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17.1.15

Having Juvenile Diabetes and Going to School

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The vital step after your child is diagnosed with juvenile diabetes is to develop a support

network in the community. Your child’s school should be at the top of this as a resource

to tap into. Not only is it essential that the teachers at your child’s school know about his

special dietary needs and what to do in an emergency they can provide help in other ways

too.

In addition to good control of blood glucose levels to ensure the current and future well-

being of your child’s health, good control of diabetes is critical to learning. When a child

is experiencing highs or lows in the blood sugar reading this can create disruptions and

make it hard for them to concentrate and learn.

The teachers or other support personnel are going to need instruction for handling your

child’s diabetes and what to do in case of an emergency. For a child with a low blood

sugar it is important that their blood glucose level is checked and that they have

something to eat. For a child with a high blood sugar, their blood glucose will need to be

checked too and a decision has to be made whether or not to give insulin. This is a big

responsibility to hand over to another adult and can be nerve-racking for parents.

An emergency kit should be with your child at all the time with instructions on what to

do to help if something is wrong. Included should be a snack, a food item or glucose

tablet that is fast acting (gets sugar into the system quickly), a list of emergency numbers

to call, and a glucose monitor. A teacher or school nurse should be designated as the

person responsible for your child while at school and they should have a back-up in case

they are not present for a day or more.

Having Juvenile Diabetes and Going to School

Getting Back on Track after Blood Sugar Spikes

Even with careful planning your child is going to test with high blood sugars – but

hopefully not too frequently. There are many reasons for this, including not taking

insulin on time or enough, eating too much, not exercising enough, and stress.

High blood sugar in children does not occur as quickly as a low blood sugar will. You

may find that over the course of a day or couple of days that your child’s blood glucose

levels are creeping upwards. Signs that high blood sugar is becoming a problem is your

child needing to urinate more and an increased need to drink (very thirsty). Over time,

elevated blood sugar can cause serious damage to eyesight and other organs including the

kidneys. With the increased urination, dehydration is also possible if enough liquids are

not taken in.

If over the course of a day, your child’s blood glucose levels do not return to normal an

increase in their insulin dosage may be required. If you have been managing your child’s

diabetes for some time you may be comfortable making these adjustments yourself. If

not, call your doctor and get advice on what adjustments need to be made and whether

they are long or short term changes.

Evaluate your child’s diet too. Have there been any foods that have been introduced

recently that could be causing the problem? Other factors to consider is if your child is ill

(some medications can raise blood sugars), and has your child been less active in the past

couple of days. If your child’s body is used to regular physical activity, by being

sedentary your child’s blood glucose levels will be higher. Until the blood glucose levels

return to normal, ensure that your child is getting plenty of fluids – the sugar free kind is

the best choice.

Getting Back on Track after Blood Sugar Spikes

Finding out Your Child has Juvenile Diabetes

It can be an emotional time when you find out that your child has been diagnosed with

type 1 diabetes. You will wonder how this is going to affect your child emotionally and

what it is going to mean for their future health. Your child is also going to be riding an

emotional roller coaster. Depending on their age, they may or may not understand

everything that is going on but they will understand that there are big changes being

implemented.

When a child is diagnosed with diabetes it affects the entire family. The day to day life

of everyone may be changed. It will be a stressful time for but the best thing to do is to

utilize the support available to you from your family, friends and health care providers.

Educate yourself and your family and take it slow and easy. You are going to have a lot

to learn and there is going to be a learning curve at the beginning. Not only do you need

to learn how to give injections and monitor blood glucose levels but you will also have to

plan very specific meals. But it can be done and after some time it will be second nature.

Your whole family can benefit from the lifestyle changes that are going to be made. It

may be especially hard for siblings but they will adjust just as everyone else will too.

Eating a healthy well-balanced diet with plenty of exercise and physical activity is good

for the entire family.

Be there to support and listen to your child when they need it. They will be going

through a range of emotions from anger to sadness and they are going to need their

parents help during these times. If you keep a positive attitude and outlook they will too.

Finding out Your Child has Juvenile Diabetes

Different Responsibilities to give Children with Diabetes

The best way to help your child adjust to being a diabetic is to involve him or her in their

treatment plan. Depending on their age and level of maturity the level that they are

involved and what they can do will be different. Be aware that as children grow older,

they are going to take more and more control over their disease and you have to know

when it is time to step back and let them.

For children three years of age and under, the management process is going to be solely

in your hands. Even if there is a desire to do things on their own, their coordination skills

and maturity level isn’t where it needs to be to give themselves injections or test their

own blood. As they are approaching the three year old mark, you may be able to involve

them in decisions like which finger is to be used to test their blood or putting the strip

into the monitor. Be on the look out for ways to include them as they become older and

interested in doing so.

As your child becomes a preschooler they are going to want to do everything on their

own no matter what it is. Your child may begin to have more control over testing their

blood but it still needs to be done under parental supervision. Insulin injections should

still be handled by the parent at this age. Your child will have definite opinions on what

they should be eating for meals. Give them options and let them decide what is going to

be made for dinner.

From the age of about eight years old and up, your child may be ready to give themselves

their own injections. You will have to follow your child’s and your own comfort level.

Different Responsibilities to give Children with Diabetes

16.1.15

Different Kinds of Insulin

There are different brands of insulin that are available but in each brand there are two different kinds of insulin that are used to control juvenile diabetes. One is known as fast-acting insulin – once it is injected it acts quickly in your child’s system. The other type of insulin is called slow-acting or last-lasting and as the name implies it is in the child’s system longer.

For most people with diabetes a combination of the two types of insulin is required. They can be mixed together in one syringe or they can be taken separately at different times in the day. In children, the two different kinds of insulin will still react at different times for each individual.

For some the fast-acting insulin will begin to work immediately and could be used up in a short period of time. In this case, they may have to have a second or even third injection of fast-acting insulin throughout the day. These are the children who may want to consider an insulin pump to reduce the number of injections they are having in a day. An insulin pump will also provide them with a steady amount of the fast-acting insulin as they need it.

The long-acting insulin sits in a child’s body for some time before it is put to use. The amount of time is going to vary by child. Ideally, once the fast-acting insulin has done its work, the long-acting insulin will take over keeping a steady supply of insulin.

The combination of the two insulins and how they work together makes planning very important. After some time you will be able to determine how your child reacts to each of the different kinds of insulins. Planning meals and activities around how the insulin works is important not just when the injection is given.

Different Kinds of Insulin

15.1.15

Complications Associated with Juvenile Diabetes

As with any disease there are possible complications and side effects and juvenile

diabetes is no exception. The risks and complications associated with this disease are

serious but can be mitigated with careful monitoring and control of your child’s blood

sugars.

All people that have been diagnosed with diabetes need to have their eyes checked on a

regular basis. It is common to have eye problems that are known as diabetic retinopathy.

This is when the blood vessels in the eyes are damaged because of raised continually

raised blood sugars.

Another complication is diabetic nephropathy. This is a problem that develops in the

kidneys taking the form of degeneration or a complete shut-down. This is a very serious

disease and should be kept in mind as an important reason to keep blood glucose levels

under control at all times. If diabetic nephropathy does develop, it will usually occur

later in adulthood but will require either dialysis or a transplant.

Some more long-term effects children with diabetes are exposed to are heart disease,

strokes, and hypoglycemia. But the severity of the complications and the likelihood of

them occurring are dependant on how well the diabetes is controlled.

Research continues everyday on ways to better treat and manage diabetes in children. As

soon as your children are old enough to understand the disease, involve them in the

management of keeping it under control. They need to learn what is needed of them

when they become independent to live with diabetes and lessening the chances of

suffering from severe complications.

There have been big strides in the treatment of diabetes which has made it possible to

delay our put off altogether some of the more troublesome problems. If you suspect that

any of the above mentioned diseases are developing, consult with your doctor right away.

Early detection is beneficial.

Complications Associated with Juvenile Diabetes

Checking for Ketones in Juvenile Diabetics

Another part of the routine for monitoring and controlling juvenile diabetes is checking

for the presence of ketones. This is done by dipping a stick available at drug stores into

your child’s urine. If ketones are present the end of the stick will turn a certain color. By

matching the color of the stick with the legend on the container you can determine the

level of ketones present.

You should check for ketones first thing in the morning before your child eats (fasting).

Give your child additional insulin and fluids if there are ketones present. Also, check

again in a few hours and if the test is still positive you should check with your doctor for

further instructions.

When there are ketones in urine it is a sign that your child’s body is not getting enough

food and it is using fat stores for energy instead of food. Excessive ketones can lead to a

condition known as ketoacidosis. This is a very serious condition and can even be life

threatening. In addition to the presence of ketones you child may be very tired, have

trouble breathing, and have stomach pains or nausea.

Ketoacidosis will be present if your child’s body does not have enough insulin to process

the food he or she is eating or if they are not eating enough. The good thing about this

condition is that it is easy to prevent with careful monitoring and by following a meal

plan. If you discover ketones, it does not mean that your child has ketoacidosis. Increase

the amount of insulin that is being given in addition to reviewing recent diet changes to

try and rule out the reason for the ketones.

As in all cases when you have questions about juvenile diabetes, contact your health care

provider or diabetes educator.

Checking for Ketones in Juvenile Diabetics

Diabetic neuropathy

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17.1.15

Having Juvenile Diabetes and Going to School

Getting Back on Track after Blood Sugar Spikes

Finding out Your Child has Juvenile Diabetes

Different Responsibilities to give Children with Diabetes

16.1.15

Different Kinds of Insulin

15.1.15

Complications Associated with Juvenile Diabetes

Checking for Ketones in Juvenile Diabetics

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