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How to support a diabetic child

How to support a diabetic child
Reader's Digest's comprehensive guide on how to help your child accept and manage diabetes, which will provide an invaluable contribution to their future health
Type 1 is the form of diabetes most often linked to onset in childhood. Today, however, increasing numbers of children and teenagers are being diagnosed with Type 2 diabetes—a phenomenon linked to the growing number of youngsters who are overweight. There is also another kind of diabetes, Maturity Onset Diabetes of the Young (MODY), which runs in families and develops before the age of 25.
"Today, increasing numbers of children and teenagers are being diagnosed with Type 2 diabetes"
Learning that your child has diabetes can spark a range of emotions—from guilt to fear and anger. You may mourn the loss of your child’s health and wonder how you and your child will ever deal with injections, blood testing and other issues. Remember your child’s diabetes care team is there to help you and support your child. Here are some tips:
  • Learn as much as you can about diabetes. Visit diabetes.org.uk or call the Diabetes UK Careline 0845 120 2960 for specific advice
  • If your child is old enough, encourage them to visit Diabetes UK’s special website for children diabetes.org.uk/Guide-to-diabetes/My-life/
  • Involve your child with the management of diabetes so they are familiar with what to do when old enough to manage it alone
  • Make sure your doctor refers you and your child to a structured education programme to learn how to manage diabetes
  • Other parents of children with diabetes can be supportive; ask your doctor or diabetes specialist nurse if there are any family or children’s support groups in your area
  • Talk to teachers, friends and family about how your child’s condition should be managed at school and make sure they know what to do if your child has a hypo (a drop in blood sugar)

Different ages and stages

Credit: Irina_Geo
Diabetes can be challenging however old your child is. But the toddler years—when your child may not understand why he or she has to have injections and blood samples taken—and the teens can be especially difficult. Teenagers do not like to be different from their friends and may rail against the inevitable restrictions diabetes places on their life, and rebel against your attempts to offer advice and help.
"The physical changes of puberty can also make diabetes more difficult to control"
The physical changes of puberty can also make diabetes more difficult to control. Diabetes UK has two magazines, My Life for younger children and On the Level for teenagers. Call Diabetes UK Supporter Services on 0845 123 2399 or email supporterservices@diabetes.org.uk

Insulin and your child

In the same way as adults with Type 1 diabetes, children have to take daily insulin either by injection or insulin pump. Your child may find the first few injections distressing, but as you both become used to it and relax, it will get easier. To help ease your child’s anxiety:
  • Be positive: Encourage your child to think of injections as a fact of life and give praise afterwards
  • Make no excuses: Don’t give in to delays or excuses; if your child wants to grumble about the injection, insist this is done after the injection
  • Address fears: If your child has a severe fear of needles, discuss this with the diabetes healthcare team. An insulin pump might be suitable for your child

Bear in mind

It is important to vary the insulin injection site to avoid small lumps building up under the skin that can impede insulin absorption. To aid rotation, children are usually shown a picture of a human figure with injection sites identified within a grid. But children often find it hard to use this kind of aid.
"Children were more successful at finding the right sites when they marked injection sites on a pair of ‘injection teddy bears’"
A 1996 study from the University of Florida found that children aged 6–11 years were more successful at finding the right sites when they marked injection sites on a pair of ‘injection teddy bears’.

Going at it alone

As your child gets older and more independent, they may decide to self-inject. Never force this—give your child time to decide when they are ready. The diabetes healthcare team will help with the transition, but you must supervise. Here are some tips:
  • Help your child to work out how much insulin is needed
  • Encourage your child to choose the injection site
  • Teach them how to draw insulin into the delivery device and inject insulin—it can help to practise on an orange

Using a pump

Insulin pump therapy (continuous subcutaneous insulin infusion) can make diabetes easier to control and enable your child to have a more flexible lifestyle. It is suitable for babies, young children and teenagers but not everyone is eligible for a pump on the NHS. To find out if your child meets official criteria, visit nice.org.uk. You can pay for a pump yourself, but it is expensive.

Monitoring blood glucose

Regular blood glucose monitoring is an important part of blood glucose control. Your child’s diabetes healthcare team can show you how to test blood glucose and advise on devices to take blood from parts of the body other than the finger.

When a child with diabetes becomes ill

Credit: Irina_Geo
If your child becomes ill, their glucose levels may either rise or fall, so testing is especially important. Be certain always to have the right testing equipment on hand. Here are some suggestions to help maintain your child’s diabetic control during bouts of illness:
  • Check your child’s blood glucose levels frequently
  • If eating or keeping food down is a problem, replace meals with drinks that contain carbohydrates, or soft foods such as yoghurt. If your child is being violently or regularly sick, contact your GP or diabetes healthcare team
  • If your child has Type 1 diabetes, you will need to test the urine or blood for ketones to find out if the diabetes is uncontrolled. You can obtain the test strips on prescription
  • Continue to give insulin or tablets as normal, but the dose can be adjusted in response to blood glucose test results

Your child’s diabetes-friendly diet

Credit: Chinnapong
You don’t need to feed your child special foods if he or she has diabetes—provide a healthy, balanced diet as you would for any other child.
A registered paediatric dietitian can help you plan your child’s meals. Diabetic children should also have a regular review with the dietitian to adjust their diet to meet their needs as they grow. The following tips may also help:
  • Keep meals regular: Make sure your child eats regularly. Go low GI Base meals around low GI (glycaemic index) starchy foods and offer plenty of vegetables and fruit
  • Reduce fats: Cut down on saturated (animal) and trans fats (in processed foods)
  • Watch sugar intake: Keep sugary foods for special treats—and look for low-sugar, low-fat versions of cakes and biscuits, or bake your own. Choose sugar-free or low-sugar drinks as sugar in liquid is absorbed quickly and can push up blood glucose levels

Activity matters

Regular physical activity is important for any child and diabetic children are no exception. Aim for your child to have a minimum of an hour of brisk exercise every day. But be aware that physical activity causes a fall in blood glucose and it can take trial and error to balance food intake, insulin and exercise.
If your child is more active than planned, they risk having a hypo. To avoid a hypo:
  • Check your child’s blood glucose before and after activity
  • Increase the amount your child eats before exercise. Reduce your child’s insulin dose before exercise
  • Teach your child to avoid strenuous activity when insulin action is at its peak—usually up to two hours after an insulin injection
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