Treatments for Type 1 Diabetes in Children

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How do you treat diabetes?

Insulin and other treatments

Children with type 1 diabetes must have daily injections of insulin to keep the blood sugar level within the normal range. In addition to insulin injections, other ways of managing your child's diabetes that her team may recommend include:

  • eating a healthful diabetes diet (to manage blood sugar level)
  • exercise (to lower—and help the body use—blood sugar)
  • regular blood check (for blood sugar [glucose] levels)
  • regular urine check (for ketone levels)

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.

In addition to insulin injections and eating a healthful diet, other ways of managing your child’s diabetes that her team may recommend include:

  • exercise (to lower—and help the body use—blood sugar)
  • regular blood check (for blood sugar [glucose] levels)
  • regular urine check (for ketone levels)

Our registered nutritionists and dietitians will work with you to develop a meal plan based on your child’s specific needs. And our diabetes nurse-educators will work with you to increase your knowledge of, and confidence in, how best to care for your child at home.                                                        

Who will be on my child’s diabetes team at Children’s?

Children’s multidisciplinary team members include:

  • pediatric endocrinologists: medical doctors who specialize in the care of children with disorders that affect any of the body’s hormone-producing glands, such as diabetes mellitus. The endocrinologist supervises the work of the diabetes team and is responsible for your child’s care.
  • diabetes nurse-educators: nurses who specialize in teaching families how to care for a child who has diabetes. The nurse educator, together with your child’s staff nurses, teach you about managing your child’s diabetes. After your child returns home, the nurse educator continues to teach and support you in our outpatient Diabetes Program, and is available by phone for urgent advice.
  • staff nurses: nurses who help while your child in the hospital. The staff nurses also work closely with the nurse educator in the outpatient Diabetes Program. Together, they’ll make sure you and your child learn all the basics for caring for your child safely at home.
  • registered nutritionists and dietitians: nutritional professionals who’ll help you develop a healthful diabetic meal plan that meets your child’s nutritional needs. After your child has left the hospital, she’ll have a follow-up appointment with the dietitian, who will also be available by phone to answer your questions.
  • medical social workers: psycho-social specialists who help families deal with the difficult feelings around living with diabetes. Your social worker can offer guidance about your child’s behavior, provide you with information about community resources, and help with the transition from hospital to home.

Complications and emergencies

Your diabetes team will 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 be in crisis and may need emergency attention.

People who have diabetes are also at risk for other autoimmune conditions such as autoimmune thyroid disease, celiac disease and, rarely, Addison's disease.                                                    

Understanding your child's feelings and condition

Regardless of your child's age, a diagnosis of diabetes can be devastating.

If your child is very young, she may not quite understand all the life changes that may come with a diagnosis of type 1 diabetes. Your child may experience feelings of:

  • vulnerability
  • anger
  • difference from peers (“Why me?”)

If your child is a teen with diabetes, the normal challenges of teenage years can even more intense. Teens want to belong, and being different in any way from one's peers can be emotionally stressful.

Even a teen who's previously complied very well with her diabetes management plan may now:

  • become rebellious and refuse to comply
  • experience denial of the disease
  • become aggressive in reaction to the stress of managing diabetes

Helping your teenager with her blood sugar control is especially hard during adolescence. Researchers believe the growth hormone produced during adolescence that stimulates bone and muscle growth may also act as an anti-insulin agent. Blood sugar levels become harder to control—resulting in blood sugar levels that swing from too low to too high. This lack of control over blood sugar levels can be very frustrating for your teen.

Family teamwork is the key

Although a child who's diagnosed with type 1 diabetes needs supervised medical care, the ideal relationship between parents and child is one of interdependence—with family members working together as a team to help the child live normally and happily.

Type 1 diabetes is a chronic, lifelong disease that can't be prevented and is usually not predictable. Children and adults with type 1 diabetes must take daily insulin to manage their condition. It's a challenge that can sometimes be frustrating, but the condition needs to be managed consistently to avoid damage to nerves, blood vessels, heart, eyes, kidneys and circulation.

With your encouragement and our diabetes team's guidance, your child will learn how to take care of her diabetes. Your child's increasing independence will improve her self-esteem—and her good habits will carry over into adulthood.

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.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944