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Type 1 Diabetes Mellitus, Self-Care, Pediatric

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Feb.04.2021
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 Type 1 Diabetes Mellitus, Self-Care, Pediatric

Type 1 Diabetes Mellitus, Self-Care, Pediatric

Caring for your child who has type 1 diabetes (type 1 diabetes mellitus) means keeping your child's blood sugar (glucose) under control with a balance of:
  • Insulin.
  • Nutrition.
  • Exercise.
  • Other medicines, if needed.
  • Support from your child's team of health care providers and others.

It is important for you to have an active role in your child's diabetes care. The following information explains what you need to know to manage your child's diabetes at home.

What are the risks?

Having diabetes can put your child at risk for other long-term (chronic) conditions. These include thyroid disease, celiac disease, high cholesterol, heart disease, and kidney disease. These problems can get worse if you do not keep your child's blood glucose under control.

How to monitor blood glucose

  • Check your child's blood glucose every day, as often as told by the health care provider.
  • Have your child's A1C (hemoglobin A1C) level checked two or more times a year, or as often as told by the health care provider.
  • The health care provider will set individualized blood glucose and hemoglobin A1C treatment goals for your child.

Follow these instructions at home:

Medicines

  • Give over-the-counter and prescription medicines only as told by your child's health care provider.
  • Give your child insulin and other medicines every day as told.
  • Do not let your child run out of insulin or other medicines. Plan ahead so you always have these available.
  • Adjust your child's insulin dosage based on how physically active your child is and what foods he or she eats. Your child's health care provider will tell you how to do this.

Eating and drinking

The things that your child eats and drinks affect his or her blood glucose and insulin dosage. Helping your child make good choices helps to control your child's diabetes and prevent other health problems. A healthy meal plan includes eating lean proteins, complex carbohydrates, fresh fruits and vegetables, low-fat dairy products, and healthy fats.

Make an appointment to see a registered dietitian to help you create an eating plan that is right for your child. Make sure that your child:
  • Follows instructions from his or her health care provider about eating or drinking restrictions.
  • Drinks enough fluid to keep his or her urine pale yellow.
  • Keeps a record of the carbohydrates that he or she eats. You and your child can do this by reading food labels and learning the standard serving sizes of foods.
  • Follows his or her sick-day plan whenever he or she cannot eat or drink as usual. Make this plan in advance with your child and his or her health care provider.

Your child should always have a 15-gram rapid-acting carbohydrate snack available to treat low blood glucose (hypoglycemia).

Activity

  • Have your child exercise regularly, as told by your child's health care provider. This may include:
    • Stretching and doing strength exercises, such as yoga or weight lifting, 2 or more times a week.
    • Doing 60 minutes of moderate-intensity exercise each day. Moderate-intensity exercise includes brisk walking, running, and certain sports.
  • Your child may need more carbohydrates before, during, and after physical activity. It is important for your child to have a rapid-acting carbohydrate snack available before, during, and after exercise. This helps to prevent or treat hypoglycemia.
  • If your child's blood glucose level is below normal, your child should have a 5–15 gram carbohydrate snack before physical activity. Your child should have another 5–15 gram carbohydrate snack for every 30 minutes of continued activity.
  • If your child plays a sport, tell the coach that your child has diabetes.
  • Talk with the health care provider before your child starts a new exercise or activity. Work with the health care provider to adjust insulin, medicines, or food intake as needed.

Care for your child's body

  • Keep your child's immunizations up to date.
  • Schedule an eye exam for your child when he or she is age 10 or older and has had diabetes for 3–5 years. After the first exam, your child should have an eye exam every year.
  • Check your child's skin and feet every day for cuts, bruises, redness, blisters, or sores.
  • After your child begins puberty, he or she should have a complete foot exam done by a health care provider. After the first exam, your child should have a foot exam every year.
  • Have your child:
    • Brush his or her teeth and gums two times a day.
    • Floss one or more times a day.
    • Visit the dentist one or more times every 6 months.
  • Have your child's blood tested by a health care provider every year. If your child has not had a blood test in more than one year, ask the health care provider if blood tests are needed.
  • Remember that growth spurts and puberty can affect blood glucose levels and the amount of insulin that your child needs.

General instructions

  • Share your child's diabetes management plan with your child's caregivers, including people in your child's school and household.
  • Family members and caregivers should learn the symptoms of hypoglycemia and should understand how to treat it.
  • Check your child's urine for ketones:
    • When your child is ill.
    • As told by the health care provider.
    • When your child's blood glucose is above 240 mg/dL (13.3 mmol/L) for 2 tests in a row. Contact the health care provider if this happens and your child has moderate or large ketone levels in his or her urine.
  • Have your child carry a medical alert card or wear medical alert jewelry.
  • Teach your child to avoid alcohol and tobacco.
  • Keep all follow-up visits as told by your child's health care provider. This is important.

Questions to ask your health care provider

  • Do my child and I need to meet with a certified diabetes care and education specialist?
  • Where can I find a support group for children with diabetes?
  • Does my child need to have an emergency glucagon kit available?

Where to find more information

Get help right away if:

  • Your child's blood glucose level is below 54 mg/dL (3 mmol/L).
  • 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

  • Caring for your child who has type 1 diabetes (type 1 diabetes mellitus) means keeping your child's blood sugar (glucose) under control. You can do that with a balance of insulin and other medicines, nutrition, exercise, and support from others.
  • Check your child's blood glucose every day, as often as told by the health care provider.
  • Share your child's diabetes management plan with your child's caregivers.
  • Keep all follow-up visits as told by your child's health care provider. This is important.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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