Managing diabetes in children and adolescents like an expert

Diabetes is a demanding disease. And while it can be difficult for an adult to manage, parents of children with diabetes experience an even more daunting task.

The typical age of diabetes onset ranges from 4 years old to 14 years old. Early signs that may suggest a child has diabetes include excessive thirst and urination. Parents may notice their child drinking more water during the day, drinking water and using the restroom overnight, and even bedwetting in previously toilet-trained children. Clinicians may notice weight loss, a history of excessive thirst and urination, and yeast infections in young girls. If you have noticed any of these symptoms in your child or adolescent, contact their pediatrician.

Diabetes management is a full-time job for parents of children with the condition, as close monitoring of blood sugar levels, carbohydrate counts and activity level is imperative.

A typical day in the life of a child with diabetes involves balancing the proper amount of insulin with food and exercise, which can prove to be a challenge. In order to calculate an insulin dose to accompany every meal, the carbohydrates a child eats need to be counted. Insulin regimens may involve four or more daily injections or insulin administration through a pump.

A child may experience high blood glucose from a lack of insulin or even stress or the common cold. High blood sugars can cause fatigue, thirst and crankiness. On the opposite end of the spectrum, low blood sugars can result from too much insulin, exercise or illness. Low blood sugar can be scary and can cause a child to feel dizzy, shaky and sweaty. In severe instances, they may lose consciousness and need emergent medical treatment with a medication known as glucagon.

Every child with diabetes should have a plan that outlines how to manage the disease at school. I advise parents to coordinate with their child’s teachers and school nurse to ensure they are properly prepared for mealtimes, recess or gym and to treat high and low blood glucose levels.

Diabetes is challenging to manage, and despite trying your hardest, blood glucose levels are not perfect. There will be times where your child will experience both high and low levels. But what’s important to remember is that blood glucose levels are data that can be learned from to help make decisions about insulin in the future. Partner with your child’s care team to develop a plan that works best for you. You are not alone.

Dr. Jennifer May is a pediatric endocrinologist with Advocate Children’s Hospital.

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