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Diabetes Mellitus Type 1 In Children, Ambulatory Care

Diabetes mellitus type 1

is a disease that affects how your child's body makes insulin and uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 1 diabetes develops because the immune system destroys cells in the pancreas that make insulin. The pancreas cannot make enough insulin, so the blood sugar level continues to rise. A family history of type 1 diabetes may increase your child's risk for diabetes.

Common symptoms include the following:

  • More thirst than usual
  • Frequent urination
  • Feeling hungry most of the time
  • Weight loss without trying
  • Blurred vision

Seek immediate care for the following symptoms:

  • Blood sugar level that is lower than directed and does not improve with treatment
  • Blurred or double vision
  • Trouble staying awake or focusing
  • Shaking or sweating
  • A fruity, sweet smell to your child's breath, or deep and labored breathing
  • Fast and weak heartbeat

Check your child's blood sugar level as directed:

You will be taught how to check a small drop of blood with a glucose monitor. You will need to check your child's blood sugar level at least 3 times each day. Ask your child's healthcare provider when and how often to check during the day. Before meals , your child's blood sugar should be between 90 and 130 mg/dL. At bedtime , it should be between 90 and 150 mg/dL. You may need to check for ketones in your child's urine or blood if his level is higher than directed. Write down the results and show them to your child's healthcare provider. He may use the results to make changes to your child's medicine, food, or exercise schedules.

If your child's blood sugar level is too low:

Your child's blood sugar level is too low if it goes below 70 mg/dL. Ask your child's healthcare provider how much carbohydrate to give your child. You may need to give him 15 grams of carbohydrate. This amount of carbohydrates can be found in 4 ounces of juice or 3 to 4 glucose tablets. Check his blood sugar level again 15 minutes later. If it is above 70 mg/dL, give him a small snack. If it is still below 70 mg/dL, give him fast-acting carbohydrates or glucose tablets as directed. Ask your child's healthcare provider for more information on diabetic hypoglycemia (low blood sugar level).

Medical alert identification:

Make sure your child always wears medical alert jewelry or carries a card that says he has diabetes. Ask your child's healthcare provider where to get these items.

Medical alert ID bracelet

Manage your child's diabetes:

  • Give your child insulin as directed. Your child may need 3 to 4 doses of insulin each day. Insulin can be injected or given through an insulin pump. Ask your child's healthcare provider which method is best for your child. You and your child will be trained in the best method for him. Give your child insulin as directed. Too much insulin may cause his blood sugar level to go too low. You will also be taught how to adjust each insulin dose he takes with meals. Always check his blood sugar level before the meal. The dose will be based on his blood sugar level, carbohydrates in the meal, and activity after the meal.
  • Encourage your child to exercise. Exercise can help keep your child's blood sugar level steady. Encourage your child to exercise for at least 60 minutes on most days of the week. Work with your child's healthcare provider to create an exercise plan. Check your child's blood sugar level before and after he exercises. He may need a carbohydrate snack before, during, or after exercise. If your child's blood sugar level is high, check his blood or urine for ketones before he exercises. Do not let him exercise if his blood sugar level is high and he has ketones in his urine or blood. If your child's blood sugar level is lower than 100 mg/dL, give him a carbohydrate snack before he exercises. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice.
  • Give directions to your child's school. Make sure your child's teachers know he has diabetes. Provide written instructions about what to do if your child has symptoms of high or low blood sugar levels at school.
  • Help your child maintain a healthy weight. Ask your child's healthcare provider how much your child should weigh. A healthy weight can help control your child's diabetes. Ask your child's healthcare provider to help you create a weight loss plan for your child if he is overweight.
  • Follow your child's meal plan. A dietitian will help you create a meal plan to keep your child's blood sugar level steady. Do not let your child skip meals. His blood sugar level may drop too low if he takes insulin and does not eat.
    • Keep track of carbohydrates (sugar and starchy foods). Your child's blood sugar level can get too high if he eats too many carbohydrates. His dietitian will help you plan meals and snacks that have the right amount of carbohydrates.
    • Give him low-fat and low-sodium foods. Examples of low-fat foods are lean meat, fish, skinless chicken or turkey, and low-fat milk. Limit high-sodium foods, such as potato chips and soup. Do not add salt to food you cook. Limit your child's use of table salt.
    • Give him high-fiber foods. Foods that are a good source of fiber include vegetables, whole grain bread, and beans.
  • Ask about vaccines. Your child has a higher risk for serious illness if he gets the flu or pneumonia. Ask your child's healthcare provider if your child should get a flu or pneumonia vaccine, and when to get the vaccine.
  • Do not smoke. Cigarette smoke can worsen the problems that occur with diabetes. Do not smoke around your child, and do not let others smoke around him. Do not let your child smoke. Ask your healthcare provider for information if you currently smoke and need help quitting.

Follow up with your child's healthcare provider as directed:

Your child may need to return to have his A1c checked at least twice a year. Your child's A1c should be less than 7.5%. He may also need tests to check his blood pressure, cholesterol, eyes, and feet.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.