Raising a child with diabetes can be challenging… Here are a few tips on caring for their well-being.
When your child is diagnosed with Type 1 diabetes, it changes your life as a parent too. A chocolate bar, takeout meal or missed breakfast can send their blood sugar into dangerous highs or lows, so you — and your child, if they’re old enough — have to be extra careful in balancing their food and medication. Type 1 diabetes isn’t related to eating or drinking too much sugar, says Dr David Segal in a paediatric diabetes ‘survival guide’ co-written with biokineticist Beverley Davey.
What is diabetes?
The body’s immune system mistakenly attacks the cells that produce the hormone insulin in your pancreas. Without insulin, your body can’t move sugar from the bloodstream into the cells that require it for energy.
– Type 1 is an auto-immune disease that often develops in childhood. It affects 1 in 500 children and requires insulin injections for life.
–Type 2 accounts for 90% of all cases and develops gradually. It’s often lifestyle-related, and can be reversed through healthy eating, regular physical activity and weight loss.
Symptoms of diabetes to look out for
Watch out if your child is extremely thirsty and peeing more than usual. Other signs of diabetes include being very hungry (yet still losing weight), being irritable, easily tired, having blurred vision or flu-like symptoms.
Seek urgent help if your child’s breath smells ‘fruity’, as this could be linked to a life-threatening complication called diabetic ketoacidosis (diabetic coma). Without medical intervention, symptoms typically progress from nausea, vomiting, abdominal pain and/or fruity breath, to drowsiness and confusion, and eventually coma.
Is it an emergency?
In someone who has diabetes, blood sugar levels that are either too high or too low can risk diabetic coma, which could be fatal.
Hyperglycaemia (levels that are too high) causes thirst, frequent urination, tiredness and blurred vision —and is often triggered by missed insulin doses, illness, stress or eating too many carbs.
Hypoglycaemia (too-low blood sugar levels) can result in sweating, shakiness, irritability and confusion — and is often triggered by too much insulin, skipped meals or excessive physical activity.
Educate yourself
The first step is getting a basic understanding of diabetes. Ask your child’s healthcare providers lots of questions and do your own research. Additional support is available from organisations such as Youth with Diabetes (www.youthwithdiabetes.com) and Diabetes SA (www.diabetessa.org.za).
Involve your child in what’s happening. “For younger children, simple explanations such as ‘your body needs extra help to use sugar for energy’ may be sufficient,” says clinical psychologist Daniel Sher. “Older children will benefit from more detailed discussions about insulin, blood glucose levels and long-term management. Using visuals, stories and even apps designed for children with diabetes can help them grasp complex concepts.”
Testing their levels
Your child’s blood sugar needs to be tested regularly so you can give the correct dose of insulin and plan meals and activities accordingly. Four daily sugar checks are necessary: before meals and at bedtime, says Dr Segal — plus extra tests during illness, exercise or highs/lows.
Your doctor will give you a finger-pricking tool and a blood glucose meter with test strips, and you’ll be taught how to draw a blood drop from your child’s finger and test it at home. You need to record the result, time, any relevant symptoms and insulin doses in a notebook or use a free mobile app (such as mySugr or Diabetes in Check).
Continuous glucose monitors (CGM) do all of the above digitally but they’re expensive. CGMs are typically worn on the upper arm and provide alerts for rising or falling glucose levels. They allow parents to track their child’s glucose levels 24/7, and even remotely by smartphone.
Giving insulin injections
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Your child’s blood glucose levels will determine the amount of insulin needed. Injecting your child with insulin may initially seem distressing but it will soon become routine. It’s important to rotate the injection sites around the body (upper arm, stomach, thigh or buttocks) to avoid scarring and to improve insulin absorption. Some experts suggest letting the child choose the site to boost their confidence and feeling of control.
The dose can also be provided through an insulin pump, which involves placing a small tube just under the skin and continuously injecting the required amount of insulin.
Living with diabetes
Your child’s diet needs to be individualised, says Dr Segal. “The carb content, amount and timing is very important. Sugar is allowed in small amounts and will make up part of the carb value at meals. Remember, everything in moderation and stick to basic healthy eating.”
Being physically active can control sugar levels and help insulin work better, so allow your child to be a child. Diabetes must fit into their lifestyle, not the other way around.
Words: Silke Colquhoun
Photography: Gallo/Getty Images
