Type 1 Diabetes: Children Living With the Disease
The goal of your child's treatment for type 1 diabetes is to always keep his or her blood sugar levels within a Reference 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 includes:
- Exercise. Experts recommend that teens and children (starting at age 6) do moderate to vigorous activity at least 1 hour every day.Reference 1
- Home blood sugar monitoring.
- Preparing and giving insulin injections.
- Living with an insulin pump.
- Counting carbohydrate.
- Dealing with low blood sugar levels.
- Preventing high blood sugar levels.
Some problems you may encounter include:
- Changing appetite and "picky eating." A Reference registered dietitian Opens New Window can help you develop 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 Reference tips for mealtimes with young children include having alternative meal choices.
- Illness. Work with your doctor to set up Reference 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. Keep your child safe during exercise by:
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 Reference medical identification bracelets Opens New Window Reference Opens New Window, necklaces, or other forms of jewelry at a pharmacy or on the Internet.
- Have your child wear shoes that fit properly. Reference Check your child's feet if he or she has signs of injury or infection. Teach your child how to Reference wash and dry his or her 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.
- Help your child care for his or her Reference skin and Reference 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 with 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 with diabetes. Diabetes camps are a good learning experience for your child, and they will allow you some time to yourself.
- Allow your Reference child with 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 Reference glycohemoglobin) to check your child's blood sugar control over the previous 2 to 3 months, and a Reference 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 Reference 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 Reference diabetic nephropathy Opens New Window. At that same time, your child needs to see an Reference ophthalmologist Opens New Window for yearly dilated eye exams (Reference ophthalmoscopy) to check for signs of Reference diabetic retinopathy Opens New Window.
Treatment for high blood sugar emergency
If your child does not take enough insulin, has a severe infection or other illness, or becomes severely Reference dehydrated Opens New Window, his or her blood sugar level may rise very high and lead to Reference diabetic ketoacidosis Opens New Window. 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 Reference electrolytes Opens New Window. 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
A 10-year study, and its follow-up study, showed that keeping blood sugar levels within a Reference target range helps decrease the chances of developing diabetes complications, such as eye, kidney, heart, blood vessel, and nerve damage. As a result of this study, experts recommend that people with diabetes carefully control their blood sugar levels. This is often called strict or tight blood sugar control.
When a child has diabetes, keeping blood sugar levels within a target range helps the child grow and develop normally, but it increases the risk for frequent low blood sugar episodes. Your doctor will figure the safest range for your child's blood sugar level.
For some children, using an Reference insulin pump Opens New Window may help keep their blood sugar levels within a target range.
- Opens New Window Diabetes: Should I Get an Insulin Pump? Opens New Window
- Reference Reference Diabetes: Living With an Insulin Pump
If your child has frequent low blood sugar levels, especially at night (Reference nocturnal hypoglycemia Opens New Window), the doctor may suggest continuous ambulatory blood glucose monitoring. This means that your child wears a special monitor that records his or her blood sugar level continuously for 24 to 72 hours. The monitor stores the results, which allows you to look for patterns of high or low blood sugar levels.Reference 2
Scientists are looking for pain-free ways to give insulin and test blood sugar levels. Under development are improved insulin pumps, and better needles and lancets. New glucose monitors may be worn continuously and be able to signal insulin pumps when the rate of insulin needs to be changed. Scientists are also studying ways to prevent or decrease complications from diabetes. If you're interested, talk to your child's doctor about participating in any of these studies.
|By:||Reference Healthwise Staff||Last Revised: Reference March 7, 2011|
|Medical Review:||Reference John Pope, MD - Pediatrics
Reference Stephen LaFranchi, MD - Pediatrics, Pediatric Endocrinology