Diabetes

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:
  • extreme thirst
  • frequent urination
  • drowsiness, lethargy
  • sugar in urine
  • sudden vision changes
  • increased appetite
  • 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,
such as:

  • 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.

Your Child's Diabetes Health Care Team

When you have a child with diabetes, you and your family have a lot to learn, but you don't have to go it alone. Your child's diabetes health care team can help.

Treating diabetes requires the expertise of many types of health care providers, such as doctors, certified diabetes educators, dietitians, and mental health professionals.

What the Health Care Team Does

The diabetes health care team teaches families all about diabetes. It helps families create and use the child's treatment plan, also called the diabetes management plan.

The team adjusts insulin and other diabetes medications, develops meal plans, and makes physical activity recommendations to help control blood sugar levels.

All team members should take into account your child's schedule, skills, preferences, lifestyle, and growth and developmental needs. The team will also help you cope with the parenting challenges of having a child with a chronic illness and will help your child cope with his or her own set of challenges.

Keep in mind that you and your child are the captains of your diabetes health care team — all of the team activities center around helping you and your child manage diabetes. In many cases, the roles and responsibilities of the team members overlap. You should feel comfortable communicating with all of the team members because you'll be in contact with them often.

Doctors

A pediatric endocrinologist is a doctor who specializes in the diagnosis and treatment of children with diseases of the endocrine system, such as diabetes and growth disorders. But pediatricians, family practitioners, and other medical doctors also can treat kids with diabetes and manage their health care needs.

It's important to recognize that seeing a specialist like a pediatric endocrinologist doesn't replace the need for your child to continue to get general health care from a pediatrician or other primary care doctor.

You and your child should feel comfortable with the doctors you choose because your child's diabetes management plan is based on the doctor's prescribed treatment. Ask plenty of questions and make sure you understand the answers.

Doctors will ask detailed questions about how your child is feeling and will do physical examinations. They'll also teach you and your child about diabetes and, with recommendations from all the team members, make a diabetes management plan.

Besides monitoring your child for diabetes complications and other medical conditions that can happen with diabetes, the doctor will make changes to insulin schedules and write prescriptions for medicines and referrals to other specialists as needed.

Certified Diabetes Educators (CDEs)

Certified diabetes educators (CDEs) are nurses, dietitians, social workers, doctors, or pharmacists who help people manage their diabetes. CDEs have had special training to teach parents and kids.

CDEs will:

  • explain what diabetes is and how it affects the body
  • teach you and your child how to give insulin injections or use an insulin pump
  • explain how to treat high and low blood sugar levels
  • show you how to adjust medications for exercise and sick days
  • show you how to test blood sugar levels, work the blood glucose meter, and test the accuracy of blood sugar monitoring equipment used at home
  • review the diabetes management goals with you
  • discuss any challenges you and your child may be facing

Dietitians

Registered dietitians are experts in nutrition and meal planning. They know about food and its effects on the body and blood sugar levels. Just as your child grows and develops, so must his or her meal plan, which you can talk about with the dietitian.

The dietitian will track your child's growth and recommend the right amount of calories needed each day. The dietitian also will:

  • make adjustments to meal plans based on sports, holidays, special events, and other activities
  • provide snack and recipe ideas
  • teach you and your child how to make healthy food choices
  • help you and your child learn carbohydrate counting and meal planning techniques
  • teach you to read food labels and develop strategies for determining the carbohydrate content of foods when food labels aren't available

Mental Health Professionals

A mental health professional, usually a social worker or psychologist (but sometimes a psychiatrist or counselor), can be a great resource for families dealing with diabetes, which can be overwhelming.

Mental health professionals can help parents watch for any problems at home, work, or school. They also can see how diabetes care affects the entire family, and help you find ways to improve your child's diabetes management.

Social workers can help you find outside resources (like support groups) for families dealing with diabetes. They can suggest ways for families to get necessary diabetes equipment and supplies and help them deal with insurance and financial issues.

Psychologists and psychiatrists can use behavior modification techniques to help kids if they're having trouble controlling their diabetes, are feeling angry or sad, or aren't taking responsibility for diabetes care as they mature. Psychiatrists also can prescribe medicines for emotional problems related to diabetes, such as depression.

Depending on where you live and the type of diabetes facility that you visit (whether it's a specialty diabetes clinic or pediatrician's office), you may find all members of your team in one place. Or you might visit several different offices for diabetes care. If you don't have access to a dietitian or mental health professional but would like to see one, ask the doctor to refer you to one.

Every person on the team is important to managing your child's diabetes. Making sure they all know the diabetes management plan will make your child's care as coordinated as possible.

Reviewed by: Steven Dowshen, MD
Date reviewed: September 26, 2016