Patient education: Checking your child's blood sugar level (The Basics)

Why is it important to check my child's blood sugar level? — If your child has diabetes, it's important to check their blood sugar level so you know:

●If the level gets too low or too high – Blood sugar levels that are very low or very high can cause serious problems. If you check your child's blood sugar levels often, you can treat low or high blood sugar before it becomes an emergency.

●What changes to make in your child's next insulin dose – Knowing your child's blood sugar level will help you choose their next insulin dose.

●How well-controlled your child's diabetes is – Keeping your child's blood sugar under control helps prevent health problems later in life.

How do I check my child's blood sugar level? — There are 2 ways to check your child's blood sugar level:

●Using a blood glucose meter – Your child's doctor or diabetes nurse will show you how to use your meter. You will need to prick your child's fingertip to get a drop of blood (picture 1). Try not to use the same finger each time.

You will put the drop of blood on a special glucose test strip that fits into the meter. After a few seconds, the meter will show your child's blood sugar level. Record your child's blood sugar levels and show the record to your child's doctor or nurse. They will use this information to make changes to your child's treatment plan.

●With continuous glucose monitoring – Some children use a device that measures their sugar level all the time. This is called "continuous glucose monitoring." The child wears a special sensor with a tiny plastic tube that goes under the skin. A sticky patch holds the device in place. The sensor measures the sugar in the fluid under the skin. Then it sends the information to a small box or to a smartphone app.

If your child has a continuous monitoring device, you might still need to check their blood sugar once in a while by pricking their skin. This is especially important when blood sugar levels are changing quickly, or if you think the monitor might not be working correctly.

How often should I check my child's blood sugar level? — If your child uses insulin, you need to check their blood sugar level 4 or more times each day. You will do this either by pricking your child's finger and using a meter to measure the blood sugar level, or by looking at the results of their continuous monitoring device.

A typical schedule involves checking blood sugar levels before meals and snacks, and at bedtime. At least once a week, you might also need to check your child's blood sugar at night (between midnight and 4 AM). Plus, you might need to do overnight checks more often if your child's overnight insulin dose changes. Teenagers should check their blood sugar anytime they plan to drive.

Certain conditions can affect your child's blood sugar. You might need to check your child's blood sugar more often when they:

●Are sick

●Travel, especially to another time zone

●Eat or exercise more or less than planned

●Are under extra stress

●Have symptoms of low or high blood sugar – These symptoms can be different, depending on the child and their age.

Common symptoms of low blood sugar can include:

●Acting cranky, tired, or not eating (especially in babies and toddlers)

●Shaking

●Sweating

●Feeling weak, tired, nervous, or hungry

●Having nightmares or not sleeping well

●Confusion

Common symptoms of high blood sugar can include:

●Urinating more than usual

●Feeling thirsty and drinking more than usual

●Feeling tired or having no energy

●Breathing fast or having a "fruity-smelling" breath – This can be a sign of a medical emergency called "diabetic ketoacidosis."

What should I do if my child's blood sugar is low? — Your child's doctor or nurse will tell you how to treat low blood sugar. It depends on the sugar level, your child's age, their symptoms, and the time of day.

In general, low blood sugar is treated with either:

●A quick source of sugar – Your child can eat or drink a quick source of sugar (table 1). Foods that have fat, such as chocolate or cheese, do not raise low blood sugar levels as quickly. You should carry a quick source of sugar for your child at all times. You should also leave quick sources of sugar at your child's school, and with babysitters and coaches.

●A dose of glucagon – Glucagon is a hormone that can quickly raise blood sugar levels. It comes as a shot (figure 1 and figure 2) or a nose spray. If your child's doctor recommends that you carry glucagon for your child, they will tell you when and how to use it. Your child's doctor might also recommend that you leave a glucagon kit with a staff member at your child's school.

What should I do if my child's blood sugar is high? — Your child's doctor or nurse will tell you how to treat high blood sugar. It depends on the blood sugar level, your child's age, and their symptoms. Episodes of high blood sugar are usually treated with insulin and extra fluids. To check how serious the high blood sugar is, you might need to test your child's urine. Your child's doctor or nurse will show you how to do this.

Should my child's blood sugar be checked at school? — Yes. You, your child's diabetes team, and the school should make a plan to manage your child's diabetes in school. This plan will list when your child's blood sugar should be checked and who will check it. Most children check their blood sugar before gym class, before lunch, and any time they do not feel well.

When can my child check their own blood sugar? — It depends, in part, on your child's age. When your child is young, have them help with blood sugar testing as much as possible so that they learn how to do it. Many children are able to check their own blood sugar by ages 8 to 11. But they usually still need help using the results to choose insulin doses.

More on this topic

Patient education: Type 1 diabetes (The Basics)
Patient education: My child has diabetes: How will we manage? (The Basics)
Patient education: Managing diabetes in school (The Basics)
Patient education: Giving your child insulin (The Basics)
Patient education: Controlling blood sugar in children with diabetes (The Basics)
Patient education: Carb counting for children with diabetes (The Basics)
Patient education: Diabetes and diet (The Basics)
Patient education: The ABCs of diabetes (The Basics)
Patient education: Using insulin (The Basics)
Patient education: Hemoglobin A1C tests (The Basics)

Patient education: Type 1 diabetes: Insulin treatment (Beyond the Basics)
Patient education: Blood glucose monitoring in diabetes (Beyond the Basics)
Patient education: Type 1 diabetes and diet (Beyond the Basics)