitian can help you build a flexible
meal plan to meet your child's appetite needs and allow for special events,
such as parties and school activities. If you use rapid-acting insulin, you can
give the insulin dose after a meal based on what your child ate. Some
tips for mealtimes with young children include having alternative meal
- Illness. Work with your doctor to set up sick-day guidelines for your child. These help you prevent high blood sugar emergencies when your child is ill. Talk
with the doctor before giving your child any nonprescription medicine.
- Exercise. If your child is not very active, limit his or her
time playing video games, watching TV, or using the computer. Plan some
activities to do along with your child, such as in-line skating or bicycling.
Use these tips for exercising safely to help prevent low blood sugar in your child.
You will also want to:
- Always have your child wear medical identification to let
medical personnel know that he or she has diabetes. You can buy
medical identification bracelets , necklaces, or other forms of jewelry at a
pharmacy or on the Internet. Temporary medical identification tattoos are another form of medical identification.
- Teach your child about good foot care. Foot problems are rare in children who have diabetes. But adults can have foot problems, especially with diabetic neuropathy. Teach your child the importance of wearing shoes that fit properly.
Check your child's feet if he or she has signs of injury or infection. Teach your child to get in the habit of washing and drying feet thoroughly. If you notice a foot problem, even a
minor one, talk with your child's doctor before treating it.
- Keep your child's day care or school plan for diabetes care up
to date. Have written instructions for your babysitter and other caregivers.
- Diabetes in Children: Preparing a Care Plan for School
- Help your child care for his or her
teeth and gums. Make sure your child has a dental
checkup every 6 months.
- Keep your child's immunizations up to date. This includes a
flu shot every year.
- Participate in a support group for parents of children who have
diabetes. These groups can be very helpful, especially the first few years
after diagnosis. Local groups are available in most areas.
- Encourage your child to attend camps for children who have diabetes. Diabetes camps are a good learning experience for your child, and
they will allow you some time to yourself.
- Allow your
child who has diabetes to help with the treatment, given
his or her age and experience with the disease.
Regular medical checkups
Your child needs to see
his or her doctor every 3 to 6 months. During these checkups, the doctor will
evaluate and adjust your child's treatment. The doctor will do a hemoglobin A1c
or similar test (glycosylated hemoglobin or
glycohemoglobin) to check your child's blood sugar
control over the previous 2 to 3 months, and a
blood glucose test.
If your child's
LDL cholesterol is less than 100 mg/dL (2.60 mmol/L)
and there is no family history of
high cholesterol, the doctor will do a
cholesterol (LDL and HDL) test every 5 years. If your child's blood pressure is consistently high and not reduced with weight control or exercise, the doctor may consider medicine.
When your child has had diabetes for 5 years, the doctor will start
yearly screening tests for protein in the urine, which points to
diabetic nephropathy. At that same time, your child
needs to see an
ophthalmologist for yearly dilated eye exams (ophthalmoscopy) to check for signs of
Treatment for high blood sugar emergency
child does not take enough insulin, has a severe infection or other illness, or
dehydrated, his or her blood sugar level may rise very
high and lead to
diabetic ketoacidosis. Diabetic ketoacidosis is almost always treated in a hospital, often in the intensive care unit, where
caregivers can watch your child closely and give him or her frequent blood
tests for glucose and
electrolytes. Insulin is given through a vein
(intravenous, or IV) to bring blood sugar levels down. Fluids are given through
the IV to correct the electrolyte imbalance. Your child may stay in the
hospital for a few days until blood sugar levels are back in the target
range and electrolytes have normalized.
What to think about
For some children, using an
insulin pump may help keep their blood sugar levels
within a target range.
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
If your child has frequent low blood sugar levels,
especially at night (nocturnal hypoglycemia), the doctor may
suggest a continuous glucose monitor (CGM). A CGM reports blood sugar at least every 5 minutes, day and night. It sounds an alarm if blood sugar levels are moving out of range.
The monitor stores the results, which allows you to look for
patterns of high or low blood sugar levels.