Diabetes In Children

diabetes children

Diabetes In Children

Diabetes children is a disease which will affect the whole family, especially when a child is being diagnosed. No matter what, it is important that family member is able to support each other and able to understand their conditions. You might not know how to manage diabetes in children. Therefore, in this article, I will provide some guideline that you are able to follow.

Diabetes Education

Studies have shown that patient and family education, intensive diabetes management, close telephone contact with the diabetes team is associated with reduced hospitalization and overall medical cost. Parents should keep in mind the patient’s siblings as they might feel neglected because of the increased attention paid to the patient who is diagnosed with diabetes.

First, when you involved with this diabetes in children situation, you have to communicate with your children and tell them about this diseases and the importance of self management. Proper diabetic education for a child and a family is crucial and complex at the same time. Education is best provided with the sensitivity to the age and developmental stage of the child, with regard to both approach and the content of the material delivered. It is important that both parents should be there as well as caregiver.

Diabetes education is not a one time thing only at the time when the kid is being diagnosed. It is important that family and the kid need ongoing education as the child grows and able to take one more element for self-care.

Studies shown that with continuous education and frequent phone call follow up, it has demonstrated that it can improve HbA1c and reduce hospitalization due to acute complication.

Therefore, keep in contact with personal health professionals including pediatrician, nurse and dietitians.

Diabetes Children Main Goal

One of the main goal is to maintain glucose control as near to normal as safely possible which is the same as adults. However, special consideration such as risk of hypoglycemia must be given more attention to young children. In the Diabetes Control and Complication Trial (DCCT), with improved control of blood glucose, it has shown that there is a reduction risk of micro vascular complications.

Age-Specific Glycemic Goal

download

Children <6 years old

In very young children, the relationship between hypoglycemia and possible neuropsychologic impairment is a greater concern compared to older children and adolescents. There are a few reports shown that there is a intellectual impairments with significant hypoglycemia in young children and this could be due to young children is unable to communicate the symptoms of hypoglycemia effectively. Other factors are unpredictable food intake as well as physical activity in this age group.

diabetes children

Children 6–12 years old

Diabetes management in this age group is quite challenging as they require insulin with lunch or other time where they might be away from home. Insulin administration at school requires close communications between the parents, healthcare team and school personnel. The lack of abstract thinking in this age group will limit the management choices. Therefore, the parents would be the one that make the choices for them. On the other hand, the children may be able to recognize and self-treat hypoglycemia better; however, adult supervision is still required.

download (51)

Adolescents (13–19 years)

DCCT has reported that teenagers were able to achieve a meal A1c level of 8.06% in an era before insulin lispro, insulin aspart, and insulin glargine were available. Therefore, it is suggested that good control is possible in this age group.

Age GroupHbA1c Goal
Children <6 years old7.5% – 8.5%
Children 6 – 12 years old≤8%
Children 13 – 19 years old<7.5%

Nutrition for Diabetes Children

Choosing the right foods, eating a balanced and healthy diet is a vital part for your child’s diabetes management. Children and teenagers should adopt healthful eating habits in order to ensure adequate intake of vitamin and mineral to promote growth.

It is the same as adult where a balanced diet consists of carbohydrate, protein, fats as well as fiber. One of the challenges you might met if your kid is a picky eater.

There is evidence showing that total carbohydrate of the meals and snacks is the most important in determining postprandial glucose readings. Besides that, the consistency of food intake (especially carbohydrate food) is important for diabetes children and teenagers who are on insulin. Do not adjust insulin dosage yourself.

Adequacy of energy is important for children’s growth and development and it can be evaluated by weight gain and growth patterns on a regular basis.

Therefore, please consult a dietitian for an individualized diet plan based on your children growth pattern.

If you are not sure whether your diabetes children are able to make the correct choice, you could always pack lunch for your children. A healthy lunchbox with colors and creative idea will attract and trigger the children’s appetite.

Sample Lunch Box

DayLunchbox
MondayCheese and tomatoes wholemeal bread sandwiches
One glass of orange juice (no sugar)
One small apple
TuesdayGrilled chicken with salad
One plain bun with butter spread
One banana
WednesdayChicken minced with tomatoes pasta
Carrot and cucumber stick
One cup of plain yogurt (no sugar)
ThursdayEgg fried rice
One slice of honey dew
One cup of water
FridayChicken tortilla wrap (whole meal)
One cup of low fat milk
One orange

Reference:

  1. Beck JK, Logan KJ, Hamm RM, Sproat SM, Musser KM, Everhart PD, McDermott HM, Copeland KC: Reimbursement for pediatric diabetes intensive case management: a model for chronic diseases? Pediatrics 113:e47–e50, 2004
  2. Sperling M: Diabetes mellitus. In Pediatric Endocrinology. 2nd ed. Sperling M, Ed. Philadelphia, Saunders, 2002, p. 323–366
  3. Mortensen HB, Robertson KJ, Aanstoot HJ, Danne T, Holl RW, Hougaard P, Atchison JA, Chiarelli F, Daneman D, Dinesen B, Dorchy H, Garandeau P, Greene S, Hoey H, Kaprio EA, Kocova M, Martul P, Matsuura N, Schoenle EJ, Sovik O, Swift PG, Tsou RM, Vanelli M, Aman J: Insulin management and metabolic control of type 1 diabetes mellitus in childhood and adolescence in 18 countries. Hvidore Study Group on Childhood Diabetes. Diabet Med 15: 752–759, 1998
  4. Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial Research Group. N Engl J Med 329:977–986, 1993
  5. Desrocher M, Rovet J: Neurocognitive correlates of type 1 diabetes mellitus in childhood. Neuropsychol Dev Cogn Sect Child Neuropsychol 10:36–52, 2004
  6. American Diabetes Association: Diabetes care in the school and day care setting (Position Statement). Diabetes Care 27 (Suppl. 1):S122–S128, 2004

Leave a Reply