If your child or teen has been diagnosed with
type 1 diabetes
, the next step is to create a treatment plan that allows your
child to manage the condition and stay healthy and active. Doctors
or members of your child's diabetes health care team may call
this a diabetes management plan.
Treatment plans for type 1 diabetes should be based on your
child's needs and the suggestions of your child's
diabetes health care team
. Treatment approaches differ in, among other things, the types of
insulin given and the schedules for giving insulin given each day.
The advantages and disadvantages of each plan should be considered
for each individual child.
Type 1 Diabetes Treatment Basics
blood glucose level
is the amount of glucose in the blood.
is a sugar that comes from the foods we eat, and it's also
formed and stored inside the body. It's the main source of
energy for the cells of our body, and it's carried to each cell
through the bloodstream.
is a hormone that allows the glucose to get into the cells. In type
1 diabetes, the body can no longer make insulin, so the glucose
can't get into the body's cells. This causes the blood
glucose level to rise.
For children with diabetes, the goals of treatment are to
control the condition in a way that helps minimize symptoms and
prevent short- and long-term health problems, while making sure a
child has normal physical, mental, emotional, and social growth and
development. To do this, parents and kids should aim for the goal
of keeping blood sugar levels as close to normal as possible.
In general, kids with type 1 diabetes need to:
- take insulin as prescribed
- eat a healthy, balanced diet, paying special attention to the
amount of carbohydrates in each meal and the diabetes meal
- monitor blood sugar levels several times a day
- get regular physical activity
Following the treatment plan can help your child stay healthy,
but treating diabetes isn't the same as curing it. Right now,
there's no cure for diabetes, so kids with type 1 diabetes will
need treatment for the rest of their lives. But with proper care,
they should look and feel healthy and go on to live long,
productive lives, just like other kids.
Take Insulin as Prescribed
Children and teens who have type 1 diabetes must take insulin as
part of their treatment plan. Insulin is the only medicine that can
keep blood sugar levels in a healthy range in kids with type 1
Taking insulin as prescribed allows kids and teens with type 1
diabetes to use the glucose in their blood for energy. When glucose
is entering and being used by the cells properly, its level in the
blood generally remains within a healthy range. Unless they are
, most children with type 1 diabetes require two or more injections
every day to keep blood sugar levels under control. Usually,
children inject a combination of different types of insulin to
handle the sugar that circulates in the blood both after eating and
in between meals. The acids and digestive juices in the stomach and
intestines can break down and destroy insulin if it is swallowed,
so it can't be taken in a pill. The only way to get insulin
into the body right now is by injection with a needle or with an
There is no-one-size-fits-all insulin schedule - the types of
insulin used and number of daily injections your child needs will
depend on your child's diabetes management plan. Also, you
can't turn off the action of insulin once it's been
injected, so insulin doses need to be adjusted to handle the rise
in blood sugar that occurs with meals and provide the amounts of
insulin the body needs between meals and overnight. Eating meals at
regular times generally makes this easier to accomplish. Although
eating on schedule may work well for younger children, sticking to
a routine may be a bigger challenge for older kids, whose school,
sleep, and social schedules may not be as routine. Your child's
diabetes health care team can help you work through any problems
your child may be having with scheduling meals and insulin
Getting insulin injections today is nearly painless, thanks to
smaller needles. Insulin pumps, which deliver insulin through a
small tube that is placed just under the skin, cut down on the
number of injections a child needs to take.
Insulin is usually injected into the fatty layer under the skin
of the abdomen, hips/buttocks, or thighs. Your child's diabetes
health care team will teach you when and how to give your child
insulin, as well as the best sites in which to inject it, based on
your child's weight, age, and activity patterns.
Eat a Healthy, Balanced Diet and Follow a Meal Plan
Eating a balanced diet and
following a meal plan
are important components of your child's treatment for type 1
diabetes. Kids with diabetes benefit from the same kind of healthy
diet as people without diabetes - one that includes a variety of
nutritious foods that help the body grow and function properly.
Kids with diabetes also have to balance the type and timing of
the food they eat with the amount of insulin they take and with
their activity level. That's because eating some foods will
cause blood sugar levels to go up more than others, whereas insulin
and exercise will make blood sugar levels go down.
How much the blood sugar level goes up after eating depends on
the type of nutrients the food contains. The three main types of
nutrients found in foods are
(carbs), proteins, and fats, which all provide energy in the form
of calories. Foods containing carbohydrates cause blood sugar
levels to go up the most. Foods that contain mostly protein and/or
fat don't affect blood sugar levels nearly as much.
Our bodies need all of these nutrients - in varying amounts - to
function normally. So you and the diabetes health care team will
create a diabetes meal plan that incorporates foods with all of the
essential nutrients. Meal plans typically consist of breakfast,
lunch, and dinner with scheduled between-meal snacks. The diabetes
meal plan won't restrict your child to eating specific foods,
but it will guide you in selecting choices from the basic
to achieve a nutritious balance. A meal plan is based on your
child's age, activity level, schedule, and food likes and
dislikes. It should also be flexible enough to accommodate special
situations like parties and holidays. The meal plan should make it
easier to keep your child's blood sugar within his or her goal
Awareness of the amount of carbohydrates in meals and snacks
will help you determine how much insulin to give your child.
Mismatching carbs and insulin can result in either high or low
blood sugar levels.
Your child's diabetes meal plan may also recommend limiting
extra fat and "empty" calories (foods that contain lots
of calories but few nutrients like vitamins and minerals). Everyone
should limit these foods anyway because eating too much of them can
lead to excess weight gain or long-term health problems like heart
disease, for which people with diabetes are already at risk.
Monitor Blood Sugar Levels
Another part of treating type 1 diabetes involves checking blood
sugar levels regularly and responding to the results. Controlling
blood sugar levels helps kids with diabetes feel well, and grow and
develop normally, and it reduces the risk of long-term diabetes
complications. Your child's diabetes treatment plan will
recommend how many times a day your child's blood sugar levels
should be checked. It's the only way to know how your child is
doing with blood sugar control on a day-to-day basis.
Your child's diabetes health care team will also let you
know what your child's target blood sugar levels should be. In
general, kids with type 1 diabetes should test their blood sugar
levels with a
blood glucose meter
at least twice a day, but preferably three or four times a day.
Depending on your child's diabetes management plan and the need
to troubleshoot problems that may come up, blood sugar levels may
need to be tested even more often at times.
The blood glucose meter tells you what your child's blood
sugar level is at the moment you test. Another type of blood sugar
(hemoglobin A1c or HbA1c) test, can give an indication of what your
child's blood sugar levels have been like over the past few
Get Regular Physical Activity
Exercise is good for everyone - adults and children - with or
without diabetes. Getting
regular physical activity
is also an important part of diabetes treatment. It helps control
blood sugar levels and may reduce the risk of other chronic
illnesses, like heart disease. In addition to helping keep blood
sugar levels under control, exercise can help kids with
- maintain a healthy body weight
- get and keep their heart, lungs, and blood vessels in good
- feel more normal by doing things that kids without diabetes
Encouraging a child with diabetes to exercise may make parents
uneasy, but exercise actually helps insulin work better in the
body. Although some adjustments of meals and insulin may be needed,
kids with diabetes can and should exercise.
All exercise is great - from walking the dog or riding a bike to
playing team sports. Encourage your child to exercise (set 60
minutes daily as a goal) to get the most benefits. Like any other
part of a healthy lifestyle, new exercise habits might be hard for
kids to adopt at first, but feeling the benefits of exercise can
help kids stick to their program.
Avoiding Problems During Exercise
To help avoid problems during exercise, kids with diabetes may
- have an extra snack prior to activity
- carry snacks, water, and supplies with them when they
- check their blood sugar levels before, during, or after
- wear a medical identification bracelet (should be worn
always, but even more important when exercising)
- make sure their coaches know about their diabetes and what to
do if problems occur
Your child's diabetes health care team will offer specific
suggestions to help your child get ready for exercise or join a
sport. They'll also give you instructions to help you and your
child respond to any diabetes problems that may occur during
(low blood sugar) or
(high blood sugar).
Putting It All Together
Treating and managing diabetes may seem overwhelming at times.
But your child's diabetes health care team is there for you.
Your child's diabetes management plan should be easy to
understand, detailed, and written down for easy reference. You
should also have the names and phone numbers of your child's
diabetes health care team members in case of emergencies, or if you
have questions about how to take care of your child's
In addition to the diabetes treatments mentioned above, you may
also hear about alternative or complementary treatments for
diabetes, such as herbal remedies and vitamin or mineral
supplements. Not enough studies have been done to prove their
effectiveness, although research is presently being done to study
their possible benefits. Aside from being potentially ineffective,
these practices can even be dangerous for kids and teens with type
1 diabetes, especially if they are used to replace medically
recommended treatments. Talk to your child's diabetes health
care team if you have questions.
Each day, researchers all over the world are working to find a
cure for diabetes, and many treatment advances have occurred to
make treatment easier and more effective. Insulin may soon be
available in pill, patch, and spray forms, and scientists continue
efforts to improve results of
transplants. Versions of an artificial pancreas - a device that
senses blood sugar and gives insulin - are currently being tested
also. Although these new developments are exciting, all of them
still need extensive testing - especially for use in children -
before they become available.
Steven Dowshen, MD
Date reviewed: April 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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