If your child or teen has been diagnosed with type
1 diabetes, the next step is to create a diabetes management plan to help him
or her stay healthy and active.
Treatment plans for type 1 diabetes are based on each child's needs and the suggestions
of the diabetes health care
team. Treatment approaches might differ in the types of insulin given and the
schedules for giving insulin each day. The advantages and disadvantages of a plan
should be considered for each child.
Type 1 Diabetes Treatment Basics
The blood glucose level
is the amount of glucose in the blood. Glucose is the main source of energy for the
body's cells and is carried to them through the bloodstream. The hormone insulin
allows the glucose to get into the cells. In type 1 diabetes, the body can no longer
make insulin, so the glucose can't get into the body's cells. This makes the blood
glucose level rise.
Treatment goals for kids with diabetes are to control the condition in a way that:
helps them have normal physical and emotional growth and development
prevents short- and long-term health problems
To do this, parents and kids should aim to keep blood sugar levels within their
goal range as much as possible.
In general, kids with type 1 diabetes need to:
take insulin as prescribed
eat a healthy, balanced diet with accurate carbohydrate counts
check blood sugar levels as prescribed
get regular physical activity
Following the treatment plan helps kids stay healthy, but treating diabetes isn't
the same as curing it. Right now, there's no cure for diabetes, so kids with type
1 diabetes will need treatment for the rest of their lives. But with proper care,
they should look and feel healthy and go on to live long, productive lives, just like
Taking Insulin as Prescribed
Children and teens who have type 1 diabetes must take insulin as part of their
treatment plan. Insulin is the only medicine that can keep their blood sugar levels
in a healthy range.
Taking insulin as prescribed lets them use the glucose in their blood for energy.
When glucose is entering and being used by the cells properly, its level in the blood
generally remains within a healthy range.
The acids and digestive juices in the stomach and intestines can break down and
destroy insulin if it is swallowed, so it can't be taken as a pill. The only way to
get insulin into the body now is by injection with a needle or with an insulin pump.
Unless they're using an insulin pump, most kids need two or more injections every
day to keep blood sugar levels under control. Usually, two different types of insulin
are needed to handle blood sugar needs both after eating and between meals.
There is no-one-size-fits-all insulin schedule — the types of insulin used
and number of daily injections a child needs will depend on the diabetes management
plan. Insulin doses need to be adjusted to handle the rise in blood sugar that happens
with meals and provide the amounts of insulin the body needs between meals and overnight.
Eating meals at regular times generally makes this easier. Although eating on schedule
may work well for younger kids, sticking to a routine can be a challenge for older
kids and teens, whose school, sleep, and social schedules often vary. The diabetes
health care team can help you work through any problems your child might have with
scheduling meals and insulin injections.
Getting insulin injections today is nearly painless, thanks to smaller needles.
Insulin pumps (which deliver insulin through a small tube that is placed just under
the skin) cut down on the number of injections needed.
Insulin usually is injected into the fatty layer under the skin of the abdomen,
hips/buttocks, arms, or thighs. The health care team will teach you when and how to
give the insulin, as well as the best injection sites, based on your child's weight,
age, and activity patterns.
Healthy Eating and Following a Meal Plan
Eating a balanced diet and following a meal
plan are important parts of type 1 diabetes treatment. Kids with diabetes benefit
from the same kind of healthy diet as those without diabetes — one that includes
a variety of healthy foods that help the body grow and work properly.
Kids with diabetes also have to balance the type and timing of their meals with
the amount of insulin they take and with their activity level. That's because eating
some foods will cause blood sugar levels to go up more than others, whereas insulin
and exercise will make blood sugar levels go down.
How much the blood sugar level goes up after eating depends on the type of nutrients
the food has. The three main types of nutrients found in foods are carbohydrates
(carbs), proteins, and fats, which
provide energy in the form of calories. Foods containing carbs cause blood sugar levels
to go up the most. Foods that are mostly protein and/or fat don't affect blood sugar
levels nearly as much.
Meal plans usually include breakfast, lunch, and dinner with scheduled between-meal
snacks. The plan won't restrict your child to eating specific foods, but will guide
you in selecting from the basic food
groups to achieve a healthy balance. Meal plans are based on a child's age, activity
level, schedule, and food likes and dislikes, and should be flexible enough for special
situations like parties and holidays.
Knowing the amount of carbs in meals and snacks will help you know how much insulin
to give your child. Mismatching carbs and insulin can result in either high or low
blood sugar levels.
The meal plan also might recommend limiting extra fat and "empty" calories (foods
that contain lots of calories but few nutrients). Everyone should limit these foods
anyway because eating too much of them can lead to excess weight gain or long-term
health problems like heart disease, for which people with diabetes are already at
Monitoring Blood Sugar Levels
Treating type 1 diabetes also involves checking blood sugar levels regularly and
responding to the results. Controlling blood sugar levels helps kids with diabetes
feel well, grow, and develop normally, and also reduces the risk of long-term diabetes
The diabetes treatment plan will recommend how many times a day to check blood
sugar levels, which is the only way to monitor the effectiveness of your child's insulin
The diabetes health care team also will let you know what your child's target blood
sugar levels are. In general, kids with type 1 diabetes should test their blood sugar
levels with a blood glucose
meter at least four times a day. Depending on your child's management plan and
any problems that arise, blood sugar levels could need to be tested more often.
The care team may recommend that your child use a continuous glucose monitor (CGM).
A CGM is a wearable device that can measure blood sugar every few minutes around the
clock. It's measured by a thread-like sensor that is inserted under the skin and secured
in place. Sensors can stay in place for about a week before they have to be replaced
and are accurate enough to replace frequent finger-stick testing. The more frequent
CGM blood sugar readings can help you and the care team do an even better job of troubleshooting
and adjusting your child's diabetes management plan to improve blood sugar control.
Exercise is good for
everyone — adults and kids, with or without diabetes. Getting regular physical
activity is also an important part of diabetes treatment. It helps control blood sugar
levels and may reduce the risk of other chronic illnesses, like heart disease.
Besides helping keep blood sugar levels under control, exercise can help kids with
get and keep their heart, lungs, and blood vessels in good shape
feel like they can do things that kids without diabetes can
Encouraging kids with diabetes to exercise might make parents uneasy, but exercise
actually helps insulin work better. Some changes to meals and insulin may be needed,
but kids can and should exercise.
All exercise is great — from walking the dog or riding a bike to playing
team sports. Encourage your child to exercise, and set 60 minutes daily as a goal.
New exercise habits might be hard for kids to adopt at first, but feeling the benefits
can help them stick with it.
Avoiding Problems During Exercise
To help avoid problems during exercise, kids with diabetes might need to:
have an extra snack prior to activity
carry snacks, water, and supplies with them when they exercise
check their blood sugar levels before, during, or after exercise
make sure their coaches know about their diabetes and what to do if problems occur
Make sure your child wears a medical identification bracelet (this should always
be worn, but it's even more important during exercise, sports, and fitness activities).
The care team will offer tips to help your child get ready for exercise or join
a sport. They'll also give instructions to help you and your child respond to any
diabetes problems that could happen during exercise, like hypoglycemia
(low blood sugar) or hyperglycemia
(high blood sugar).
Putting It All Together
Treating and managing diabetes can seem overwhelming at times. But the diabetes
health care team is there for you. Your child's diabetes management plan should be
easy to understand, detailed, and written down for easy reference. You also should
have the names and phone numbers of the health care team members in case of emergencies
or if you have questions.
You might hear of alternative or complementary treatments, such as herbal remedies
and vitamin or mineral supplements. Although research continues into their possible
benefits, studies thus far haven't proved their effectiveness. They also could be
dangerous for kids and teens with type 1 diabetes, especially if used to replace medically
recommended treatments. Talk to the diabetes health care team if you have questions.
Each day, researchers all over the world are working to find a cure for diabetes,
and many advances have made treatment easier and more effective. Insulin might soon
be available in patch and spray forms, and scientists continue efforts to improve
results of pancreas or islet
cell transplants. Versions of an "artificial pancreas" — a device that senses
blood sugar continuously and gives insulin directly based on the blood sugar level
— also are being tested.
Your diabetes health care team keeps track of the latest research developments
and will introduce new products as they become available.