Children with Diabetes: Helping them Cope, Giving them Care – Part 3

September 19th, 2010

A Child Shall Lead

So how do you treat children with type 2 diabetes? You handle type 2 diabetes in children in much the same way you deal with it in adults—by managing the diet, increasing physical activity, and monitoring blood glucose.

  • Nutrition Management. Children with type 2 diabetes need to follow a healthy meal plan that will ensure proper nutrition for normal growth and development. Making an appointment with a registered dietitian is a good idea, because she can tell you how   many calories your child needs daily to balance her needs for growth and development, but avoid excess calories.  An R.D. Can also provide assistance with menu makeovers and meal planning.
  • Increased Physical Activity—Children with diabetes should be physically active at least 60 minutes each day. Physical activity helps to lower blood glucose levels and control weight.
  • Monitoring Blood Glucose—Children with diabetes should be taught the acceptable range for their blood glucose. Your diabetes dream team can teach your child how to use a blood glucose meter properly to test their numbers. Children as young as five years old can learn to do it on their own. Using a glucose meter with a built in memory will ensure that meter readings are recorded, but you can give a responsible older child a fun journal or log book to record test results and jot down questions for his dream team.

 If diet and exercise don’t reduce blood glucose then your pediatrician may prescribe one of the two medications the FDA has approved for use by children. Metformin is approved in children as young as 10 years old;  Exenatide is approved in children 16 and up. As with type 2 diabetes in adults, the goal of treatment is to get blood glucose levels as close to normal as possible. The larger goal, of course is to prevent long-term complications.  It is especially important to help children establish good habits and learn to control their diabetes early, because they have so much longer to live with it.

Your Child’s Dream Team

If your child has diabetes, she also needs a dream team, but it may look a little different or function differently from one for adults. For instance, there are pediatric specialists in every discipline—endocrinology, dietetics, nursing, psychology, dentistry—people who are experts in dealing with children’s special needs. Ideally you will be able to find someone who is well versed in caring for young people with diabetes.

You will need to work with the school nurse to make sure that your child’s blood glucose is being monitored, that she is able to get the food he needs, and that there is someone available to give her medication or insulin as required. A medical management plan may need to be developed and followed by all the school personnel—from the bus driver to the lunchroom staff.  Most states have laws about the care of a child with a disability, which includes diabetes. Check the laws in your area to find out what support the school is required to provide.

This “special treatment” might make your child feel “different” from the other kids, which can be difficult to handle emotionally.  Teens with diabetes will have to cope with managing their disease while trying to enjoy being a teen. But children of any age will face birthday cake, unhealthy snacks at sleepovers, and the temptations of fast-food. And try playing sports while trying to manage blood glucose levels. For a kid, that can be a drag. You and your child’s diabetes dream team will need to provide as much support and encouragement as possible. For younger children, your task is to help them understand what is happening to them. Teens might be mentally capable of  handling their diabetes but at this is the age that risky behavior and rebellion starts.  This means that you will still need to keep an eye on their diabetes self care.  

Call on the team to help you determine the safe glucose range for your child and help to develop a sick day management plan as well as a daily diabetes care plan.  All of these things (as well as others) will need to be explored with your child and well planned.

So how are you and your child coping with diabetes? Who’s on your child’s dream team?

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