Finding out your child has a condition like diabetes can be overwhelming. And, although it’s a disease that will always be part of your child’s life, getting help sooner rather than later is key to successfully managing the disease so your child can live a childhood unrestricted by the condition.
When children are diagnosed with Type 1 or Type 2 diabetes, it means there’s too much glucose — the body’s main source of energy for cells — in their bloodstream. Although glucose is found naturally in child’s body, it also comes from the food they eat. Too much or too little glucose in the blood can cause serious health problems.
Both types of diabetes can occur at any age, but kids with Type 1 diabetes make no insulin, and kids with Type 2 make insulin, but it doesn't work as well as it should.
Insulin is a hormone found in the pancreas that allows sugar to get into cells of the body so that sugar can be used as energy.
Symptoms of Children With Diabetes
Some of the most common signs and symptoms of children with diabetes include:
sugar in urine
sudden vision changes
sudden weight loss
fruity or sweet-like odor on breath
heavy or labored breathing
Diagnosing Children With Diabetes
Children diagnosed with Type 1 diabetes are typically diagnosed after presenting with symptoms such as unexplained weight loss, excessive urination, or excessive thirst. Children are diagnosed with Type 2 diabetes typically through a urine sample during a routine examination and symptoms are less dramatic.
Some lab tests that may be used to diagnose diabetes include:
fasting plasma test (FPG): a blood test that measures blood glucose in someone who has fasted for at least 8 hours
oral glucose tolerance test (OGTT): this test is given to someone who has fasted for 8 hours and then is asked to drink a glucose-containing beverage
random plasma glucose test: this blood glucose test is done without regard to fasting
Nutrition Tips for Children With Diabetes
At Nemours, our registered dietitians are part of your child’s diabetes care team. Nutrition is an important part of proper diabetes management. It’s not only about counting carbohydrates; it’s about healthy eating habits that are enjoyable.
Developing a Healthy Meal Plan
Healthy food choices should be encouraged for all family members. A registered dietitian at Nemours can help plan a healthy meal plan for your child with diabetes. Just as your child grows and develops, so must your child’s meal plan.
A healthy meal plan includes certain types of carbohydrates (carbs), lean protein, and fat and can be used for children with diabetes and without.
Carbohydrates are found in foods such as bread/starch, fruit, milk, and sweets. Eating carbs makes blood sugar levels rise, but that doesn’t mean that people with diabetes should avoid them — the body needs carbs. Since they affect blood sugar levels, it’s recommended children with diabetes track how many carbs they eat.
Follow these tips for healthy nutrition:
Choose healthy carbs that provide fiber, vitamins, and other nutrients,
whole wheat/grains instead of white bread, white pasta, or white rice
fresh fruit instead of fruit juices
fat-free or 1% milk instead of whole or 2% milk
light ice cream instead of full fat ice cream
limit desserts like cake, cookies, and candy, to special occasions
Choose protein from lean meats (cuts of beef and pork that end in “loin” or skinless chicken/turkey), egg whites, reduced-fat cheese, nuts, tofu, and beans.
Avoid foods high in saturated fats and trans fats, as these can raise heart-damaging cholesterol in the body. Choose heart-healthy fats, such as olive oil, canola oil, peanuts, and avocado. Remember that all fats are high in calories, so watch your portion sizes if you are trying to lose or maintain weight.
Drink mainly water instead of regular soda, fruit punch, sweet tea, and other sugary drinks. It’s OK to have calorie-free “diet” drinks occasionally.
Watch your portion sizes! Eating too much of even healthy foods can lead to excessive weight gain.
Understanding DIABETES, By H. Peter Chase, MD, published by Children’s Diabetes Foundation at Denver (ISBN 978-098326500-9). An instructional manual for families of children with diabetes.
Diabetes and Sports Special Needs Factsheet
What Teachers and Coaches Should Know
Diabetes affects how the body uses glucose, the main type of sugar in the blood. Glucose — an important source of energy for the body's cells — comes from the foods we eat. Glucose is carried to the cells through the bloodstream. Several hormones, including insulin, control glucose levels in the blood. When a person has diabetes, the body either can't make or can't respond to insulin properly.
Exercise makes insulin work better in the body, which helps people with diabetes keep their blood sugar levels in a healthier range. But when kids with diabetes exercise, they can experience low blood sugar, called hypoglycemia, or high blood sugar, called hyperglycemia.
Hypoglycemia (low blood sugar levels) can occur during or after exercise, when the body has used up much of its stored sugar, especially if insulin levels in the body are still high after an insulin injection. Signs of hypoglycemia include extreme hunger, tremors, rapid heart rate, cold sweat, pale-gray skin color, headache, moodiness or irritability, drowsiness or dizziness, blurred or double vision, confusion, seizures, or loss of consciousness.
Hyperglycemia (high blood sugar levels) can occur during sports and exercise because the muscles need more energy and the body responds by releasing extra glucose into the bloodstream. If the body doesn't have enough insulin to use the glucose, then the sugar will stay in the blood, which can cause increased urination and dehydration. Other signs of hyperglycemia include excessive thirst, fatigue, weakness, and blurry vision.
Students with diabetes who play sports may:
need to monitor blood sugar levels several times a day, as well as before and after playing sports or practicing
take insulin injections or wear an insulin pump
experience signs of hypoglycemia or hyperglycemia
need to use the bathroom frequently
need plenty of water and extra snacks before, during, and after exercise
need to sit out of practice or games if their blood sugar is too low or too high
What Teachers and Coaches Can Do
Students with diabetes can play sports and exercise at the same level as anyone else. And just like most kids and teens, students with diabetes are healthier if they get plenty of exercise, which can help them manage the disease.
You may need to remind students with diabetes to check their blood sugar levels before, during, and after exercise, practice, and games. Also, make sure that:
you and your student know the symptoms of hypoglycemia and hyperglycemia
you keep extra snacks, juices, and emergency supplies in the classroom and on the playing field in case your student starts to have symptoms of hypoglycemia
your student with diabetes has a diabetes management plan
you know how to respond, in accordance with the plan, in case of an emergency
Students with diabetes may miss class time, practices, or games due to doctor visits or hospital stays. Teachers and coaches should give them special consideration regarding missed instruction, assignments, testing, and sports.
Reviewed by: Mary L. Gavin, MD
Date reviewed: September 26, 2016