Caring for A Child with Type 1 Diabetes
Taking care of a child with type 1 diabetes mellitus, or T1DM, can be challenging both emotionally and in terms of its practicalities, as it requires constant careful attention.
You will need to make sure that your child is eating the right foods at the appropriate times and taking the right amount of insulin correctly. There will be physical and emotional needs that will require understanding and management. In addition, it is important to inform those who are spending a lot of time with your child, such as teachers and coaches, about their condition and its impact on a daily basis.
To be able to respond to the general and more specific needs of your child, it is not only important to understand what type 1 diabetes entails, but also what a typical day may be like for them.
A typical day
A large part of the management of type 1 diabetes involves ‘self-care’, which requires much attention, planning, and adjustment.
There are four categories that contribute towards the overall daily self-care and management of T1DM. They include:
- blood glucose monitoring
- dietary awareness and modification
- physical activity and exercise
When these components are appropriately managed and incorporated well into your child’s daily routine, you are heading in the right direction.
Glucose monitoring in T1DM is quite frequent and carried out at least four times a day, which is usually around all the meals, snacks, and at bedtime. In addition, it is important to keep track of glucose levels before and after certain activities such as exercise and sport, as insulin dosage may need to be adjusted accordingly.
Keeping a record of your child’s daily meals and snacks is also a significant part of management. This is particularly important for carbohydrates that are consumed (such as rice, lentils, and certain fruits and vegetables), as they affect blood glucose levels the most.
Here is a general snapshot of what a typical day would be like for a child with T1DM, bearing in mind that this may differ depending on your child’s age and individual needs.
Start your morning by first checking your child’s blood glucose level as soon as possible after waking up, as this will give you an idea of what the blood glucose was like overnight. You can therefore correct it if necessary, with either food or insulin, based on its level. Do record and keep a chart of the readings to give you an idea of what the pattern looks like throughout the day.
Eating well is crucial in T1DM and you can begin by giving your child a nutritious breakfast that follows the healthy eating plan. A healthy diet is comprised of foods from all groups including fruits, vegetables, grains, and lean protein, as well as healthy fats. There should also be some carbohydrates in each meal since your child is taking insulin, and they will reduce the risk of having hypoglycemia (lower than normal blood glucose levels).
Carbohydrates also provide some essential nutrients and fiber.
Since the blood glucose levels are mostly affected by carbohydrates, it is important to keep a regular record of all the carbohydrates that are being consumed. This is also important as it affects the insulin dose being administered as well.
There are some useful sources of information available on the internet, as well as books and guides which may help you better understand what healthy eating is (particularly for diabetics), including what the good carbohydrates consist of and how much they can be consumed. Some examples of healthy carbohydrates include brown rice, lentils, oats as well as fruits and vegetables.
- Eating healthy can also prevent childhood obesity from developing. Read more here.
- Vitamins are important in keeping us healthy. Learn more about the benefits of vitamin D now.
It is useful to take glucose readings after your child’s meals, as it can capture peak blood glucose levels and give an idea of how your child’s body is responding to carbohydrates in general, as well as any particular foods they are eating. This will also contribute to overall diabetic control. The post-meal glucose reading is best taken around 1-2 hours after the meal.
Insulin is the only medication that keeps blood glucose levels within a healthy range and allows your child to utilize the body’s glucose as energy and it is the most important part of treatment. This will be prescribed by the doctor looking after your child and will need to be given several times a day. Therefore, it is useful to have medication reminders and a record of how much and what time insulin is being administered throughout the day. Health apps like Halza are great for staying organized when managing T1DM. Learn more about Halza here.
It can also be helpful to have a ‘diabetes kit’ with all the essential equipment and medications such as your child’s glucose monitor, syringes or pens, insulin, and other necessary supplies. This will help you stay organized for each day as it comes.
Your child may require a mid-morning snack to keep their energy levels up and maintain the blood glucose within a stable range. It is important to make sure that all snacks are healthy.
Another useful way to keep track of all the relevant information is through a diabetes journal which helps in controlling your child’s diabetes on a day-to-day basis. Aside from glucose readings, this information may include details of meals, physical exercise, insulin dosage, and any special circumstances that may need noting down.
The Halza app also has a feature specially designed to ease T1DM management Halza’s feature on T1DM has been designed to make your life easy and keep your child’s condition under control. Track glucose readings daily to graph an overview for easier observation of the trends in blood glucose levels. Find out more about the Halza app here.
At lunchtime, you will need to check your child’s pre-meal blood glucose level again. To make sure that your child is eating healthily, it is beneficial to plan well. This may mean packing lunch and meal preparation ahead of time. Do remember to also check the post-meal level as well.
Children, regardless of whether they have Type 1 Diabetes, need to be physically active. However, it is even more important in T1DM. Teaching the importance of exercise and physical activity early on will form healthy habits that benefit your child in the future. Exercise helps your child control their diabetes, and in the long run, this will reduce the chances of your child experiencing any complications that are associated with it.
Being active is most beneficial when it is done on a regular basis. Therefore it may be a good idea to explore activities that interest your child to increase their chances of continuing them regularly. This could be swimming, sport or just being more active throughout the day, for example by walking to places and using stairs instead of the lift. A good guideline to follow is that your child should be getting at least one hour of physical activity every day. You can mix it up with different kinds of exercises, which (depending on the age) could include some aerobic (e.g., biking and swimming) and anaerobic (more high intensity) exercises.
Physical exercise can also affect blood glucose levels and sometimes make them go too low causing hypoglycemia. Therefore it is also necessary to know how to adjust and respond to such changes. It is important to check glucose levels before certain activities (particularly the strenuous ones), and ensure you have appropriate snacks and sources of glucose kept in your bag, car, and other places. Examples of glucose sources include fruits, juices, and glucose gels, which are intended to increase the blood glucose level quickly enough in situations where hypoglycemia may be imminent.
Do make sure that teachers and coaches are also aware and know how to manage if there is a problem. Your child should also be wearing a medical identification bracelet at all times, as it alerts others to the condition should an emergency occur.
- For more on preparing your child for school while ensuring their medical needs are taken into consideration, read here.
It is time to check the blood glucose level again before and after the evening meal. It might be helpful to plan your grocery shopping and stock up on healthy ingredients and food choices.
Taking out sufficient time for your child to relax and do things they enjoy is also a significant part of self-care, and in fact, compliments the other aspects of management. That could be reading a book, watching a movie, play dates with friends, parties, or simply having quality time with family members.
There may be some adjustments that will be required, such as ensuring necessary supplies are close by and careful consideration of what your child is eating However that should not be a deterring factor for your child towards leading an enjoyable and fulfilling life.
Sleep is also a large factor that is associated with T1DM. Children in their pre-school years (aged 3-5) require around 10-13 hours of sleep each day and those in their school-age (6-13 years) require around 9-12 hours of sleep daily.
Getting enough sleep is especially important as lack of sleep makes it harder to control blood glucose levels. Conversely, sleep problems could be caused by blood glucose that is either too high or low. Therefore, make sure your child has a good sleep routine and try to adhere to it as best as you can. Let your doctor know if your child is having trouble sleeping at night.
It is important to check the blood glucose level before going to bed. Also, if there is a tendency of the blood glucose levels dropping at night, it may help to have a snack before bed. In such circumstances, there may be more frequent monitoring throughout the night.
All in a day’s work…
Diabetes management involves much planning and patience to maintain good control and avoid any complications from occurring.
We have discussed the four crucial categories that contribute towards better control of T1DM, and they are likely to form your child’s routine care. This may all seem overwhelming at first, as it can be tedious and may interfere with everyday life. However, it eventually becomes part of daily life and contributes towards not only better management of your child’s condition, but also healthy living.
As a parent, you will also have a more comfortable life after understanding the condition and its management as well as maintaining some form of organization and discipline. This will also allow your child to observe and learn, so they can eventually manage their condition independently and successfully. It might be easier to take it one day at a time.
There will also be frequent communication with the health care team that is looking after your child. They will be able to guide you through the process and discuss any concerns or questions that you may have. In addition, there are several community-based and online support groups which are very helpful in sharing information, and even some individuals with their real-life experiences.
They can have an amazing, full life with diabetes, and it doesn’t have to be something that keeps you down. Sure, there’ll be some more steps along the way to make sure you can do the things you want, but you can still do them, and thrive!
– Diabetic Danica, a registered nurse and YouTuber, who has been sharing her personal journey with other diabetics
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