If your child has recently been diagnosed with type 1 diabetes (T1D), you probably have a lot of questions, concerns, and anxieties about what their treatment plan will look like going forward.
It may help to know that this autoimmune condition is manageable. As a parent or caregiver, you may be wondering how you can help your child learn to care for themselves while going to school, playing with friends, and having all the typically happy, carefree experiences of childhood.
Don’t worry too much. Managing T1D in kids involves daily management tasks, but life with this condition still leaves plenty of room for your child to enjoy the day-to-day routine of their siblings, friends, and classmates.
Here’s what you need to know about caring for a child with T1D at home and at school, along with what the current best practices are for diabetes care in kids.
Taking care of a child with T1D can be a daunting task — especially in the beginning after diagnosis when you’re learning lots of new information and trying to figure out what works best for your child.
According to Nemours Children’s Health, there are four main parts to a diabetes care plan for children:
- Blood sugars. Different types of fingerstick glucose meters and continuous glucose monitors (CGMs) allow you and your child to check blood sugar levels throughout the day, helping you keep the levels within a targeted range. Depending on a child’s age and diabetes management dependency, it may be helpful to supervise blood sugar checks.
- Insulin. T1D means your child’s pancreas doesn’t produce enough insulin to function properly, per the
Centers for Disease Control and Prevention (CDC). This means that kids with the condition need to take insulin so their body functions properly. This is administered by either an injection or insulin pump.
- Exercise. Physical activity helps regulate blood sugar levels and can actually make insulin work better, according to Nemours Children’s Health. Ideally, your child should be active for at least 60 minutes every day. You can work up to this goal over time and motivate your child by finding an activity they enjoy and even participating in the activity with them.
- Meal planning. Eating nutritious foods will help your child maintain a healthy weight and keep their blood sugar levels from spiking. Whole fruits and vegetables, lean protein, whole grains, and healthy fats are great places to start. You can work with your diabetes care team on what options work best and whether low carb food choices are appropriate for your child’s lifestyle.
The psychosocial side of life with diabetes, or keeping an eye on mental and emotional health, is also an important part of a child’s management plan. Kids with chronic health conditions can have trouble making friends, being confident in their bodies, and feeling supported — not isolated — at home and at school.
There are many local and online communities offering peer support for kids with T1D, which can be vital in helping your child feel they are not alone in living with this chronic condition.
Peer support groups can also teach your child creative ways to manage their own diabetes, introduce them to new friendships, and help caregivers better understand how to support their child. (As always, remember to monitor your child’s online activities and make sure virtual groups are safe for your child to interact with.)
Several groups like the American Diabetes Association (ADA), JDRF, and Children with Diabetes (CWD) can assist your family with finding people who “get it,” both in person and online.
You can be diagnosed with T1D at any age.
Although this autoimmune condition was once known as juvenile diabetes, that name is outdated and does not reflect the reality that kids, teens, and adults can all be diagnosed with T1D.
The CDC still reports that the peak age is between
Of course, no matter the diagnosis age, diabetes is a lifelong illness. So even people who receive a diagnosis in childhood will need to learn how to manage their condition as an adult.
In general, the treatment plans for kids and adults with T1D are the same:
- checking blood sugar levels
- taking insulin
- getting regular exercise
- eating a healthy diet
That said, the
As kids grow into adolescents and go through puberty, their diabetes care plan should reflect how their changing body responds to things like exercise, sleep schedules, and diet.
Though many people with diabetes choose to take insulin via injection and monitor their blood sugars with a fingerstick meter, many opt for an insulin pump and CGM technology.
Some new technologies have introduced a few other ways to do this, including insulin pumps and continuous glucose monitors:
- Insulin pump. This diabetes technology has become more popular since the 1990s. It’s a small device that administers insulin continuously in the background throughout the day and night (basal), as well as in bursts (boluses) around meal times. A tiny catheter is injected into the top layer of fatty tissue under your skin and the little needle is removed, so insulin is delivered that way. You typically replace a pump infusion site every 2 or 3 days.
- Continuous glucose monitor (CGM). This diabetes device has been around since 2004. It measures your glucose levels every few minutes, using a sensor inserted under the top layer of skin and communicating via a transmitter that you stick on your skin. The
sensor transmits the informationthe data to a handheld receiver, smartphone app, and sometimes an insulin pump. You typically change out the CGM sensor every 7 to 14 days.
Both of these devices can make diabetes management more flexible, without a need to do fingersticks or take insulin by injection as you’d have to do otherwise. But there are pros and cons to these technologies that you should keep in mind.
Pros of CGMs and insulin pumps
- more fine-tuned doses of insulin
- ability to more closely monitor one’s glucose levels and management stye
- fewer fingersticks and injections
- more flexibility in your daily schedule, especially around meals and activities
- blood sugar changes are detected no matter what you’re doing, including showering, exercising, and sleeping
- can reduce caregiver stress around monitoring blood sugars levels and administering insulin manually
Cons of CGMs and insulin pumps
- more expensive than traditional methods (insurance coverage may vary)
- requires more training and education for use
- relies on system accuracy
- diabetes device fatigue from alerts, alarms, and beeps can lead to emotional burnout
- increased risk of skin irritations and infections
- you may still need to perform traditional blood sugar checks, even with a CGM
- increased risk of diabetic ketoacidosis (DKA) if the insulin pump isn’t working correctly — and because DKA can be a medical emergency, getting medical care may be necessary
Many parents of kids with diabetes share concerns about trusting their child’s care to other people. But unless you choose to homeschool, this is an important step in managing your child’s condition.
Both the ADA and the JDRF offer guides for working with your child’s school, which include:
- initiating a conversation about your child’s condition
- working with various school staff to discuss management
- coordinating the necessary diabetes supplies and equipment
All federally funded schools are required to develop a 504 plan for kids with diabetes. These can vary for each child, but generally, they may include information on:
- how the school plans to keep your child safe
- preventing discrimination on the basis of their disability
- allowing your child to manage their condition within the school building (for example, eating outside of the standard meal times, if necessary)
- what technology is used and the settings
- when to contact a parent or diabetes care team professional
- how to respond to emergency situations and whether 911 should be called
The 504 plan will help the school provide the best care for your child during school hours and ensures that your child will have access to everything they may need to be healthy over the course of a school day.
How do you take care of a child with type 1 diabetes?
- Insulin. Your child will need take insulin, either by syringe, pre-filled insulin pen or a diabetes device known as an insulin pump. It will be important to learn about short-acting insulin and long-acting insulin, how each work, when to take insulin, and how to afford this life-sustaining medication.
- Blood sugars. A key to diabetes management is checking glucose levels, or blood sugars. This can be done through a traditional glucose meter using a drop of blood from the finger, or a continuous glucose monitor (CGM) that uses a sensor on the body to measure glucose readings.
- Meal planning. Learning what foods and drinks impact glucose levels can be tricky. You will need to learn how to count carbohydrates (separate from calories) and see how various foods and beverages impact glucose levels in different ways. This will include dosing insulin correctly for food and drinks.
- Activity. Exercise often lowers glucose levels, meaning that it can be dangerous if too much insulin and not enough food is in your child’s body before, during, or after physical activity.
How serious is type 1 diabetes in a child?
Type 1 diabetes is an autoimmune condition that can be managed. But it does involve active attention and management every day. Aside from long-term diabetes complications that can impact the eyes, nerves, heart, kidneys, the impact of low or high blood sugars can be dangerous if not treated. This is a lifelong condition that cannot be cured or reversed, although many live long healthy lives with T1D.
Why did my child get type 1 diabetes?
Science does not know the exact causes of T1D. But researchers believe it may be inherited through specific genes that cause a predisposition to the disease. A virus or other environmental factor may then trigger an immune system response that affects the pancreas’ ability to make insulin. Not everyone with these genes develops T1D, but nothing you or your child did “wrong” caused the condition.
What can my child with diabetes eat?
For the most part, kids with T1D can eat a fairly typical diet as long as you help them manage their portions and carbohydrate amounts. Fresh veggies, low sugar fruits, lean protein, low fat dairy, and whole grains are all nutritious foods for kids with T1D.
While there may be food limitations, most diabetes experts advise that complete restriction isn’t the best approach. Allowing your child to enjoy treats in a reasonable manner, like a piece of cake on their birthday, is important for their mental and emotional health. You may simply need to plan ahead for those types of indulgences, making sure your child monitors their blood sugar levels and takes the appropriate amount of insulin.
Type 1 diabetes isn’t an easy condition to manage, especially at first, thanks to a fairly steep learning curve. As a parent, you’ll need to learn how to maintain your child’s blood sugar levels, administer insulin, incorporate diabetes care into your family life, and keep your child safe no matter where they are.
The good news, though, is that there’s no shortage of resources for caregivers and kids with diabetes. Aside from the management tools that exist, diabetes experts encourage people within the diabetes community to find local or online peer support so they don’t feel alone in life with diabetes.