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Type 1 Diabetes Management For Adolescents, Ambulatory Care

What you need to know about managing your diabetes:

As you get older, you will be able to manage your own health. You may be away from home more often spending time with your friends or being involved in sports. When you manage your blood sugar levels, you will feel well and be able to enjoy your activities. Your healthcare providers can show you how to fit diabetes care into your schedule. Adults, such as your parents and healthcare providers, are available to help you as you become more active in your diabetes care.

What you can do to manage your blood sugar levels:

  • Know what your blood sugar levels should be. Before meals , your blood sugar should be between 90 and 130 mg/dL. At bedtime , it should be between 90 and 150 mg/dL.
  • Check your blood sugar level as directed and as needed.
    • Look at your schedule and make a plan for how you will check your blood sugar levels throughout the day.
    • Check more often if you think your blood sugar is too high or too low. This will allow you to take care of any low or high blood sugar levels so they do not interfere with your activities.
    • Rotate the sites where you do fingersticks. This will help make the checks less painful, and make fingerstick sites less noticeable.
    • Write down your blood sugar levels so you can show them to your healthcare provider during your visits. Talk to your healthcare provider if you are having trouble keeping your blood sugar at the recommended levels.


  • Take your insulin as directed. Your healthcare provider will teach you how and when to give yourself insulin injections or use an insulin pump. Your healthcare provider can also teach you how to adjust your insulin dose. This will be helpful when you are going to change the amount of food you usually eat or the physical activity you do.

What you need to know about low blood sugar:

You can prevent symptoms such as shakiness, dizziness, irritability, or confusion by preventing your blood sugar from going too low.

  • Treat low blood sugar right away. Eat 15 grams of carbohydrate. This amount of carbohydrates can be found in 4 ounces of juice or 3 to 4 glucose tablets. Check your blood sugar again 10 to 15 minutes later. When it goes back to normal, eat a meal or snack to prevent another decrease in blood sugar. Left untreated, low blood sugar can lead to other serious conditions, such as seizures. It can become life-threatening.
  • Your blood sugar can drop too low if you take insulin and do not eat enough food. Eat a snack in the evening to prevent low blood sugar at night. Do not skip meals.
  • Increased physical activity can cause low blood sugar. Check your blood sugar level before you exercise. If it is below 100 mg/dL, eat 15 grams of carbohydrate. If you will exercise for more than 1 hour, check your blood sugar level every 30 minutes. You may need to adjust your insulin before exercise and have a carbohydrate snack during exercise.

What you need to know about high blood sugar:

High blood sugar may not cause any symptoms. It may cause you to feel more thirsty than usual or urinate more often than usual. Over time, high blood sugar levels can damage your nerves, blood vessels, tissues, and organs. You may need to check for ketones in your urine or blood if your level is higher than directed. Ask your healthcare provider when and how to check for ketones. High blood sugar that is not controlled can lead to diabetic ketoacidosis (DKA). This is a serious condition that can become life-threatening.

  • A lower dose of insulin or a late dose can raise your blood sugar. There is not enough time for your insulin to work as it should if you take it late. When you take a lower dose of insulin, there is not enough insulin needed to lower your blood sugar.
  • Large meals or large amounts of carbohydrates at one time can raise your blood sugar. You may need to adjust your insulin dose if you know that you are going to have a large meal or eat more carbohydrates than you normally do.
  • Decreased physical activity can raise your blood sugar. For example, your blood sugar can increase if you stop playing a sport or getting regular physical activity. Do not sit for longer than 90 minutes at a time.
  • Stress can raise your blood sugar. Ask your parents or healthcare provider for help if you are having trouble managing stress.
  • Illness can raise your blood sugar. This can happen even if you eat less than usual while you are sick. Work with your healthcare provider and parents to develop a sick day plan. This is a plan that helps you manage your blood sugar levels while you are sick.

Other things you can do to manage your diabetes:

  • Wear medical alert jewelry or carry a card that says you have diabetes. Ask your healthcare provider where to get these items.
  • Make healthy food choices. Healthy foods can give you energy to learn and be active. Healthy foods can also help you keep your blood sugar in balance, and manage or lose weight safely. Work with a dietitian to develop a meal plan that works for you and your schedule. A dietitian can help you learn how to eat the right amount of carbohydrates during your meals and snacks. Carbohydrates can raise your blood sugar if you eat too many at one time. Some foods that contain carbohydrates include breads, cereals, rice, pasta, sweets, soda, and juice.
  • Get regular physical activity. Physical activity helps to lower your blood sugar levels. It can also help you manage your weight. Get at least 60 minutes of physical activity throughout your day. If your blood sugar is high, check your blood or urine for ketones before you exercise. Do not exercise if your blood sugar is high and you have ketones in your urine or blood.
  • Be safe when you learn to drive. Check your blood sugar before you drive. If your blood sugar is low, treat it with 15 grams of carbohydrate and wait for your blood sugar to go back to normal. Keep snacks that contain carbohydrate in the car. If you feel like your blood sugar is low, pull over and check your blood sugar. Treat your blood sugar before you start driving again, if needed.
  • Do not drink alcohol or smoke. Alcohol affects your blood sugar level and can make it harder for you to manage your diabetes. You may not be aware of low blood sugar when you drink alcohol. Nicotine can damage blood vessels and make it more difficult to manage your diabetes. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.

Follow up with your healthcare provider as directed:

You may need to return to have your A1c every 3 months. An A1c test shows the average amount of sugar in your blood over the past 2 to 3 months. Your A1c should be less than 7.5%. You may also need to return at least once each year to have your feet checked.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 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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