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There are many ways you can help children and their families get the care they need.
Because our research informs our treatment, our diabetes team is known for our innovative treatments and science-driven approach. Children’s Hospital Boston is home to the world’s most extensive pediatric hospital research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in family-centered care, our physicians never forget that your child is precious, and not just a patient.
In dealing with your child’s diabetes, you probably want to know the basics about what diabetes is, and how type 1 diabetes differs from other forms of the disease.
What is diabetes?
Diabetes (diabetes mellitus) is a lifelong condition that occurs when the body doesn’t make enough insulin, or when the body doesn’t respond properly to the insulin it makes. There are many forms of diabetes mellitus, several of which have undergone name changes as the disease has become better understood.
Note: diabetes insipidus is a very different condition from diabetes mellitus.
Is there more than one form of type 1 diabetes?
There are two forms of type 1 diabetes:
What is insulin?
Insulin is the hormone that allows glucose to enter the cells of the body to provide fuel in the form of glucose. Without insulin, glucose builds up in the bloodstream, starving the body’s cells. Children with type 1 diabetes must take daily insulin injections and must regularly monitor their blood sugar levels.
How and when should I give insulin to my child?
Your child’s diabetes team will help you decide what types of insulin your child should use, and when you should give it.
Does having type 1 diabetes put my child at risk for other conditions?
Unfortunately, children who have diabetes are also at risk for other autoimmune conditions such as autoimmune thyroid disease, celiac disease and, rarely,Addison’s disease.
What’s a healthful diet for kids with type 1 diabetes?
Proper meal-planning is very important if your child has diabetes, since the type and amount of food your child eats affects her blood sugar levels. If she eats too much, her blood sugar may go up too high. If she skips meals, her blood sugar may go too low. Good blood sugar control requires a balance of food, exercise and medication. Healthy meals include foods that contain the right amounts of carbohydrates, protein and fat.
Carbohydrates (“carbs”) are an important source of energy for kids, and they affect the body's blood sugar the most since the body turns carbohydrates into blood sugar. If your child eats too many foods with carbs, her blood sugar can go too high. About half the calories your child eats should come from carbs, and a certain amount of carbohydrates should be included with each meal and snack. Your child’s dietitian can help you decide how much carbohydrate your child needs each day.
Sugar is a carbohydrate. It doesn’t affect your child’s blood sugar any differently from other carbs. Your child can eat sweets and sugars if they’re counted as part of her daily carbohydrate intake. (Sweets don’t have many vitamins or minerals, so your child should eat them only in small amounts.)
Proteins and fats don’t affect the body’s blood sugar level as much as carbs do. But the amount of protein and fat in your child’s diet may need to be counted, since it’s important for her to eat them in appropriate amounts. Too much fat can increase your child’s risk for heart disease and may make it difficult for her to maintain a healthy weight. Your child’s dietitian can help you decide how much protein and fat your child needs.
How can I monitor my child’s diabetes day-to-day?
Checking your child’s blood glucose (sugar) levels every day will tell you if she’s maintaining a good balance of insulin, food and exercise.
What about emergencies?
We’ll teach you how to cope with emergency situations in which you may need to administer extra insulin (“booster shot”) or check your child’s urine for ketones (toxins released by the body’s breakdown of fat caused by a lack of sugar to the cells of the body. We’ll help you recognize signs that your child may need emergency attention.
What about exercise for kids with type 1 diabetes?
Exercise is always important for growing children, regardless of diabetes. When exercise is combined with the right amounts of food and insulin, it will help keep your child healthy, and her blood glucose levels will remain in balance.
In general, exercise tends to lower blood glucose levels.
To avoid low blood glucose when exercising:
Plan vigorous activities for roughly the same times each day.
Plan activities to follow meals and snacks.
Check your child’s blood glucose level before and after exercise.
Add an extra snack before exercise.
Plan activities and snacks according to when insulin starts to work, when its peak effect is reach and how long it works to lower blood glucose levels.
Your diabetes team will help you figure out how insulin works in your child; what types of snacks are most helpful before exercise; how to check your child’s glucose; and any other questions you may have—we’re here to help.
What are the dangers of not treating type 1 diabetes?
Uncontrolled type 1 diabetes can be dangerous. It can lead to serious, even life-threatening, problems such as:
What are some complications associated with diabetes?
People who have diabetes are also at risk for other autoimmune conditions such as autoimmune thyroid disease, celiac disease and, rarely, Addison’s disease.
Although type 1 diabetes can cause many different problems, there are several key complications that if uncontrolled, can cause emergencies.
measure her blood glucose level
check her urine for ketones
check with your diabetes team to see if you should administer a “booster shot” of extra insulin
Insulin, food and exercise: How do we find the right balance?
Many factors can affect your child’s blood sugar level, including:
The key to maintaining your child’s blood sugar in a normal range is to balance your child’s insulin dosage, type and amount of food intake and level of exercise. Your diabetes team will help you determine a healthful regimen for your child that balances these key elements.
How do we cope with traveling and vacationing?
Traveling with a child who has diabetes requires some advance planning—but it is doable, and your child’s condition doesn’t have to slow up the family’s plans. Joseph Wolfsdorf, MD, associate chief of Children’s Division of Endocrinology, has written a helpful article called Traveling with Diabetes. Wolfsdorf’s article offers tips for packing, airline travel, spending time outdoors, dining out, transporting insulin, wearing an ID bracelet, packing an emergency kit and lots more.
Your diabetes team will give you a great deal of helpful information about helping your child manage other kinds of stays outside your home when you’re not around—such as sleepovers, school, day care and summer camp (including diabetes camp programs). Here, too, some planning and communication smooth the way.
Will my child be OK?
With proper attention to maintaining the balance among your child’s insulin, food and exercise, she should not only be OK—she should be able to maintain good general health. But untreated diabetes can be dangerous, and can lead to damage to nerves, blood vessels, heart, eyes, kidneys and circulation.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”