Special Considerations
No matter how hard you try, there are going to be times when your child doesn't handle things the way you'd like them to, or their blood sugar doesn't respond as expected. It's nobody's fault - just an opportunity to learn from the experience.
Knowing that, always make sure your child wears a medical ID bracelet or necklace. There are a lot of different styles available - ask your pharmacist or diabetes educator for suggestions.
Low Blood Sugar (Hypoglycemia)
When your child hasn't had enough to eat, has been especially active, or has an infection - or sometimes for no apparent reason - their blood sugar can fall too low. This is what people used to call an "insulin reaction." Today, it's more likely to be called "hypoglycemia" or "a low." Everyone is different, so your doctor will give you guidelines on what blood sugar level constitutes a low for your child.
Low blood sugar isn't pleasant - it makes your child feel shaky, hungry, nervous, confused, or gives them a headache. You may notice them sweating, getting cranky, or even walking strangely. Each person is different, so ask your child what a low feels like, get familiar with the signs, and test frequently. And keep the lines of communication open, since the symptoms can change as your child gets older.
If the test shows that their blood sugar is low, have them drink four ounces of fruit juice or eat two tablespoons of jelly, honey, or prepared cake frosting from a tube, seven or eight hard candies, or special glucose tablets. Avoid overcompensating for the low. Wait 15 minutes to allow the sugar to work, then re-test. This process, always waiting 15 minutes between eating and re-testing, can be repeated until blood sugar levels return to normal.
When blood sugar is falling, act quickly. If blood sugar drops too low, your child can lose consciousness. Have your doctor show you how to administer a glucagon injection in an emergency, and keep some at home. This hormone stimulates the liver to release stored blood sugar quickly.
High Blood Sugar (Hyperglycemia)
As kids get older, they may be tempted to let their blood sugars run high, in order to avoid having low blood sugar in public. They may feel embarrassed by having other people see them in this way.
Unfortunately, high blood sugar presents its own problems, making it hard to concentrate, leading to dehydration, and sometimes contributing to a buildup of toxic ketones in the urine. Whenever a blood sugar test shows hyperglycemia (or high blood sugar), people with type 1 diabetes should perform a urine test for ketones. If ketones are moderate or high, it's time to drink a lot of water and avoid exercise, which can make blood sugar go even higher. If ketones get too high, a condition called ketoacidosis can occur, which may require hospitalization for treatment.
Sick Days
Ear infections, colds, the flu - they're all part of growing up. But when your child has diabetes, these stressful events can make it harder to keep blood sugar under control. Why? Stress hormones released when we're ill can raise blood sugar. Plus, it can be harder to eat normally. Vomiting and dehydration further complicate the situation.
Make sure you have a specific sick day plan worked out with your doctor in advance. Since you never want to stop insulin injections, even if your child isn't eating, you'll need to know what steps to take to keep their blood sugar in control. Frequent testing will help them monitor blood sugar levels. If they are too sick to eat or can't keep solid foods down, they can get the necessary carbohydrates from ginger ale, non-diet soda, juice, ice pops, or gelatin. If they can't eat at all, just sipping small amounts of these foods hourly will help.