Patient education: Controlling blood sugar in children with diabetes (The Basics)

What does "controlling blood sugar" mean? — It means making sure the amount of sugar in your child's blood is in the right range and not too high or too low. This is very important for children who have diabetes.

Why is it important to keep my child's blood sugar under control? — Keeping your child's blood sugar level from getting too low or too high is important, because it can prevent:

●Short-term problems – Blood sugar levels that get very low or very high can be a medical emergency.

●Long-term problems – Having high blood sugar levels over many years can damage the kidneys, eyes, nerves, and heart.

Why might my child's blood sugar get out of control? — Your child's blood sugar can get out of control when they:

●Get sick or have surgery

●Get off their usual schedule or travels

●Use too much or too little insulin

●Eat much more or less than planned, or skip meals

●Exercise much more or less than planned

●Are excited, upset, or worried

What should my child's blood sugar level be? — Your child's doctor or diabetes nurse will tell you the target range for daily blood sugar levels. Target blood sugar levels depend on a child's age and the time of day (for example, if it is before or after a meal or bedtime).

How do I know what my child's blood sugar level is? — You can check your child's blood sugar level using a device called a "blood glucose meter." There are different types of blood glucose meters, but most of them work the same way. You will need to prick your child's fingertip to get a drop of blood (picture 1). You will put the drop of blood onto a test strip that goes into the meter. After a few seconds, the meter will show your child's blood sugar level.

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.

Every few months, your child's doctor will also do a blood test. This test, called an "A1C," shows what your child's average blood sugar level has been over the past 2 to 3 months.

How do I keep my child's blood sugar under control? — To help control your child's blood sugar, you can:

●Learn about diabetes and the things that can raise or lower your child's blood sugar. Ask your child's doctor or nurse if you have any questions.

●Spread out the carbs your child eats over the whole day. Carbs are sugars and starches that are in the food we eat. They can raise a person's blood sugar level. If you spread out your child's carbs over the whole day, you can help keep their blood sugar level from getting too low or high.

●Learn how to balance your child's insulin dose with what they eat and how much they exercise.

●Check your child's blood sugar often. This way you can treat low or high blood sugar before it becomes an emergency. Checking your child's blood sugar often will also help you learn how food and exercise affect their levels.

●Keep a record of your child's blood sugars. Show the record to your child's doctor or nurse so that they can change the treatment plan as needed.

●Work with your child's school to plan how to manage your child's diabetes during school hours.

●If your child is a teen, talk to them about their diabetes. Most teens can check their own blood sugar and give themselves insulin. But they sometimes need help to understand how their actions can affect their heath. For example, drinking alcohol or skipping meals can lower blood sugar, while taking too little insulin can cause high blood sugar. To help prevent a driving accident, teens should test their blood sugar anytime they plan to drive.

●Teach the important adults in your child's life about diabetes and how to take care of your child's diabetes. These adults can include babysitters, grandparents, or other relatives, friends, and coaches.

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

Low blood sugar might be 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.

●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.

High blood sugar is usually treated with insulin and extra fluids. If your child has an episode of high blood sugar, you might need to test their blood or urine. Your child's doctor or nurse will show you how to do this.

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: Checking your child's blood sugar level (The Basics)
Patient education: Managing diabetes in school (The Basics)
Patient education: Giving your child insulin (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)