Managing Diabetes in Children
Diabetes is a disorder that disrupts the way a person’s body uses sugar. This causes sugar to build up in the blood. Diabetes is also called “diabetes mellitus.”Most children with diabetes lead healthy and active lives. Over time, they learn how to take care of their diabetes on their own.

There are two types of diabetes. People with type One diabetes make little or no insulin. Insulin is a hormone that helps the body use sugar. People with type 2 diabetes sometimes also make too little insulin, but more often the problem is that their body doesn’t respond to insulin.

Most children with diabetes have “type 1 diabetes.” But some children, especially overweight teenagers, have “type 2 diabetes.”

You, your child, his Doctor, dietician, school teacher, diabetes educator generally will form your child’s Diabetes care team.Your child will see these people on a regular basis.But having diabetes can make children feel sad or worried. If your child is sad or worried, have him or her talk to the doctor, nurse, or mental health counsellor.

Your child’s diabetes team will teach you how to take care of your child’s diabetes at home. As your child grows older, he or she should learn more and more about how to take care of his or her diabetes.

Children with type 1 diabetes need to take a medicine called insulin every day. Insulin works to lower a person’s blood sugar level.

Insulin usually comes in the form of a injection/pen like device. There are different types of insulin. Your child will need several insulin doses each day.

Your child’s diabetes team will:
  • Teach you about the different types of insulin and when to use them
  • Show you how to give your child an insulin shot/pen
  • Teach you how to choose your child’s insulin dose – An insulin dose depends on different factors, such as what your child eats and how active he or she is.
Checking blood sugar regularly
You will need to check your child’s blood sugar level 4 or more times each day. To do this, you will use a device called a “blood glucose meter.” Your child’s doctor or nurse will show you how to use your child’s blood glucose meter.

Your child’s doctor or nurse will also do a blood test called an “A1C” on a regular basis. This test shows what your child’s average blood sugar level has been over the past 3 months.

Your child’s doctor or nurse will look at the daily blood sugar levels and the A1C result to know:
  • How well-controlled your child’s diabetes is
  • If your child’s treatment plan needs to be changed
Diet and blood sugar
You might need to change what and how much your child eats, and when your child eats. It’s important to know what, how much, and when your child eats to make sure that he or she gets the right amount of insulin.

Your diabetes team will work with you to:
  • Help you plan healthy meals and snacks for your child
  • Help you make a schedule for meals and snacks
  • Teach you how to choose the correct insulin dose based on what your child eats and how much exercise he or she gets
Enhance Diabetes Care 
  • Learn about diabetes – The more you know about it, the better you can take care of it.
  • Keep your child’s blood sugar levels under control – Levels that are very low or very high can cause serious problems. They need to be treated right away. Also, having high blood sugar levels over many years can damage the kidneys, eyes, nerves, and blood vessels.
  • Learn the symptoms that could mean that your child’s blood sugar level is too low or too high – These symptoms can be different, depending on a child’s age.
  • Learn what to do when your child’s blood sugar level is too low or too high – Know when to treat it at home and when to go to the hospital or call for an ambulance.
  • Have your child wear a medical bracelet or necklace so that others will know about their diabetes in case of an emergency.
Keeping Your Child’s Blood Sugar Under Control
It is important to ensure that the amount of sugar in your child’s blood is in the right range and not too high or too low, because it can prevent:
  • Short-term problems – Blood sugar levels that get very low or very high can be a medical emergency.
  • Long-term problems – Having high blood sugar levels over many years can damage the kidneys, eyes, nerves, and heart.
Your child’s blood sugar can get out of control when he or she:
  • Gets sick or has surgery.
  • Gets off his or her usual schedule or travels.
  • Uses too much or too little insulin.
  • Eats much more or less than planned, or skips meals.
  • Exercises much more or less than planned.
  • Is excited, upset, or worried.
  • Gets vaccines – Vaccines are treatments that prevent infections.
Target blood sugar levels
Your child’s doctor or diabetes nurse will tell you the target range for your child’s daily blood sugar levels. Target blood sugar levels depend on a child’s age and the time of day (for example, if it is before or after a meal or bedtime).

Checking child’s blood sugar level
You can check your child’s blood sugar level using a device called a “blood glucose meter.” There are different types of blood glucose meters, but most of them work the same way. You will need to prick your child’s fingertip to get a drop of blood. You will put the drop of blood onto a test strip that goes into the meter. After a few seconds, the meter will show your child’s blood sugar level.

Every few months, your child’s doctor will also do a blood test. This test, called an “A1C,” shows what your child’s average blood sugar level has been over the past 3 months.

To help control your child’s blood sugar, you can:
  • Learn about diabetes and the things that can raise or lower your child’s blood sugar. Ask your child’s doctor or nurse if you have any questions
  • Spread out the carbs your child eats over the whole day. Carbs are sugars and starches that are in the food we eat. They can raise a person’s blood sugar level. If you spread out your child’s carbs over the whole day, you can help keep his or her blood sugar level from getting too low or high.
  • Learn how to balance your child’s insulin dose with what he or she eats and how much he or she exercises.
  • Check your child’s blood sugar often. If you check your child’s blood sugar often, you can treat low or high blood sugar before it becomes an emergency. Checking your child’s blood sugar often will also help you learn how food and exercise affect your child’s blood sugar.
  • Keep a record of your child’s blood sugars. Show the record to your child’s doctor so that he or she can change the treatment plan as needed.
  • Work with your child’s school to plan how to manage your child’s diabetes during school hours.
  • Talk to your teenager. Although most teens can check their own blood sugar and give themselves insulin, there can be challenges, especially for example, they might drink alcohol or skip meals, both of which can lower blood sugar.
  • Also teach other care takers like grandparents, maids, teachers about diabetes and how to take care of your child’s diabetes.
Ask your child’s doctor to teach you as to how to manage low or high blood sugar. The treatment depends on the blood sugar level, your child’s age, symptoms, and the time of day.

Low blood sugar might be treated with either:
  • A quick source of sugar – Your child can eat or drink a quick source of sugar. Foods that have fat, such as chocolate or cheese, do not raise low blood sugar levels as quickly. You should carry a quick source of sugar for your child always.
  • A glucagon shot – Glucagon is a hormone that can quickly raise blood sugar levels. It comes in the form of a shot. If your child’s doctor recommends that you carry a glucagon shot for your child, he or she will tell you when and how to use it.
High blood sugar is usually treated with insulin and extra fluids. If your child has an episode of high blood sugar, you might need to test his or her blood or urine. Your child’s doctor will show you how to do this.
Checking Your Child’s Blood Sugar Level
It’s important to check your child’s blood sugar level so that you know:
  • If the level gets too low or too high – Blood sugar levels that are very low or very high can cause serious problems. If you check your child’s blood sugar levels often, you can treat low or high blood sugar before it becomes an emergency.
  • What changes to make in your child’s next insulin dose – Knowing your child’s blood sugar level will help you choose his or her next insulin dose.
  • How well-controlled your child’s diabetes is – Keeping your child’s blood sugar under control helps prevent health problems later in life.
Monitoring Blood Glucose at home
To check your child’s blood sugar level, you use a device called a “blood glucose meter.” Your child’s doctor or diabetes nurse will show you how to use yours. You will need to prick your child’s fingertip to get a drop of blood. Try not to use the same finger each time.

You will put the drop of blood on a special glucose test strip that fits into the meter. After a few seconds, the meter will show your child’s blood sugar level. Be sure to record your child’s blood sugar levels and show the record to your child’s doctor or nurse. He or she will use this information to make changes to your child’s treatment plan.

If your child uses insulin, you need to check his or her blood sugar level 4 or more times each day. That will probably mean checking blood sugar levels before meals and snacks, and at bedtime. At least once a week, you might also need to check your child’s blood sugar at night (between midnight and 4 AM). Plus, you might need to do overnight checks more often if your child’s overnight insulin dose changes.

Certain conditions can affect your child’s blood sugar. You might need to check your child’s blood sugar more often when he or she:
  • Is sick.
  • Travels, especially to another time zone.
  • Eats or exercises more or less than planned.
  • Is under extra stress.
  • Has symptoms of low or high blood sugar – These symptoms can be different, depending on the child and his or her age.
Common symptoms of low blood sugar can include:
  • Acting cranky, tired, or not eating (especially in babies and toddlers).
  • Shaking.
  • Sweating.
  • Feeling weak, tired, nervous, or hungry.
  • Having nightmares or not sleeping well.
  • Confusion.
Common symptoms of high blood sugar can include:
  • Urinating more than usual.
  • Feeling thirsty and drinking more than usual.
  • Feeling tired or having no energy.
  • Breathing fast or having a “fruity-smelling” breath – This can be a sign of a medical emergency called “diabetic ketoacidosis.”
In general, low blood sugar is treated with either:
  • A quick source of sugar – Your child can eat or drink a quick source of sugar. You should carry a quick source of sugar for your child at all times.
  • A glucagon shot – Glucagon is a hormone that can quickly raise blood sugar levels. It comes in the form of a shot only if your child’s doctor recommends.
Episodes of high blood sugar are usually treated with insulin and extra fluids. To check how serious the high blood sugar is, you might need to test your child’s urine. Your child’s doctor or nurse will show you how to do this. You, your child’s diabetes team, and the school should make a plan to manage your child’s diabetes in school. This plan will list when your child’s blood sugar should be checked and who will check it. Most children check their blood sugar before gym class, before lunch, and any time they do not feel well. Many children are able to check their own blood sugar by ages 8 to 11. But they usually still need help using the results to choose insulin doses.
Managing Diabetes In School
Let your child’s school know right away if he or she has diabetes (or “diabetes mellitus”).

Ask for help, school may help to designate one person for care, during school hours. If this person does not know how to take care of diabetes, he or she will need to learn how.

Your child can also help manage his or her diabetes in school. As your child gets older, he or she can do more and more to manage it. But even if your child manages the diabetes on his or her own, a staff member at school should know about it and be ready to help in case of a diabetes emergency.

With your Doctor try to develop a written plan for school, which should list all the ways that the school will manage your child’s diabetes. The school should let you know if they have questions about your child’s diabetes or if any new problems come up.

Child’s school Diabetes plan
Your child’s school plan should have information about how to take care of the diabetes day to day. It should also have information about how to treat problems or emergencies that might happen. The plan should include information from both you and your child’s doctor about:
  • Your child’s medicines – This should include all the medicines your child takes, where they are kept, and when and how they are given. The timing and dosing of your child’s insulin are especially important
  • Your child’s meals and snacks – For example, the plan might list foods that your child should or shouldn’t eat. If your child needs to eat on a schedule, it can list the times and amounts that he or she should eat.
  • Checking your child’s blood sugar level – The plan should discuss who will check your child’s blood sugar, and when and how it will be checked.
  • Symptoms that could mean your child’s blood sugar level is too low or too high – Let the school know which symptoms to watch for.
  • How to treat a blood sugar level that is too low or too high, including when to get emergency help.
  • How to reach you, another family member, and your child’s doctor in case of an emergency
  • How to safely include your child in physical activities, school parties, field trips, and other special events.
  • Your child’s other needs – For example, your child might need to leave class at certain times of the day to take insulin, use the bathroom, or eat a snack.
The person who manages your child’s diabetes in school should share this plan with the other school staff. He or she should tell them how your child’s diabetes will be managed, which symptoms to watch for, and what to do in case of an emergency.

Every year before the school year starts, you and the school should review your child’s plan. You might need to change the plan as your child gets older.

To help the school manage your child’s diabetes, you can:
  • Bring in the diabetes supplies that your child will need at school – This can include daily medicines, blood testing supplies, and emergency medicines. .
  • Leave food or snacks for your child at school – You might want to make up snack bags that the school can give your child if his or her blood sugar gets too low.
  • Offer to teach the staff and students about diabetes and how it is managed.
  • Share information about your child’s health with the school and let them know if anything changes with your child’s diabetes.