You've probably heard your child's doctor talk a lot about "diabetes control," which usually refers to how close the blood sugar, or glucose, is kept to the desired range. What does this mean and why is it important?
Too much sugar in the bloodstream also can cause long-term damage to body tissues. For example, it can harm blood vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems.
These problems don't usually affect kids or teens with diabetes who have had the disease for only a few years. But they can happen in adults with diabetes, particularly if they haven't managed or controlled their diabetes properly.
Kids with diabetes who don't control their blood sugar levels may also have problems with growth and development. They might even have a delay in when puberty starts. Puberty is when the body changes as kids start growing into adults.
Also important is avoiding frequent and/or severe episodes of hypoglycemia (low blood sugar), which can interfere with participation in school and other activities, making it hard for kids to cope with their diabetes and achieve a healthy, happy childhood and adulthood.
Controlling diabetes means keeping blood sugar levels as close to normal as possible. It's a three-way balancing act: Your child's diabetes medicines (such as insulin), food, and activity level all need to be balanced to keep blood sugar levels under control. If any one of these is off, blood sugar levels will be, too.
In general, poorly controlled blood sugar levels can be due to any of the following:
not taking medicines as prescribed
not following the meal plan (like eating too much or not enough food without adjusting medicines)
not getting regular exercise or not making the necessary changes in the diabetes treatment plan when there is a significant change in physical activity level
illness or stress
not watching blood sugar levels closely enough so that changes can be seen and addressed quickly
The Benefits of Good Control
The complications associated with diabetes can seem frightening. But the good news is that people with diabetes who keep their blood sugar levels as close to normal as possible have a much lower chance of developing them.
One large study showed that people with type 1 diabetes who checked blood sugar levels four or more times a day — and adjusted their medicines, diet, and exercise based on their readings — had a lower risk of developing eye disease, kidney problems, nerve damage, and high cholesterol levels (a major risk factor for heart disease).
How do you find out if your child's diabetes is under control? First, the diabetes health care team will tell you what the blood sugar levels should be (the "target" range), which is based on things like your child's age and medical condition.
Day to day, the only way to know if the blood sugar levels are close to your child's target range is to measure them often with a glucose meter or continuous glucose monitor (CGM). Glucose meters measure the amount of glucose in droplets of blood obtained by a lancet (small device that pricks the skin). These should be used several times a day.
CGMs are wearable devices that measure blood sugar every few minutes throughout the day and night by using a sensor that is inserted under the skin. By providing a more detailed profile of a person's blood sugar levels, these devices can help some people with diabetes do an even better job of "fine-tuning" their blood sugar control.
Your doctor will also check your child's blood sugar with a hemoglobin test (HbA1C test for short). The HbA1C test gives your health care team information about your child's blood glucose control in the 2 to 3 months before the test. This lets doctors know if you need to make changes in your diabetes care plan.
Checking blood sugar regularly and keeping an organized and accurate record of the results will ensure that the health care team has the information needed to adjust your child's diabetes management plan.
Helping Your Child Control Diabetes
Helping your child achieve good blood sugar control can be challenging. Here are some tips:
Make sure your child takes insulin or other diabetes medicines as prescribed.
Provide meals and snacks that fit into your child's meal plan.
Encourage your child to engage in regular physical activity.
Check blood sugar levels often and make changes in the treatment plan with guidance from the diabetes health care team.
Make sure your child gets regular medical checkups.
Learn as much as possible about diabetes.
Working with the diabetes health care team will help you better understand and manage the challenges of diabetes and help your child avoid many of the problems associated with it.