Day-to-Day Care
The school years may be the easiest time to establish a good diabetes care program, because your child's schedule will begin to be much more regulated. By the time kids are about eight or ten years old, they're beginning to have a sense of time and are thinking for themselves. They'll be able to help with their own self-care by remembering snack and medication times and starting to select foods that fit within their meal plans. What's more, blood sugars tend to be more stable than in infancy or the pre-teen years.
Naturally, you'll work with your healthcare team to outline an eating, exercise, testing, and medication plan tailored to your child's age and developmental needs. You'll also want to talk to your doctor about ways to accommodate special situations like birthday parties and at-school needs. Here are a few tips on putting that plan into action.
Healthy Meals & Snacks
For children with type 1 diabetes, today's rapid-acting insulins make it much easier to deal with kids' changing eating patterns. You can see what they've eaten, count carbohydrates, and tailor the insulin appropriately.
For children with type 2 diabetes, nutrition is going to be key in helping them establish and maintain good control over their blood sugar.
Fortunately, because your child is just learning habits that will last a lifetime, you have an opportunity to help them establish positive attitudes about food. This will pay off later, as your child moves into puberty and adulthood.
• Everyone in the family can eat the same menu. A healthy meal plan is right for the whole family, and won't make the child with diabetes feel singled out.
• Keeping mealtimes cheerful will help instill in your child the idea that food isn't the "enemy." It's to be enjoyed.
• Lots of kids are picky eaters. Rather than insisting your child eat something, give them a choice. Cereal and milk or cheese and crackers each provide about the same nutritional value, but letting them pick gives your child a sense of control and independence.
• Avoid making the child feel deprived - don't make any foods "off limits" and the temptation of the forbidden won't exist.
• As your child begins to make his or her own food choices, or begins eating meals away from home, sometimes they may slip up. Encourage your child to be honest with you and praise them for it. Getting in trouble for eating the wrong foods will only encourage them to bend the truth next time.
Ongoing Activity
Whether your child has type 1 or type 2 diabetes, exercise is an excellent way of maintaining a healthy body weight and controlling blood sugar. Many children this age are enthusiastic participants in a wide range of activities. Others need a little more encouragement. But your child doesn't have to become a soccer star to enjoy the benefits of exercise - any time they can walk the dog, ride a bike, swim, or dance counts. However, if you can get them to join in, playing sports is a great way for kids to build confidence, make friends, and exercise on a regular basis.
• Your doctor will give you an idea of how often your child should be exercising each week.
• Make sure your child's teachers and coaches know that your child has diabetes, and what to expect. Read more about this in our Away from Home section
• Have your child test blood sugar before and after exercise. If the exercise is intense or over a long period of time, you'll also want them to test during exercise.
• If blood sugar is high, your child should check for ketones in their urine. If ketones are moderate or high, they should not exercise
• If your child needs an injection prior to activity, choose a site that won't be exercised. For example, if the child will be running, choose the abdomen instead of a leg.
• Make sure your child wears a medical ID bracelet or tag, in case of emergency
• Always keep a carbohydrate source, such as glucose tabs or hard candy, on hand.
Blood Sugar Monitoring
Fortunately, by the time a child is between five and seven years old, they're usually able to identify the feelings associated with low blood sugar. Still, blood sugar can be unpredictable. You can do everything right and the test results may still come as a surprise. That's why frequent monitoring is as important as always. Here's how to take out some of the sting.
• Make sure that your child understands that the goal of monitoring, as well as other self-care efforts, it to make them feel good.
• As they develop and show interest, let the child participate in testing. Many children take over their own testing and injections (with supervision).
• Make the process quick, calm, and no big deal. The less upset you get about it, the less upset your child will be, too.
• Never negotiate blood tests or injections. Tests are necessary for your child's health - not optional. And the first time you get talked out of one, you'll set a precedent your child will never forget.
• Start having your child take over logging responsibilities, and make sure that even out-of-range results are recorded. The goal of logging is to learn - they aren't being graded on the results.
Insulin Injections
Children with type 1 diabetes need insulin injections every day - often several times a day - as will some children with type 2 diabetes. Creating a soothing atmosphere will help make it go more smoothly.
Most of the tips for blood sugar monitoring hold true for giving injections - the more matter-of-fact you can be, the easier it will be for everyone. A few other ideas...
• Use an ice cube to chill the injection site beforehand.
• Rotate sites regularly, to avoid any issues that may arise from using the same site too often.
• Let your child take over responsibilities for injections or controlling a pump as they become more and more ready - but don't stop supervising the process. They still need your support.