What is diabetes in children and teens?

Diabetes in Children and Teens

Helping your child manage diabetes

Childhood and the teen years are a hard time to be diagnosed with diabetes. You play a major role in helping your child manage this disease. Try to set a good example. It will be easier for your child if the rest of the family also eats well and gets regular exercise.

  • Teach your child to make healthy food choices.
    • 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.
  • Encourage your child be more active.

    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.
  • Check your child's blood sugar.

    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.

  • Help your child take medicine, if needed.
    • 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.
  • Learn how to prepare and give insulin shots.

    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.

  • Help your child become independent in caring for diabetes.

    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.

What are some common ways that teens with diabetes rebel?

Your teenager may be very mature and assume the right amount of responsibility for their diabetes care. If so, your job as a parent of providing supervision will be fairly easy. On the other hand, teenage rebellion is normal. To rebel, teens with diabetes may:

  • Skip doses of insulin or other diabetes medicine.
  • Eat high-fat, high-calorie meals. Or they may eat whenever and whatever they want, ignoring the daily meal plan.
  • Falsify or lie about blood sugar test results.
  • Hide or deny the disease when they're around friends, in an effort to fit in.

These behaviors may lead to high or low blood sugar emergencies.

What special challenges are common in teens with diabetes?

The teen years may be the hardest time for young people with diabetes and their parents. Normal teen behaviors include going to bed late, sleeping late, and eating meals at varying times. These behaviors combined with the normal cycle of rapid growth spurts and periods of slow growth make it hard to keep a teen's blood sugar level consistently within a target range.

Eating fast foods often also makes it hard for teens to follow a balanced diet and stay at a healthy weight. Teens may try to control their weight by going on fad diets, vomiting after meals, or eating very little food. Insulin can cause a person to gain weight, so a teen who uses insulin may skip doses. These actions can be dangerous. They may lead to high or low blood sugar emergencies or an eating disorder.

Helping your child with diabetes exercise safely

Here are some things you can do to help your child exercise safely.

  • Talk with your child's gym teacher and coaches about how exercise affects blood sugar.

    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.

  • Talk with your child's doctor to see if it makes sense to lower the insulin dose that your child takes before exercise.
  • Have your child always wear a medical bracelet or necklace.

    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.

  • Do some pre-exercise planning.

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

  • Check your child's blood sugar level before, during, and after exercise.
    • 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.
  • Inject insulin before exercise in a site other than the parts of the body your child will be using during exercise.

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

  • Consider giving your child a quick-sugar food before exercise.

    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.

  • Make sure your child drinks plenty of water.

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

  • Talk to your doctor about having glucagon on hand.

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

  • Watch for symptoms of low blood sugar for 12 hours after exercise.

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

Diabetes in Children: Healthy Eating at School

Parenting a teen who has diabetes

The teen years can be a hard time for teens with diabetes and their parents. Here are some things you can do that may be helpful for both you and your teen.

  • Expect your teen to be in charge of their own diabetes care.

    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.

  • Allow your teen to meet with health professionals alone.

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

  • Don't overreact to high blood sugar levels.

    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.

  • Keep the disease in perspective.

    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.

  • Help your teen identify a safety support system.

    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.

  • If insulin is needed, help your teen be successful.

    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.
  • Try to be patient and understanding.

    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.

  • Get support for your teen.

    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.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.