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Type 1 Diabetes In Children

WHAT YOU NEED TO KNOW:

Type 1 diabetes 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.

DISCHARGE INSTRUCTIONS:

Return to the emergency department if:

  • Your child has a low blood sugar level and it does not improve with treatment.
  • Your child's blood sugar level is above 240 mg/dL and does not come down after a dose of insulin.
  • Your child has ketones.
  • Your child has a fever.
  • Your child has nausea or is vomiting and cannot keep any food or liquid down.
  • Your child has symptoms of a low blood sugar level, such as trouble thinking, sweating, or a pounding heartbeat.
  • Your child has blurred or double vision.
  • Your child's breath has a fruity, sweet smell, or his breathing is deep and labored.
  • Your child's heartbeat is fast and weak.

Contact your child's healthcare provider if:

  • Your child's blood sugar levels are higher than his or her target goals.
  • Your child often has low blood sugar levels.
  • Your child has abdominal pain, diarrhea, or is vomiting.
  • Your child has numbness in his or her arms or legs.
  • Your child has warm, red patches of skin or a wound that does not heal.
  • Your child gets easily irritated.
  • You have questions or concerns about your child's condition or care.

Medicines:

  • Your child will need 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 or her. Give your child insulin as directed. Too much insulin may cause his or her blood sugar level to go too low. You will also be taught how to adjust each insulin dose he or she takes with meals. Always check his or her blood sugar level before the meal. The dose will be based on his or her blood sugar level, carbohydrates in the meal, and activity after the meal.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

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 or her level is higher than directed. Write down the results and show them to your child's healthcare provider. The provider may use the results to make changes to your child's medicine, food, or exercise schedules.

How to check your blood sugar

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. If the level is too low, have your child eat or drink 15 grams of fast-acting carbohydrate. These are found naturally in fruits and dairy products. Fast-acting carbohydrates will raise your child's blood sugar level quickly. Examples of 15 grams of fast-acting carbohydrate are 4 ounces (½ cup) of fruit juice or 4 ounces of regular soda. Other examples are 2 tablespoons of raisins or 3 to 4 glucose tablets. Check your child's blood sugar level 15 minutes later. If the level is still low (less than 100 mg/dL), give another 15 grams of carbohydrate. When the level returns to 100 mg/dL, have your child eat a snack or meal that contains carbohydrate and protein. This will help prevent another drop in blood sugar. Always carefully follow your healthcare provider's instructions on how to treat low blood sugar levels.


Medical alert identification:

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

Medical alert ID bracelet

Give directions to your child's school:

Make sure your child's teachers know he or she 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 or she is overweight. The provider can help your child set reasonable weight loss goals.

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 or her blood sugar level may drop too low if he or she 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 or she eats too many carbohydrates. His or her dietitian will help you plan meals and snacks that have the right amount of carbohydrates.
  • Give him or her 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 or her high-fiber foods. Foods that are a good source of fiber include vegetables, whole-grain bread, and beans.

Have your child exercise as directed:

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 exercise. Healthcare providers may tell you to change the amount of insulin your child takes or food he or she eats. If the blood sugar level is high, check your child's blood or urine for ketones before you exercise. Do not let your child exercise if the blood sugar level is high and he or she has ketones.
  • If your child's blood sugar level is less than 100 mg/dL, have him or her eat a carbohydrate snack before exercise. Examples are 4 to 6 crackers, ½ banana, 8 ounces (1 cup) of milk, or 4 ounces (½ cup) of juice. Have your child drink water or liquids that do not contain sugar before, during, and after exercise. Ask your dietitian or healthcare provider which liquids your child should drink when he or she exercises.

Ask about vaccines:

Your child has a higher risk for serious illness if he or she 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 around your child:

Do not let others smoke around him or her. Do not let your older child smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung and heart damage. Cigarette smoke can worsen the problems that occur with diabetes. Ask your healthcare provider for information if you or child currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you or your child use these products.

Foot care:

Have your child's feet checked at least 1 time each year for problems that may develop if his or her diabetes is not controlled. Check your child's feet each day for sores. Make sure his or her shoes and socks fit correctly. Ask your child's healthcare provider for more details about foot care.

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

Your child may need to return to have his or her A1c checked at least 2 times each year. Your child's A1c should be less than 7.5%. He or she may also need tests to check his or her blood pressure, cholesterol, eyes, and feet.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

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