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Diabetes Positive Approach, Issue #1304-- Cope with Diabetes; Live Healthy
April 02, 2013
Diabetes treatment for children with type 1 is with insulin. This is administered through injection or with the use of insulin pump along with monitoring the blood sugar and a thoroughly planned and handled diet and exercise program. The children should be allowed to test their blood sugar in school although some parents choose to have this done in the clinic.
Why is insulin injected? It is because it becomes ineffective when taken by mouth since it is broken down by the digestive system. Scientists have tried to experiment on the use of eye drops and nasal sprays but they have not been thoroughly successful. Anyway, the insulin syringes use smaller and thinner needles so they are not really uncomfortable to use.
Diabetes treatment for children and adults is a lifetime commitment of insulin injections, blood glucose monitoring, eating healthy and exercising regularly. This treatment plan changes as the child grows so it can appear disturbing but no one is alone. The diabetes treatment team of the doctor, dietician and diabetes educator can help make the whole thing easier. And we are here to help with this website.
Insulin is Needed For Type 1 Diabetes to Survive
Here are the many types of insulin:
Regular insulin like human insulin (Novolin R and Humulin R) works half an hour after injection and peaks around 60 to 90 minutes.
Rapid-acting insulin like the insulin aspart (Novolog) and the insulin lispro (humalog) begins working around 5 to 15 minutes after injection and peaks half an hour to an hour and a half later.
Intermediate-acting insulin like NPH insulin (Novolin N, Humulin N), begins working 2 to 4 hours after injection and peaks in 4 to 12 hours.
Long-acting insulin like insulin glargine (Lantus) almost has no peak and may give coverage for as long as 24 hours.
The doctor may prescribe a mixture of types of insulin after considering the child's needs and age. As for insulin delivery, some children need insulin many times every day, some use insulin pump which employs a thin and small catheter to deliver insulin. The catheter is placed under the skin that delivers insulin continuously.
The children who use insulin pumps can give themselves extra insulin for every meal they eat. The pump can be programmed to deliver specific insulin dose automatically allowing for adjustments for less or more, depending on the child's activity, meals and blood sugar level.
Some use pen injectors to help make the injection easily in the clinic or in the classroom but not in the bathrooms for most times they are not clean. Those who need insulin injection before lunch need some extra time for this. Some children need only two injections before breakfast and before dinner. Type 1 diabetic children need two kinds of insulin: the long-acting and the short-acting one.
Monitoring the Blood Sugar
The number of times to check the blood sugar level depends on the type of insulin treatment needed. It should be at least three times a day which means quite a few finger sticks. There are meters though that allow to test other sites of the body. Testing often is important because it is the way to make certain that the blood sugar of the child stays within the target level. The doctor will inform you of the target level.
Recording the blood sugar reading for each test is important too. The doctor will want to get a copy of this, or sometimes this can be downloaded from the glucose meters. It is important though to know what foods and activities are affecting the blood sugar level so the diabetes treatment for children plan can be adjusted accordingly.
Another tool that helps with the blood sugar testing is the continuous glucose monitoring or CGM device especially for those who have hypoglycemia unawareness. This device uses a fine needle placed under the skin that tests the blood glucose every few minutes. This and the next part on this will make it easier to succeed at the diabetes treatment for children.
Diabetes treatment for children, part of which is covered in Part A on such treatment as administering insulin and monitoring the blood sugar. Here we are in Part B where the coverage is on getting regular physical activity, eating healthy, the treatments under investigation and dealing with other issues.
Type 1 diabetes children need regular physical activity just like everyone else. They can join sport teams, take dance or swimming lessons or walk around the neighborhood with friends or family. Just remember that any physical activity lowers the blood sugar level for up to 12 hours after exercise.
Physical activity generally lowers the blood sugar and the effect can last for up to 12 hours after the exercise is over. Check the blood sugar level more often when there is a new activity to find out how the body responds to the activity. Adjust the meal plan and insulin dose if needed. A snack may also be needed before the physical activity.
Eating healthy does not mean consuming tasteless foods. It just means eating whole grains and lots of fruits and vegetables. It is eating foods that are nutritious and are low in calories and fat. It is a diet that is good for the whole family. With time you will learn what foods affect the child's blood sugar and an adjustment to the meal plan may be necessary.
The type and amount of foods eaten can affect the blood sugar level which peaks after one to two hours after eating. This could become a problem when a child does not eat enough to compensate the insulin dose you have given him. Tell your doctor so together you can come up with a plan to suit the situation.
Treatments Under Investigation
1. Transplantation of the islet cell studies have been going on for years. What the researchers do is use the cells from a donor pancreas that produce insulin and transplant them. The trouble is that the process still has to use immune-suppressing medications because the body still destroys the islet cells that have just been transplanted, thus the length of time to be off insulin is short.
2. Transplantation of pancreas will someday hopefully make diabetes a thing of the past because then when this is successful, there will be no more need for insulin. The trouble is that they are not always successful and are risky. Why? It is because the child will need potent immune-suppressing drugs all his life so the organ will not be rejected.
In addition, the side effects of the drugs are quite serious. There will be such a high risk of infection for one thing. Then there is the danger that an organ will be injured. This makes transplantation of the pancreas more dangerous than having diabetes so this not a usual procedure for children.
Dealing With Other Issues
1. When the child is sick, his body produces hormones that raise the blood sugar level. Then there is the fever that increases the metabolism of the child. For this reason, the child may need larger dose of insulin and more often too. If he is throwing up and can't keep any food down, he will still need insulin. Find out from the doctor what to do during sick days so you will be able to cope with any unexpected situation.
2. Medications other than insulin may also affect the blood sugar level of the child so be aware of this. What to do is tell the doctor all the medications your child is taking so you will know if there is a need to change the diabetes treatment plan.
3. During sleep, the child may have low blood sugar so before sleeping, it is wise to have the child's blood sugar level to be a little bit higher than it is during the day. Here are some blood sugar levels before bedtime to check out: Teenagers - Between 5 to 8.3 mmol/L (90 and 150 mg/dL), Children from 6 to 12 years old - 5.6 to 10 mmol/L (100 to 180 mg/dL), Children Under 6 Years Old - 6.1 to 11.1 mmol/L (110 to 200 mg/dL)
4. Puberty and Growing by leaps and bounds could sometimes pose a problem, Just when you thought you had everything down pat when it comes to your child's diabetes, suddenly your child just grew overnight and is not getting enough insulin. Hormones can pose a problem too but you will be ready for any eventuality if you look ahead and talk to the child's doctor as to how to deal with such a situation.
There we have all the different ways to treat the children's diabetes. It is not simple to deal with this but it is not as hard as we think it is either. Just look at the successful people who have gone through this situation. They are proof that one can be successful at diabetes treatment for children.
"Feeling sorry for yourself, and your present condition, is not only a waste of energy but the worst habit you could possibly have." - Dale Carnegie
6. Some Humour - Let's laugh together at this joke even if it's not funny. Researchers have been exploring the benefits of laughter. In the "Anatomy of Illness" Norman Cousins said that comedies like the ones by Marx Brothers help him get pain-free sleep. Comedies helped him feel better, too. Why? It is because laughing helps the pituitary glands let loose its own opiates that suppress pain.
We will tell you the benefits of laughter but there are too many of them so we will continue on the next issue. For now, here are some of them: Laughter increases the oxygenation of the blood as well as the vascular blood flow. It also lowers the blood pressure.
Learn a Lesson
Policeman: You ran through the red light Ma'am.
Lady: I'm sorry, sir!
Policeman: What do you do for a living?
Lady: I'm a school teacher, sir.
Policeman: Oh, I've waited for this for a long time. Here's a piece of paper and write down 100 times, I will not pass through a red light.
7. Do you have a question or comment for the team?
Drop us a line at our contact form and write your questions or comment there.
7. Question: "How Do We Prepare for the Doctor's Appointment?"
Answer:The time is short for the doctor's appointment so it is wise to be ready for it. Here are some suggestions on how to prepare for the doctor's appointment:
1. Take a friend or a member of the family to come to the doctor's appointment with you. There will be a lot of information to absorb so you may need help in remembering everything.
2. Write down all the information you receive in a notebook so bring that with you along with a pencil or a pen.
3. Write down all the concerns you have about the well-being of the child that you want to tell the doctor.
4. Make a list of all supplements and medications the child is taking.
5. Write down all the questions you want to ask the doctor. Here are some examples of questions to ask the doctor:
a. How do I know if the child is having low blood sugar and how do I treat it?
b. How do I know if the child is having high blood sugar & how do I treat it?
c. How often and when is the best time to check the child's blood sugar level?
d. What are the types of insulin used, when and how much is the dose?
e. What types of food do I serve the child and their effects on the blood sugar?
f. Do I need to count the carbohydrates and how do I do that?
g. How do I adjust the insulin dose with food eaten and exercise of the child?
h. How do I deal with diabetes in schools, camps and other special activities?
i. How often do we visit the doctor and other diabetes specialists?
j. What are ketones and how do I test and treat it?
1. Has the child suffered from low blood sugar level?
2. What is the usual diet the child eats on any given day?
3. How much exercise or physical activity does the child do each day?
4. How much insulin dose does the child receive on any given day?
5. Do you feel able to manage the child's diabetes?
8. Got something to say? Please write down your questions and comments in the contact form in our website.
Sometimes we wrongly think we are the worst and so we do not deserve the best in life. This thinking is so wrong. Let us not get ourselves caught thinking this way because no one is perfect. All of us make mistakes. What we can do is to get over them. To go on the right track, we learn to live with them, accept them so we can move on.
We don't really have a choice, do we, because the future of these children is in our hands, whether they have diabetes or not. And we all have to help somehow make life better for them. Just forwarding this newsletter, for example, to anyone with diabetic children will help. We probably have two more issues on children and diabetes so bear with us, please.
Roger and Evelyn Guzman
Did you like this newsletter? If so, please recommend it to your friends. If you have any questions or tips, please leave a comment at our contact form and write your questions or comment there. This newsletter is copyright 2013 Roger Guzman, M.D.
Please get permission if you want to publish it. Also, this newsletter disclaims all responsibility for any product mentioned. Please do not rely on the newsletter having examined or endorsed any product unless the author clearly said it. You are advised to exercise due diligence before buying.
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