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Diabetes care in young children 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 child with diabetes. Ask your child’s healthcare provider for more information. Use the side of the thumb or the side of the big toe (see shaded areas) to check your child’s blood sugar.
Very young children need to have their blood sugar checked often. You may be checking your child’s blood sugar 5-6 times a day. Make sure that you always use a lancet device to draw a drop of blood. The best places to use for blood sugar checks at this age are:
Side of fingers (not the pad)
Side of big toe (not the pad)
Side of heel (for very young children who are not yet walking)
Your child may sometimes need to be checked for ketones. Ketones are chemicals that are produced when fat, instead of glucose, is burned for energy. To check for ketones in very young children, place a cotton ball inside your child’s diaper to absorb urine. Then press the cotton ball to the ketone test strip. If ketones are present, always call your child’s healthcare provider right away.
It’s very important for young children’s blood sugar never to get too low. Very low blood sugar (hypoglycemia) can affect a child’s developing brain. So, manage your child’s blood sugar as much as possible without letting it get too low. Very young children can’t tell you when they have low blood sugar. Over time, you will learn what is normal for your child. This will help you recognize symptoms of low blood sugar. Pay close attention to how your child 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 100, 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 will raise 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
Young children may need 5-6 injections (shots) of insulin a day. This includes both slow-acting and fast-acting insulin. 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. This is especially true if your child is being breastfed. Your child’s healthcare team will teach you how to give your child shots. In young children, the best places to give shots are:
Sides of thighs
Backs of upper arms
At first, you may have some concerns about giving shots. If you are nervous, you may want to practice on yourself first. Talk to 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.) How quickly your child adjusts may depend on how comfortable you are giving shots. Treat shots as a normal routine.
It’s not unusual for children to cry and be upset when they get shots. But most children adjust very quickly to diabetes care. Shots and blood sugar checks may not be easy for your child to deal with at first. Your child should never feel that blood sugar checks and insulin shots are “punishment.” Here are some tips to help make getting shots easier for your child:
Always give your child love and attention before and after shots.
Use toys or other types of play to focus your child on something fun.
Use “play therapy” to help your child adjust by demonstrating shots on stuffed animals. You can use a syringe without a needle to pretend to give the shots.
Talk to your child’s healthcare team about other ways to help your child deal with insulin shots.
What your child is eating will help determine his or her treatment plan. You will likely start by learning 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 may teach you about “carb counting.” This is a technique to help you figure out how many carbohydrates your child eats each day. You may learn about carb counting even if your child is still being breastfed.
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 buildup in your child’s blood. But too much activity can cause your child’s blood sugar to get too low. That’s why it’s important to check your child’s blood sugar often when he or she is active. Talk to your child’s healthcare provider to learn how to balance your child’s activity with food and insulin.
Caring for a young child with diabetes is a full-time job. You may sometimes feel worn out or overwhelmed. This can lead to burnout. Feeling burned out means that you might have a harder time managing your child’s blood sugar. These tips can help you:
All the adults in the household should be involved with diabetes management. Anyone else who takes care of your child, such as a babysitter, must also be prepared to manage your child’s diabetes. A diabetes class can help. So can joining a diabetes support group or talking with a social worker.
Keep in mind that it may take some time for your family to adjust to diabetes care. At first, it might seem like your child with diabetes needs more attention than siblings without diabetes. Try to give siblings equal attention.
Despite your best efforts, your child’s blood sugar numbers will sometimes be too high or too low. When this happens, you may take these readings personally. After all, you’re working hard every day to keep your child’s blood sugar in target range. But try to remember: The numbers are tools to help you make decisions about your child’s management plan. As your child grows, his or her body changes quickly. This means that perfect blood sugar control is impossible. Adjustments to your child’s management plan are not a sign of failure. They are a normal part of your growing child’s diabetes care.
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