Diabetes: tips for children

What is diabetes?

Diabetes is a chronic (ongoing) condition characterised by high blood sugar levels due to the body's inability to produce or respond to insulin, a hormone that allows blood glucose to enter the cells of the body and be used for energy.

There are 2 main types of diabetes: type 1 and type 2. Children are most commonly affected by type 1 diabetes, although a growing number of young people are developing type 2 diabetes, a type of diabetes more commonly diagnosed in adults.

Type 1 diabetes is an autoimmune disease (caused by the body's own immune system) in which the body attacks its own beta cells (the cells that produce insulin in the pancreas). This means the pancreas produces little or no insulin to regulate blood sugar, resulting in abnormally high levels of blood sugar. It most commonly develops during childhood, which is why it is also sometimes known as juvenile onset diabetes.

People who have type 1 diabetes need to take daily insulin to regulate their blood sugar.

Tips to help your school-aged child manage diabetes

1: Be aware of your child's feelings

Young children who have been diagnosed with diabetes sometimes misunderstand their condition. They might feel that they are being punished for something they have done, or they might feel guilty and ashamed of their diabetes. You might find that your child believes you have the power to make their diabetes go away or, on the other hand, you might find that your child blames you for their condition and becomes hostile towards you for a time.

Whatever your child may be feeling, you can help by teaching your child to have a sense of control over their condition.

2: Be protective, but don't be overprotective

It's all too easy for anxious parents to be overprotective, particularly when their child has a chronic condition such as diabetes. However, being overprotective can have a negative effect on your child, by promoting a sense of low self-esteem. For example, if you are overprotective, you might inadvertently be encouraging your child to feel as if they can't cope, thinking of themselves as sickly and helpless against their condition, instead of feeling able to manage their diabetes themselves. By getting your child involved in the management of their diabetes, you can remain protective of your child while encouraging self-reliance.

3: Encourage independence

A child with diabetes will have to master the daily challenges involved in controlling their condition. For example, they will gradually have to learn how to monitor their blood sugar, administer insulin, monitor their diet and know how to deal with hypoglycaemia if it occurs.

Hypoglycaemia is a condition in which blood sugar becomes too low, resulting in symptoms such as:

  • headache;
  • weakness or drowsiness;
  • shaking;
  • hunger;
  • sweating;
  • odd behaviour or irritability;
  • faintness; and
  • confusion.

It can be caused when a person with diabetes hasn’t eaten enough food, has exercised without eating extra food to meet the increased demand, or has administered too much insulin. Consuming sweet juices or food with sugar such as jellybeans or glucose tablets should help recovery. Your child should carry 'emergency' food such as jellybeans with them at all times.

As a parent, you can encourage your child to learn the management skills they need so that, eventually, they can become adept at self-care and can manage their condition independently. Of course, supervision is vital at first, and some children will be physically and emotionally ready to take control of their diabetes earlier than others, so let your child go at their own pace.

As a guide, by the time your child starts primary school, your child should be able to 'assist' you in carrying out all the tasks associated with their diabetes.

By the age of about 8 years, your child may be able to perform their own blood glucose test (with supervision, of course), and by about the age of 10 years, they might feel ready to try administering their own insulin, again with supervision.

Older children should become adept at administering their own insulin and conducting their own blood glucose tests, with supervision, so that by the time they reach high school, your child should be able to administer insulin without supervision, and should be able to monitor their own blood glucose levels.

Of course, like anyone with diabetes, if their blood glucose becomes too low (that is, when they have hypoglycaemia or a ‘hypo’), they will need help to conduct their blood glucose test and get the treatment they need to recover. You should encourage your child to tell their friends about their diabetes and to teach their friends what to do in the case of a hypo.

4: Create a routine

To help your child learn to manage their diabetes, establish a daily routine. Encourage your child to eat at regular times, to administer insulin regularly, to plan ahead and have a snack when they are going to exercise, and to monitor their blood glucose throughout each day.

Informing the staff at your child's school about your child's diabetes should help to ensure that your child sticks to their management routine.

Eating and snacking

Make sure your child knows that they shouldn't skip meals and they should try to eat at the same times each day. Your child might need additional snacks, such as at mid-morning, mid-afternoon or before bed. Make sure your child knows the timing of their snacks and meals so that they can manage their blood sugar levels to the best of their ability, and make sure they carry glucose tablets or jellybeans to help treat hypoglycaemia.

Ensure your child knows that they should choose foods from the school canteen that are healthy, well-balanced and low in simple sugars.

Exercising

Make sure your child knows they can enjoy sports and exercise like any other child, provided they take precautions. They might need to plan extra time before exercising so they can take a blood glucose test, or have a snack to prevent low blood sugar as a result of exercising.

Measuring blood glucose levels and taking insulin

Your child might need to monitor their blood glucose levels a few times a day, including before meals and before going to bed, and some children might need to take insulin during school hours. Make sure your child feels comfortable doing these tasks, or if they are too young to do them by themselves, make sure they know who to ask for help while at school.

5: Seek support from your child's teachers

You can help improve your child's diabetes management by talking to your child's teachers. They should be made aware that your child has diabetes and, if necessary, you can inform them about what they might need to do to help your child while at school.

For example, teachers at your child's school can:

  • supervise or help your child to take their insulin or conduct a blood glucose test in a private area;
  • ensure your child eats meals and snacks on time;
  • ensure that your child has time to have a snack before starting exercise classes or sports;
  • ensure that your child has permission to eat snacks in the classroom or during examinations, if they need to; and
  • recognise the warning signs of hypoglycaemia and keep a source of sugar handy, such as jellybeans or glucose tablets, to treat your child quickly.

6: Encourage normal activity

A child who has diabetes has certain special needs, however, there’s no reason that your child should avoid taking part in group activities and normal classroom activities such as sports, exercise classes or excursions, provided your child knows the principles of managing their diabetes, and provided your child's teachers know how to help manage your child's diabetes while your child is in their care.

Be aware that your child may not like being the focus of special treatment, so you should arrange with your child's teachers that your child be allowed to follow their diabetes routine inconspicuously.

7: Consider going to diabetes camp

Some organisations, such as Diabetes Australia, promote educational camps to help children use their diabetes management skills and encourage self-reliance and confidence in managing their diabetes. Meeting up with other children with diabetes often has a positive effect, and it can encourage children to take on tasks that they might previously have avoided, such as administering insulin by themselves.

By supporting your child as he or she learns the skills they need to manage their diabetes, you can ensure that diabetes does not become a barrier to a happy, normal childhood.

Last Reviewed: 14 October 2014
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References

1. Diabetes in children (revised October 2013). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2014 Mar. http://online.tg.org.au/complete/ (accessed Sep 2014).
2. Australian Diabetes Council; Diabeteskidsandteens.com.au. Information for parents of kids aged 5-7 years. http://www.diabeteskidsandteens.com.au/parents_and_carers_3.html (accessed Sep 2014).
3. Australian Diabetes Council; Diabeteskidsandteens.com.au. Information for parents of kids aged 8-12 years. http://www.diabeteskidsandteens.com.au/parents_and_carers_4.html (accessed Sep 2014).
4. Royal Children’s Hospital Melbourne; Children’s Hospital Westmead. Caring for diabetes in children and adolescents, 3rd edition 2010. http://video.rch.org.au/diabetes/Diabetes_Book_Third_Edition.pdf (accessed Sep 2014).
5. MayoClinic.com. Type 1 diabetes in children (updated 1 Apr 2014). http://www.mayoclinic.org/diseases-conditions/type-1-diabetes-in-children/basics/definition/con-20029197 (accessed Sep 2014).
6. MayoClinic.com. Type 2 diabetes in children (updated 3 May 2014). http://www.mayoclinic.org/diseases-conditions/type-2-diabetes-in-children/basics/definition/con-20030124 (accessed Sep 2014).
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