Caring for Children
Choosing a Team
Blood Sugar Monitoring
Diet
Exercise
Exercising Safely
Sick days
Insulin and Medications
When a child gets diagnosed with diabetes, both parent and child are upset. It's natural to experience a range of emotions-anger, sadness, fear, anxiety, and grief. It can take time for children, especially young children or teens, to accept the reality of living with a chronic illness.
It also means big changes ahead for your child and your family. But you don't need to do it alone-your child's team of diabetes health professionals can help you manage his or her care.
Helping your child follow the food, exercise and treatment plan developed by the diabetes team plays a key role in maintaining his or her good health and preventing complications and side effects from developing. Learning about diabetes and teaching your child about it will help you both take constructive action and develop practical strategies to manage the illness and make it feel less overwhelming.
As the first step, you should choose a doctor with experience treating diabetic patients - either a diabetes specialist, internist, pediatrician or family practice specialist. Make sure that you feel comfortable asking the doctor questions and can understand the answers. Your diabetes team can also include the following health professionals:
- Diabetes Educator-A Certified Diabetes Educator (CDE) can help you and your child understand diabetes and develop an effective treatment regimen, including the three key components: insulin, diet and exercise.
- Dietitian-A nutrition professional can develop a food plan that meets your child's nutritional needs and helps maintain a healthy blood sugar level.
- Mental health professional-Working with a counselor, psychologist, psychiatrist or social worker can help you, your child and your family cope with the psychological side of the illness.
- Eye Doctor (Ophthalmologist or Optometrist) -Children with diabetes need eye exams every three to five years.
- Exercise Physiologist-A physiologist can develop an exercise regimen that your child will enjoy and be able to follow.
- Podiatrist-This foot specialist treats foot problems that can arise with diabetes.
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Checking glucose levels regularly is key to keeping your child's blood glucose in a healthy range. Your doctor will determine your child's target range and when you need to check. Insulin-dependent diabetics generally need to check blood glucose three to four times a day. Illness and activity level can affect blood glucose and might require additional checking.
Your diabetes educator can help you select an easy-to-use blood glucose meter (a device used to check blood glucose) that fits your budget.
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Eating a structured meal plan can be a difficult adjustment for a child but it is critical to maintaining healthy blood sugar. Living with diabetes no longer means cutting out sweets completely; instead, it means eating a healthy, balanced diet that every growing child needs. A balanced diet features foods from the three major groups - protein, carbohydrates and fats - in the appropriate amounts.
Meeting your child's nutritional needs requires some changes in food shopping and preparation and keeping the right snack foods available. Your dietitian provides the best source for guidance with meal planning and helping your child follow a food plan. In general, the same nutritional principles apply to all diabetics - children or adults. Some diabetics use carbohydrate counting or food exchanges to ensure a healthy balance of nutrients to maintain the blood sugar target range. (See "Nutrition" section.)
With a little extra effort and planning, children with diabetes can live a normal life. When your child eats out at restaurants, choose the lower fat options and healthier desserts, such as frozen yogurt. Also, don't overdo the bread. When your child goes to a party, call ahead of time to check what foods will be served. You might want to pack some healthy snacks. Check your child's blood glucose beforehand; giving some extra insulin might also be a good idea. And being diabetic doesn't mean your child must forgo birthday cake - as long as you prepare for it.
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Physical activity not only benefits your child's overall health, it also helps the body use insulin and lowers blood glucose. It also helps keep weight down, which is critical in controlling diabetes and preventing complications.
You can help your child stay active by making physical activity a part of your entire family's routine. Find activities you all enjoy - whether it's walking, swimming, hiking, volleyball or jogging. Enroll your child in an after-school exercise program or another organization such as the YMCA that offers a fitness program.
If your child leads an inactive life, start by making small changes, such as taking short walks or using stairs instead of elevators.
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Exercise, for a child with diabetes, means your child must take some special precautions:
- Check blood glucose before beginning to exercise.
- If it is less than 100 mg/dl, eat a snack and wait until it goes up.
- If it is more than 250 mg/dl, check for ketones; if they are moderate or high, don't exercise.
- Bring a snack and a bottle of water - diabetics must stay well-hydrated.
- If your child plays competitive sports, inform the coach or leader about his or her condition.
- Give your child an ID bracelet or necklace to wear.
- Watch for signs of hypoglycemia (low blood glucose). Your child should take 2 to 3 glucose tablets or 1/2 cup of juice or ½ serving of a regular soda at the first sign of symptoms: tiredness, weakness, and dizziness.
- After exercise, check the child's blood glucose several times over the next few hours.
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Diabetes can complicate typical childhood illnesses, such as a cold or flu. Children with diabetes who effectively control their blood sugar don't get sick more often; however, illness can significantly impact blood glucose levels. Your doctor can advise you on managing diet, insulin doses and medications when your child gets sick.
Some general guidelines might help:
- Make sure your child drinks plenty of fluids to prevent dehydration. If he or she can't eat, it's important to drink liquids with carbohydrates, such as fruit juices, sports drinks and ginger ale.
- Maintain insulin intake. Younger or newly diagnosed children might need less insulin while older children might need more insulin. When in doubt, consult your child's doctor.
- Stick to the usual meal plan as closely as possible if your child can eat.
- When possible, choose medications without sugar or alcohol, which can raise blood glucose. Other medications, such as decongestants, can also raise blood glucose. And anyone with kidney problems should not take ibuprofen.
- Check blood glucose every few hours all day and night.
- Check ketones if your child takes insulin to prevent diabetic ketoacidosis (DKA), which illness can trigger. Too little insulin in the system causes DKA.
- Write down the results of the blood glucose and ketone checks in case you need to call your child's healthcare provider.
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Children with type 1 diabetes need to take insulin and perhaps oral medications. Your diabetes educator can help you learn to administer insulin injections to your child, including using syringes and rotating sites. Other methods for taking insulin include a skin patch and the newly available inhaled insulin.
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Thursday
November 20, 2008
Tip of the Day
Regular exercise increases the number of insulin receptor sites on cells, making the body more sensitive to insulin.
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