Blood Glucose Monitoring, Pediatric

Monitoring your child's blood sugar (glucose) is an important part of managing your child's diabetes. Blood glucose monitoring involves checking blood glucose as often as directed and keeping a log or record of the results over time.

• Help you and your child's health care provider adjust your child's diabetes management plan as needed, including medicines or insulin.
• Help you and your child understand how food, exercise, illnesses, and medicines affect blood glucose.
• Let you and your child know what your child's blood glucose is at any time. You can quickly find out if your child has low blood glucose (hypoglycemia) or high blood glucose (hyperglycemia).

Your child's health care provider will set individualized treatment goals for your child's blood glucose levels before meals (preprandial) and after meals (postprandial).

Supplies needed:

• Blood glucose meter.
• Test strips for your child's meter. Each meter has its own strips. You must use the strips that come with your child's meter.
• A needle to prick the finger (lancet). Do not use a lancet more than one time.
• A device that holds the lancet (lancing device).
• A journal or log book to write down your child's results.

How to check your child's blood glucose

Checking your child's blood glucose

1. Wash your hands and your child's hands for at least 20 seconds with soap and water.
2. Prick the side of your child's finger (not the tip) with the lancet. Use a different finger each time you check blood glucose.
3. Gently rub the finger until a small drop of blood appears.
4. Follow instructions that came with the meter for inserting the test strip, applying blood to the strip, and using the blood glucose meter.
5. Write down the result and any notes in the journal.

Using alternative sites

Some meters allow you to use areas of your child's body other than the finger (alternative sites) to test the blood. The most common alternative sites are the forearm, the thigh, and the palm of the hand.

Alternative sites may not be as accurate as the fingers because blood flow is slower in those areas. This means that the result you get may be delayed, and it may be different from the result that you would get from your child's finger.

• You think your child has hypoglycemia.
• Your child sometimes does not know that his or her blood glucose is getting low (hypoglycemia unawareness).

General tips and recommendations

Blood glucose log

• Every time you check your child's blood glucose, write down the result. Also write down any notes about things that may be affecting your child's blood glucose, such as diet and exercise for the day. This information can help you and your child's health care provider:
  • Look for patterns in your child's blood glucose over time.
  • Adjust your child's diabetes management plan as needed.
• Check if your child's meter allows you to download records to a computer or if there is an app for the meter. Most glucose meters store a record of glucose readings in the meter.

If your child has type 1 diabetes:

• Check your child's blood glucose 4 or more times a day if your child is on intensive insulin therapy with multiple daily injections (MDI) or an insulin pump.
• Also check your child's blood glucose:
  • Before every meal.
  • Two hours after a meal.
  • At bedtime.
  • Before and after exercise.
  • Occasionally between 2:00 a.m. and 3:00 a.m., as directed.
  • Before activities that create a risk for injury, like riding a bike or driving.
  • If your child has symptoms of hypoglycemia.
  • After treating your child's low blood glucose.
• You may need to check your child's blood glucose more often, up to 6–10 times a day, if your child:
  • Has diabetes that is not well controlled.
  • Is ill.
  • Has a history of severe hypoglycemia.
  • Has hypoglycemia unawareness.

If your child has type 2 diabetes:

• If your child takes insulin, check his or her blood glucose before every insulin injection, or check it 4 or more times a day.
• If your child takes diabetes medicines by mouth (oral medicines), check his or her blood glucose 2 or more times a day.
• Also check your child's blood glucose:
  • Before and after exercise.
  • If your child has symptoms of hypoglycemia.
  • After giving your child treatment for a low blood glucose.
  • Occasionally between 2:00 a.m. and 3:00 a.m., as directed.
  • Before activities that create a risk for injury, like riding a bike or driving.
• You may need to check your child's blood glucose more often if:
  • Your child's medicine is being adjusted.
  • Your child's diabetes is not well controlled.
  • Your child is ill.

General tips

• Make sure your child always has his or her supplies available.
• If you have questions or need help, all blood glucose meters have a 24-hour hotline phone number that you can call. Also contact your child's health care provider with questions or concerns you may have.
• After you use a few boxes of test strips, adjust (calibrate) your child's blood glucose meter by following instructions that came with the meter.

Where to find more information

• The American Diabetes Association: www.diabetes.org
• The Association of Diabetes Care & Education Specialists: www.diabeteseducator.org

Contact a health care provider if:

• Your child's blood glucose is out of his or her healthy range. Your child's health care provider will tell you when you should contact a health care provider in these cases.
• Your child develops a serious illness.
• Your child has been sick or has had a fever for 2 days or longer, and he or she is not getting better.
• Your child cannot eat or drink.
• Your child has nausea or vomiting.
• Your child has diarrhea.

Get help right away if:

• Your child's blood glucose is lower than 54 mg/dL (3 mmol/L).
• Your child becomes confused or has trouble thinking clearly.
• Your child has difficulty breathing.
• Your child has moderate or large ketone levels in his or her urine.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

Summary

• Monitoring your child's blood glucose is an important part of managing your child's diabetes.
• Blood glucose monitoring involves checking blood glucose as often as directed and keeping a log of the results over time.
• Your child's health care provider will set individualized treatment goals for your child's blood glucose levels before meals (preprandial) and after meals (postprandial).
• Every time you check your child's blood glucose, write down the result. Also write down any notes about things that may be affecting your child's blood glucose, such as diet and exercise for the day.