You've probably heard your child's doctor talk a
lot about "diabetes control," which usually refers
to how close the blood sugar, or
glucose
, is kept to the desired range. What does this mean and why is
it important?
When Diabetes Isn't Under Control
Too much or not enough sugar in the bloodstream can lead to
short-term problems that must be treated right away, like
hypoglycemia
,
hyperglycemia
, or diabetic
ketoacidosis
.
Too much sugar in the bloodstream also can cause long-term
damage to the vessels that supply blood to vital organs, which can
increase the risk of heart disease and stroke, kidney disease,
vision problems, and nerve problems.
These problems don't usually affect kids or teens with
diabetes who've had the disease for only a few years. But they
can occur in adults with diabetes, particularly if they haven't
managed or controlled their diabetes properly.
Kids with diabetes who don't control their blood sugar
levels may also have problems with growth and development and can
even experience a delay in the onset of
puberty
.
Also important is avoiding frequent and/or severe episodes of
hypoglycemia (low blood sugar), which can interfere with
participation in school and other activities, making it hard for
kids to cope with their diabetes and achieve a healthy, happy
childhood and adulthood.
Controlling diabetes means keeping blood sugar levels as close
to normal as possible. It's a three-way balancing act: Your
child's medications (such as
insulin
), food, and activity level all need to be balanced to keep blood
sugar levels under control. If any one of these is off, blood sugar
levels will be, too.
In general, poorly controlled blood sugar levels can be due any
of the following:
- not taking medications as prescribed
- not following the
meal plan
(like eating too much or not enough food without adjusting
medications)
- not getting regular
exercise
or not making the necessary adjustments in the diabetes treatment
plan when there is a significant change in physical activity
level
- illness or stress
- not monitoring blood sugar levels closely enough so that
changes can be recognized and addressed promptly
The Benefits of Good Control
The complications associated with diabetes can seem frightening,
but the good news is that studies have shown that people with
diabetes who keep their blood sugar levels as close to normal as
possible have a much lower likelihood of developing diabetes
complications.
One large study showed that people with
type 1 diabetes
who checked blood sugar levels four or more times a day - and
adjusted the amounts of insulin and other diabetes medicines, diet,
and exercise based on their readings - had a reduced risk of
developing eye disease, kidney problems, nerve damage, and high
cholesterol levels (a major risk factor for heart disease).
How to Know if Diabetes Is Under Control
How do you find out if your child's diabetes is under
control? First, the diabetes health care team will tell
you what the blood sugar levels should be (the
"target" range), which is based on factors such as your
child's age and medical condition.
Day to day, the only way to know if the blood sugar levels are
close to your child's target range is to measure them several
times a day with a glucose meter. Your child's
diabetes health care team
will recommend how and when to test based on your child's
treatment plan. Checking regularly and keeping an organized and
accurate record of the results will ensure that the health
care team has the information needed to adjust your child's
diabetes management plan.
Besides daily checks with a
glucose meter
(to measure the current blood sugar level), you might also use
the
glycosylated hemoglobin test
, which shows blood sugar levels over a longer period. The HbA1C
test will give you and the health care team information about your
child's blood glucose control during the 2 to 3 months before
the test.
Helping Your Child Control Diabetes
Helping your child achieve good blood sugar control can be
challenging. Here are some tips:
- Make sure your child takes insulin or other diabetes
medicines as prescribed.
- Provide meals and snacks that fit into your child's meal
plan.
- Encourage your child to engage in regular physical
activity.
- Check blood sugar levels often and make changes in the
treatment plan with guidance from the diabetes health care
team.
- Make sure your child gets regular medical checkups.
- Learn as much as possible about diabetes.
Working with the diabetes health care team will help you better
understand and manage the challenges of diabetes and help your
child avoid many of the problems associated with it.
Reviewed by:
Steven Dowshen, MD
Date reviewed: September 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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