What is diabetes in children and teens?

• Help your child to eat about the same amount of carbohydrates at each meal. This helps keep your child's blood sugar steady. Carbohydrate affects blood sugar more than other nutrients. It is found in sugar and sweets, grains, fruit, starchy vegetables, and milk and yogurt.
• Your child's doctor, a diabetes educator, or a registered dietitian can help you make an eating plan that is good for your child and also good for your family.

Kids need at least 1 hour of moderate to vigorous activity every day. It's okay for a child to be active in smaller blocks of time that add up to 1 hour or more each day. Your child doesn't have to start a strict exercise program, but being more active can help control blood sugar.

• Help your child find ways to make activity more fun. For example, your child could play outside with friends, take brisk walks with a family member, and take part in sports.
• Limit the amount of time your child watches TV and uses the computer and cell phone.

You and your child will need to monitor your child's blood sugar. This will help you learn how different foods and activities affect your child's blood sugar. Your doctor can teach you and your child how to do this.

• A child with type 2 diabetes may need diabetes medicine to stay in the target blood sugar range. Your child may need one medicine at some times and more than one at other times.
• If your child has high blood pressure or high cholesterol, your child may need medicines for those conditions.

A child with type 1 diabetes may take several injections a day or use an insulin pump. A child with type 2 diabetes may need to take insulin for a while when first diagnosed or during illness or surgery. In time, a child may need daily insulin.

Let your child do as much of the care as possible. But provide support and guidance as needed.

• Children in grade school can help with all tasks required for their care. By age 8, children can test their own blood sugar if they are supervised.
• Children in middle school or junior high should be able to test their own blood sugar, but they may need help during low blood sugar episodes. By age 10, some children can give insulin shots if they are supervised.
• Teens should be able to handle their own care with some adult oversight.

Teachers and coaches may not know the signs of sudden high or low blood sugar. You might need to explain what symptoms your child may have and how to deal with them.

You can buy these at most drugstores. Or try a temporary medical ID tattoo. All of these products can help medical personnel give the right care.

Make a checklist that you and your child can follow. Make sure that your child uses it with the gym teacher or coach too.

• Make sure that blood sugar is in the child's target range.
• If your child's blood sugar is over 250 mg/dl, your child may need to drink more fluids. You also may need to check for ketones. Check your child's blood sugar during the activity to make sure it's going down.

For example, if your child will be running, don't inject it in the leg.

If your child's blood sugar is below the target range before exercise, consider giving your child 15 grams of carbohydrate from a quick-sugar food. These foods include glucose tablets, hard candy, and fruit juice.

If your child will be exercising very hard and for longer than 30 minutes, you may want to give another 15 grams of carbohydrate from a quick-sugar food. Younger children may need less carbohydrate from quick-sugar foods.

This helps to avoid dehydration. (You can also use sports drinks to give your child needed fluids and sugar.)

It can be used if your child is unable to take anything by mouth or is unconscious.

This is especially important to do if it's a new activity.

You can be there to support and guide. But accept that ultimately it's up to your teen to take control of their care. This transition will be smoother if you encourage your teen to take on more and more responsibility over time.

This will encourage your teen to be highly involved in their care. A registered dietitian can help your teen build a healthy meal plan.

Everyone with diabetes has them from time to time. Praise your teen for checking their blood sugar level. Offer to help problem-solve ways to handle high blood sugar effectively.

Diabetes is only one part of a person's life. Encourage your teen to be as active as they'd like to be in sports and other healthy activities.

Low blood sugar levels are likely to occur at times. So your teen needs to have at least one friend who knows what to do in case of an emergency. Discuss who else needs to know and what they need to know.

It may help for your teen to:

• Use an insulin pump. Some young people like using the pump because it's a less obvious way of giving their insulin injections. If rapid-acting insulin is used with meals, the pump makes it convenient to give an extra dose if needed.
• Use a flexible insulin dosing schedule. Using a combination of long-acting and rapid-acting insulins allows greater flexibility for those times when a teen sleeps late, goes to parties, or changes the meal schedule.

Your teen may lash out at you for the ups and downs of the disease. Try to empathize. Imagine the fear, sadness, anger, and even guilt your teen may be feeling.

It may be a good idea to have a mental health professional, such as a counselor, involved with your teen's care from the time of their diagnosis.