How to Manage Type 1 Diabetes in Children: A Guide for Overwhelmed Parents

Your child has just been diagnosed with Type 1 Diabetes, What Now?

If you are in this post, it means that your child has just been diagnosed with Type 1 Diabetes and you might be feeling overwhelmed with the news.

First of all, I just want to say how sorry I am that you are going through this journey. It’s not easy to hear the news that your child has the life-long chronic illness of Type 1 Diabetes.

As parents, we always want to protect our children.

I know what you are going through on a daily basis. I hope this guide to Type 1 Diabetes is helpful in your journey with your little one. My goal is to help you manage Type 1 Diabetes and give your child the best and healthiest life.

So let’s get to it, let’s do a quick summary of all the terms diabetes-related, and what you need to do in certain cases, of sickness, high blood sugars, and low blood sugars.

Type 1 Diabetes Medical Terms

What Is Type 1 Diabetes?

Type 1 Diabetes is an autoimmune disease where the person’s pancreas stops producing insulin. The person’s immune system causes to attack the insulin-producing beta cells in the pancreas. It continues to attack these beta cells until the pancreas is no longer capable of producing any insulin, which causes blood glucose levels to rise.

It is very different from Type 2 Diabetes, where the person still produces insulin, but its production is not enough, or the person is insulin resistant.

What Is Insulin?

Insulin is a hormone that controls blood-sugar levels on the person’s bloodstream. Insulin is not a cure, but it keeps people living with this chronic disease alive. It helps keep the blood glucose levels in range, and it helps prevents the side effects of Diabetes, like amputation, blindness, kidney failure and more.

People with  Type 1 Diabetes need to inject themselves with insulin in order to compensate for the death of their beta cells. Every person that you meet that has Type 1 Diabetes, is insulin-dependent.

Types of Insulin

Fast Acting Insulin, (i.e Novolog and Humalog), is used for correcting high blood sugars, and when you need to cover carbohydrates (carbs) s in foods. This insulin needs to be injected a couple of times per day. It usually starts making an effect about 15-30 mins after injection and lasts for about 2-3 hrs.

Long-Acting Insulin, (i.e Lantus), lasts for about 20-24 hours. This is what doctors call basal insulin, meaning that it acts as background insulin, and assists the fast-acting insulin in controlling your blood sugars.

What is Bolus?

Bolus is when you give an injection/insulin to your child due to him/her having high blood sugars or when he/she is about to eat a meal, so their sugar levels do not rise.

Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis (DKA) is a possible complication of diabetes caused by extreme hyperglycemia, also known as high blood glucose. It is a serious and potentially life-threatening complication, one that you should work hard to avoid.

If DKA occurs, you need to call your child’s Endocrinologist immediately and wait for instructions. Some doctors will have you give push liquids and insulin into your child, and depending on the severity, you might need to take your child to the hospital.

Why does DKA occur?

This happens when the body does not have enough insulin, and therefore the blood sugars rise.

After a period of time, the body is forced to burn fat for energy. When the body fat is used for energy, ketones develop which are a waste product of fat. Ketones accumulate in the blood and DKA can develop. DKA can occur within a few hours.

Mom Tip: We need to teach our kids, as soon as possible, how to prevent DKA. Once they turn into adults, they are on their own. By teaching them about the risks of having this chronic complication and opening the conversation of trust, this can help them make better life-decisions once they are out of under our care.

What Is the Cause Of Type 1 Diabetes?

No one knows why Type 1 Diabetes occurs.  Some theories say that it could be the food, the environment, or even genetics. Type 1 Diabetes has nothing to do with diet or lifestyle.

Mama, you did nothing wrong here!

Sadly, there is no prevention or cure for Type 1 Diabetes, unlike Type 2 Diabetes, which may “go away” with diet, exercise, and oral medication.

Type 1 Diabetes is a chronic and life long condition that can occur at any age.

There are some people that could call it Juvenile Diabetes because back in the days, kids were the ones that used to be diagnosed with this condition.

However, with more investigation, doctors have noticed that adults can also acquire it, and now the name is more commonly known as Type 1 Diabetes

How is Type 1 Diabetes Managed?

Insulin Injections

In the beginning, your child’s diabetes may be managed by multiple daily injections (MDI) during the day, and he/she will be prescribed two types of insulin (fast-acting insulin and long-lasting insulin, as indicated above).

Being physically active

Exercise and physical activity have been proven to help manage sugar levels better, and lower a child’s A1c.

The CDC,  indicates that

Being More Active Is Better for You – If you have diabetes, being active makes your body more sensitive to insulin (the hormone that allows cells in your body to use blood sugar for energy), which helps manage your diabetes. Physical activity also helps control blood sugar levels and lowers your risk of heart disease and nerve damage.

So get your sneakers ready mama, and go out to the park with your child or just do a simple stroll around the neighborhood!

Insulin Pumps

Diabetes can also be managed by using an Insulin pump, like Medtronic, Omnipod, and T-Slim. This basically substitutes the daily injections, and you would need to insert the infusion sites into your skin once every 2-3 days.

Managing the Highs and Lows of Type 1 Diabetes

One of the most frustrating things that you will encounter in managing your child’s diabetes are the unpredictable highs and lows of his/her blood sugar levels.

One week everything is going well, sugar levels are between the ranges, you give insulin and everything on their diabetes care management just clicks!

Then the following week, everything goes haywire. Nothing works, the basal is not working because glucose levels keep rising, you are pouring insulin like crazy into your child’s body, and you just feel frustrated and defeated.

Hang in there mama. you will have those highs and lows. The important thing here is to calm down, and think about the training that you received at the Endocrinologist’s office.

Managing Low Blood Sugar

Low blood sugar occurs when the glucose meter reads 70 mg/dL or below. Remember to use the rule of 15 carbs for treatment.

Have an area in your home, either the kitchen, your closet in the hallway or in your child’s bedroom, that is designated for “diabetes low snacks”.

I like to have a “diabetes low snacks” in different parts of my home, especially during night time. It is killer to wake up super tired and hit every single wall in your home to go to your kitchen and look for carbs to raise your child’s glucose levels.

One of the things that have kept my sanity, is having a closet hanging organizer, like the one below, in my daughter’s room. Here I keep her sugar raising snacks and her diabetic supplies. It keeps everything in one place, organized and tucked away.

Mom Tip: At times, you will not need to use the “rule of 15 carbs” to treat low glucose levels. Sometimes 4-8g of carbs will be enough. It will all depend on how low your child is at the moment.

Snack Ideas to Treat Low Glucose

• 3-4 glucose tabs (not too fan of these, unless they are grape or cherry)

• 1/2 cup (4oz) juice or soda (I LOVE the Honest juice apple boxes)

• 15 Skittles

• 8oz milk (we use Fairlife Milk)

• 10-15 M&M’s

Mom Tip: ALWAYS read the labels on candy or any other food to determine carb amounts.

High Blood Sugar Symptoms

On the other side of low blood sugars, we have high blood sugar levels.

Sadly, this is going to be unpreventable as well. Your child will have high blood sugar, especially after eating sugary and carby foods. The important thing is to attack it as soon as you can.

Mom Tip 1: What I do is that depending on what my daughter ate, I do temp basal increases. For us, it works by me increasing her temp basal rate to 100-200% for 2-3 hrs increments. Once I see that she starts dipping down, I keep my eye on the Dexcom CGM graphic, and when she is at a number, about 200s and going down, I cancel her temp basal rate.

Mom Tip 2: We need to teach our children to listen to their bodies. Some children will start having some physical symptoms, like tummy ache, headache, chills, etc, when their glucose levels are in the extreme ranges. When extreme ranges occur (low and high), it is the perfect moment to teach your child to listen to what his/her body is telling him/her. Always confirm with a glucose meter, if you are using a Continuous Glucose Meter.

Treating High Blood Sugars

• 1. Check your child’s glucose levels with a glucose meter, and also check for ketones.
• 2. If your child’s blood sugar is more than 250 mg/dl, give a correction dose of insulin.
• 3. If ketones are present, give ketone correction dose, (as indicated by your doctor), have your child drink liquids (sugar-free fluids, water), do not make your child exercise if there are ketones present. (it has been said that it increases ketones in the blood-stream, which could leave to DKA).

Sick Day and Type 1 Diabetes

Like you mama, I do not like when my baby girl gets sick. Even though she has her diagnosis of diabetes, she is a very healthy girl. She barely gets sick.

Here is what I do when my child gets sick:

• Check blood glucose every 2 hrs with the glucose monitor/meter

• Check ketones each time when checking blood glucose

• If vomiting, wait for 2 hrs to give carb-containing fluids like Gatorade. Carbs are needed to prevent ketone production.

Mom Tip: If your child is on the pump, like mine is, then I make sure her infusion site is working properly. A possible change of infusion site might be needed. From my experience, this has not occurred to me, but if it happens to you, the recommendation is to change the site and give insulin via syringe.

Advice from a Type 1 Diabetes Mom

Diabetes is ever-changing

You will be dealing with highs and lows constantly. Just remember that everything passes.

Just try to keep yourself calm during the event. My best advice to you mama is to prepare yourself beforehand, on how to deal when these situations occur.

For example, for low glucose levels events, have a designated area in your home for snacks to deal with these lows. Do an assessment of your home, and designate an area where you or anyone has easy access to snacks quickly. Have the glucagon handy, for extreme emergencies where your child losses consciousness. Honestly, these are very rare, but it’s better to be safe.

Get ready for comments from other people

People say the darnest things mama. You will hear things like:

At least is not cancer

Will he/she grow out of it?

My grandma had diabetes and… (add additional family history and events here)

To all these comments, you can do one of two things: ignore. smile, nod, and go on your merry way. Or if you are up for the challenge, educate them.

There is no point in you getting mad about their ignorance. Honestly. there are a lot of misconceptions about type 1 diabetes. Just be conscious that your sanity and calmness is more important.

Some people just ask out of the goodness of their hearts, because the honestly, do not know, and are open to learning.

You are not alone in the journey

You will feel that you and your family are the only ones dealing and managing your child’s diabetes. I am here to tell you that your are not alone!

There are numerous support groups in your town, state, and even on social media, where parents of kids with type 1 diabetes, can ask for advice and/or just vent!

Some of my favorite communities that can help you get started are:

• Juicebox Podcast Facebook Group

• Sugar Surfing Facebook Page

A lot of your family and friends, will not understand what is it like to be a parents of a child with diabetes.

Only another parent of a Type 1 Diabetic child will understand that you were able to keep your child in range after eating a pizza or a cupcake. Or how scary it is when your child demonstrates ketones because he/she is sick, and you don’t know if you need to rush to the hospital.

These communities are there to support you and give you advice.

Be kind to yourself

You will get frustrated when:

• your child’s A1c’s is not in the range that you want
• when you give too much insulin and a low occurs
• when you give insulin, but it’s not enough and your child gets high glucose levels
• when you forget something on your vacation trip
• when you are sleeping and are so tired that you do not hear the Dexcom alert indicating that your child is not in the target range that you want
• when you forget to refill your child’s diabetes supplies at school
• and so many more

I am here to tell you mama, that is ok! You are human. It’s not easy being someone’s pancreas 24/7/365 days a year.

I know with technology at our reach, things are a bit easier, but this technology still needs the human input for correction and for regular diabetes management.

You will be adapting every time to every different situation you encounter when managing your child’s diabetes.

Final Thoughts

Managing diabetes is a full-time job without pay, with little benefits and a lot of frustrations and set backs.

You will become a pro at fighting with the health insurance, training teachers on how to manage your child’s diabetes, so on and so forth.

My best advice to you mama is to take it day by day.

Educate yourself.

A couple of my favorite books are:

Ask questions to your child’s Endocrinologist. If you do not understand what is being explained to you, ask again. you are your child’s best advocate. Do not be afraid to advocate for your child, your child’s life and well-being depends on it.

“Life is not over because you have diabetes. Make the most of what you have, be grateful.” – Dale Evans

For more information about Diabetes, please head over to the JDRF website for more information.

The Beginner’s Guide to Type 1 Diabetes