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Diabetes care in preteens and teens is not always easy. It might seem like there is a lot for you to remember. But you don’t have to do it alone! You’ll work with your child’s healthcare team to develop a diabetes management plan. Use the tips on this sheet to help you adjust to managing your child’s diabetes. NOTE: This sheet does not give all the information you need to care for your preteen or teen with diabetes. Ask your child’s healthcare provider for more information.
At this age, keeping your preteen or teen’s blood sugar in range may not be easy. This is due to the hormones that cause puberty. So, don’t worry that your child’s blood sugar isn’t perfect. Encourage your child to handle some of the responsibility for blood sugar checks as he or she gets older. Your child must be prepared to check blood sugar regularly as directed by the healthcare provider. The best sites to do checks are the sides of the fingers, heels of the hands, or the arms. Even if your child does his or her own checks, you MUST monitor your child’s results. This is the only way to make sure that his or her blood sugar is staying in a healthy range. You can act as your child’s coach. To do this:
Sit down with your child at least once a week to talk about his or her blood sugar numbers.
Download meter numbers to a computer. Or, review the numbers in his or her log book.
Decide together if your child’s blood sugar is staying on target.
It’s very important for your child’s blood sugar never to get too low. So, you and your child must manage his or her blood sugar as much as possible without letting it get too low. Over time, you and your child will learn what is normal for him or her. This will help you both recognize symptoms of low blood sugar. You can help support your child by paying close attention to how he or she is acting. Your child may have low blood sugar if he or she is:
Lethargic (sleepy or drowsy)
Staring into space or glassy-eyed
If you suspect your child has low blood sugar, check it right away. If the result is less than 70, take action. Treat your child right away with a fast-acting sugar as you were told by the healthcare provider. If your child is confused, unresponsive, unconscious, or having convulsions (seizures), he or she may have severely low blood sugar. Treat your child right away with glucagon. This is a substance that raises your child’s blood sugar very quickly. Always have an emergency kit with a shot of glucagon with you. (Your child’s healthcare team will teach you how to give a glucagon shot.)
Call your child’s healthcare provider right away or seek emergency care if your child has any of the following symptoms:
Hard to wake or unresponsive
Passes out (faints)
Fruity-smelling breath (or breath smells like nail polish remover)
Blood sugar below the “danger number” given to you by the healthcare provider
Ketones present in urine or blood
The amount of insulin your child needs and how often it’s needed may vary. It depends on when and how often your child is eating and how active he or she is. Your child might even show an interest in doing his or her own insulin shots. But all shots MUST still be supervised, at home and at school. Let your child decide when he or she is ready for more responsibility. You can support your child’s efforts to take over his or her diabetes care. But be prepared to manage your child’s shots when needed, such as when your child is sick.
It’s not unusual for children to be upset about having to take insulin shots at first. But most children adjust quickly to diabetes care. How quickly your child adjusts may depend on how comfortable you are giving shots. At first, you may have your own concerns. If you are nervous, here are some things that can help:
You may want to practice on yourself first. Ask your child’s healthcare provider about giving yourself an injection of sterile saline to learn how a shot feels.
If you are afraid of needles, using an injection device may help ease your fear.
Treat shots as a normal routine. This helps speed up the adjustment process for you and your child.
If you are still having trouble, discuss your concerns with your child’s healthcare team. They can help you adjust.
Most children don’t want to be seen as being different from their peers. This can get in the way of diabetes care, especially when your child is away from home. Encourage your child to learn more about diabetes and to take on more responsibility when ready. But remember that things may not always go smoothly. This doesn’t mean that your child has failed at diabetes management. Just know that your child may need more support. If your child is having a hard time adjusting to life with diabetes, counseling may help. Talk to your child’s healthcare team about this.
Your child will need to learn about foods that affect blood sugar the most. Keep these things in mind:
Your child’s healthcare team will teach you about carbohydrates. Carbohydrates are foods that give your child the energy he or she needs to grow. But they also raise blood sugar higher and faster than other kinds of foods. Your child’s healthcare team will teach you “carb counting.” This is a technique to help you figure out how many carbohydrates your child eats each day. Carb counting helps you decide how much insulin your child needs.
If needed, you can write the carb count of each food on a piece of paper. Then put the paper into your child’s lunch bag when he or she goes to school. This helps both your child and the teachers know how many carbohydrates are being eaten. It will also help your child learn to connect carbohydrates with his or her insulin dose.
Remember that kids will be kids! Don’t restrict what your child is eating or when he or she can eat. Children will sneak treats if they feel deprived. So, work the foods your child likes to eat into his or her meal plan. Adjust insulin dosages as needed. The healthcare team will teach you and your child how to adjust insulin based on what your child eats.
At this age, food and eating may be a sensitive issue for your child. So be aware of problems that can affect blood sugar management. One such problem is called diabulemia. People with diabulemia skip shots or take too little insulin. They do this to lose weight or to keep from gaining weight. Diabulemia is a dangerous condition. Watch for any signs that your child is having trouble following his or her meal plan. If needed, contact your child’s healthcare provider for advice and assistance.
Like food and insulin, physical activity plays a big role in managing your child’s blood sugar. Being active helps reduce the amount of glucose in your child’s blood. But too much activity can cause his or her blood sugar to get too low. That’s why it’s important for your child to check his or her blood sugar closely during activity. Talk to the healthcare provider to learn how your child should balance activity with food and insulin. NOTE: Don’t inject insulin into a muscle, such as in the leg, right before physical activity. The insulin will absorb too quickly.
Your child has the right to receive proper diabetes care and equal treatment at school.
To make sure your child’s needs are met, write down his or her diabetes care plan. This is sometimes called a “504 plan.” At the beginning of the school year, meet with your child’s teachers, school officials, and school nurses. Explain your child’s treatment plan.
Your child will need to be able to check his or her blood sugar in the classroom. Your child must be free to eat or drink in class if blood sugar is low.
Someone at the school will need to perform or supervise your child’s insulin shots. This may be a job for the school nurse.
Your child will need to carry a kit for diabetes supplies. This includes testing supplies, medications, and fast-acting sugar for emergencies.
Inform the school that your child can still be active and participate in all school activities.
Your child’s healthcare team can teach your child how to talk about diabetes with classmates.
It’s important to let your teen know that driving carries extra responsibility. Your child must check his or her blood sugar each time before driving. This is because low blood sugar can affect your child’s ability to operate a car safely. And he or she must keep blood sugar supplies close at hand (not in the trunk or back seat.) Work with your child’s healthcare team to determine when your child is ready to drive. And have the healthcare team help your child learn to stay safe when driving.
Sex is a sensitive subject for many families. But when your child has diabetes, it’s an important topic to discuss. Sex, like any physical activity, can cause blood sugar to rise or fall quickly. And getting pregnant can be very risky for a teen with diabetes. This is because high blood sugar can be dangerous for both the teen and the unborn baby. So your child needs to be aware of the risks of unplanned pregnancy. If sex is hard for you to talk about at home, ask your child’s healthcare provider for help.
Smoking, drinking alcohol, and doing drugs are especially unsafe for children with diabetes. They can seriously harm your child’s health. Ask your child’s healthcare provider to talk to your child about the importance of avoiding these substances. You should also stay alert for signs that your child is participating in any of these risky behaviors. This doesn’t mean spying on your child. But it does mean staying involved in his or her life (see “Staying Involved”). If you think your child is involved in risky behaviors, contact his or her healthcare provider for help.
Managing diabetes can be a lot of work. Your child may sometimes feel worn out or overwhelmed. This can lead to burnout. Feeling burned out means that your child might slip up more often on blood sugar management. This can affect your child’s health now and in the future. If your child is feeling burned out, ask for help! Your child’s healthcare team can help you adjust your child’s schedule or blood sugar goals. Another result of burnout can be depression. Depression may be an issue as your child realizes that diabetes doesn’t go away. Contact your child’s healthcare provider right away if you notice that your child:
Doesn’t care about things that he or she used to.
Withdraws from family and friends.
Shows signs of feeling helpless or hopeless.
Has trouble sleeping or is sleeping too much.
Has trouble concentrating.
Shows signs of fatigue, nervousness, or anxiety.
The best way to support your child is to remain involved in his or her life. Preteens and teens do best with diabetes care when parents help them every step of the way. Work with your child to develop a management plan that suits the family. Help your child follow the plan by acting as his or her coach. The plan will need adjustment sometimes. So stay in close contact with your child’s healthcare team. And don’t hesitate to ask the team for advice when you run into tough spots.
For more information about diabetes, visit these websites:
American Diabetes Association www.diabetes.org
Children with Diabetes www.childrenwithdiabetes.org
Juvenile Diabetes Research Foundation www.jdrf.org
American Association of Diabetes Educators www.aadenet.org
American Association of Clinical Endocrinologists www.aace.com
National Diabetes Information Clearinghouse www.diabetes.niddk.nih.gov