He was doing excellent with his self care until a couple of days ago, he thinks he can eat whatever he wants and if sugar is high, he can just eat something with sugar,and if too low he can just take a shot for it, I was going to have his dr. talk to him about it tomm, I don't think it's as simple as that?
He has only been diagnosed a few weeks, all new to us. Helping Children Manage Diabetes ^ top
The health care provider team, in partnership with the young person with diabetes and caregivers, can develop a personal diabetes plan for the child that puts a daily schedule in place to keep diabetes under control. The plan shows the child how to follow a healthy meal plan, get regular physical activity, check blood glucose levels, take insulin or oral medication as prescribed, and manage hyperglycemia and hypoglycemia.
Follow a healthy meal plan
Young people with diabetes need to follow a meal plan developed by a registered dietitian, diabetes educator, or physician. For children with type 1 diabetes, the meal plan must ensure proper nutrition for growth. For children with type 2, the meal plan should outline appropriate changes in eating habits that lead to better energy balance and reduce or prevent obesity. A meal plan also helps keep blood glucose levels in the target range.
Children or adolescents and their families can learn how different types of food -- especially carbohydrates such as breads, pasta, and rice -- can affect blood glucose levels. Portion sizes, the right amount of calories for the child's age, and ideas for healthy food choices at meal and snack time also should be discussed including reduction in soda and juice consumption. Family support for following the meal plan and setting up regular meal times is a key to success, especially if the child or teen is taking insulin. See NDEP's "Eat Healthy Foods" Tip Sheet for Kids with type 2 Diabetes.
For more information about healthy eating for children, visit the American Dietetic Association, an NDEP partner. Their 鈥淗ealthy Habits for Healthy Kids鈥?guide for parents is available in English and Spanish, and includes tips for a balanced diet. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) also offers diet tips for people with diabetes.
Get regular physical activity
Children with diabetes need regular physical activity, ideally a total of 60 minutes each day. Physical activity helps to lower blood glucose levels, especially in children and adolescents with type 2 diabetes. Physical activity is also a good way to help children control their weight. In children with type 1 diabetes, the most common problem encountered during physical activity is hypoglycemia. If possible, a child or a teen should check blood glucose levels before beginning a game or a sport. If blood glucose levels are too low, the child should not by physically active until the low blood glucose level has been treated. See NDEP鈥檚 鈥?Be Active 鈥?Tip Sheet for Kids with type 2 Diabetes.
For more information on helping your child be physically active, visit the Weight-Control Information Network ( WIN ) of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). WIN offers a number of publications that address healthy eating and physical activity. The Centers for Disease Control and Prevention鈥檚 (CDC) Verb campaign encourages youth to be physically active. 鈥淒iabetes and Physical Activity at School鈥?provides additional information.
Check blood glucose levels regularly
Young people with diabetes should know the acceptable range for their blood glucose. Children, particularly those using insulin should check blood glucose values regularly with a blood glucose meter, preferably one with a built-in memory. A health care team member can teach a child how to use a blood glucose meter properly and how often to use it. Children should keep a journal or other records of blood glucose results to discuss with their health care team. This information helps providers make any needed changes to the child's or teen's personal diabetes plan.
Take all diabetes medication as prescribed
Parents, caregivers, school nurses, and others can help a child or teen learn how to take medications as prescribed. For type 1 diabetes, a child or teen takes insulin at prescribed times each day via multiple injections or an insulin pump. Some young people with type 2 diabetes need oral medication or insulin or both. In any case, it is important to stress that all medication should be balanced with food and activity every day. 鈥淢anaging Insulin Requirements at School鈥?provides additional information.
Special Issues ^ top
Diabetes presents unique issues for young people with the disease. Simple things, such as going to a birthday party, playing sports, or staying overnight with friends, need careful planning. Checking blood glucose, making correct food choices, and taking insulin or oral medication can make school-age children feel "different" from their classmates and this can be particularly bothersome for teens.
For any child or teen with diabetes, learning to cope with the disease is a big task. Dealing with a chronic illness such as diabetes may cause emotional and behavioral challenges, sometimes leading to depression. Talking to a social worker or psychologist may help young people and their families learn to adjust to the lifestyle changes needed to stay healthy.
Family Support
Managing diabetes in children and adolescents is most effective when the entire family gets involved. Diabetes education should involve family members. Families can be encouraged to share concerns with physicians, diabetes educators, dietitians, and other health care providers to get their help in the day-to-day management of diabetes. Extended family members, teachers, school nurses, counselors, coaches, day care providers, and other resources in the community can provide information, support, guidance, and help with coping skills. These individuals also may be knowledgeable about resources for health education, financial services, social services, mental health counseling, transportation, and home visits.
Diabetes is stressful for both the children and their families. Parents should be alert for signs of depression or eating disorders and seek appropriate treatment. While all parents should talk to their children about avoiding tobacco, alcohol, and other drugs, this is particularly important for children with diabetes. Smoking and diabetes each independently increase the risk of cardiovascular disease and people with diabetes who smoke have a greatly increased risk of heart disease and circulatory problems. Binge drinking can cause hyperglycemia acutely, followed by an increased risk of hypoglycemia. The symptoms of intoxication are very similar to the symptoms of hypoglycemia, and thus, may result in delay of treatment of hypoglycemia with potentially disastrous consequences.
Transition to Independence
Children with diabetes鈥攄epending on their age and level of maturity--will learn to take over much of their care. Most school-age children can recognize symptoms of hypoglycemia and monitor blood glucose levels. They also participate in nutrition decisions. They often can give their own insulin injections but may not be able to draw up the dose accurately in a syringe until a developmental age of 11 to 12 years.
Adolescents often have the motor and cognitive skills to perform all diabetes-related tasks and determine insulin doses based on blood glucose levels and food intake. This is a time, however, when peer acceptance is important, risk-taking behaviors common, and rebellion against authority is part of teens' search for independence. Thus, adolescents must be supervised in their diabetes tasks and allowed gradual independence with the understanding that the independence will be continued only if they adhere to the diabetes regimen and succeed in maintaining reasonable metabolic control. During mid-adolescence, the family and health care team should stress to teens the importance of checking blood glucose levels prior to driving a car to avoid hypoglycemia while driving.
Diabetes at School
The NDEP has developed a guide to educate and inform school personnel about diabetes, how it is managed, and how each member of the school staff can help meet the needs of students with the disease. School principals, administrators, nurses, teachers, coaches, bus drivers, health care, and lunch颅room staff all play a role in helping students with diabetes succeed.
Several Federal and some state laws provide protections to children with disabilities, including diabetes. These laws help ensure that all students with diabetes are educated in a medically safe environment and have the same access to educational opportunities as their peers-in public and some private schools. Students with diabetes are entitled to accommodations and modifications necessary for them to stay healthy at school. Accommodations may need to be made in the classroom, with physical education, on field trips, and/or for after-school activities.
Written plans outlining each student's diabetes management help students, their families, school staff, and the student's health care providers know what is expected of them. These expectations should be laid out in written documents, such as a:
Diabetes Medical Management Plan, developed by the student's personal health care team and family
Quick Reference Emergency Plan, which describes how to recognize hypoglycemia and hyperglycemia and what to do as soon as signs or symptoms of these conditions are observed
Education plans, such as the Section 504 Plan or Individualized Education Program (IEP)
Care Plan or Individual Health Plan generated by the school nurse that provides instructions to faculty and staff.
The school nurse is the most appropriate person to coordinate care for students with diabetes. Each student with diabetes should have a written plan, developed by the school nurse, incorporating physician orders, parent requests, and tailored to the specific developmental, physical, cognitive, and skill ability of the child. The nurse will conduct a nursing assessment of the student and develop a nursing care plan, taking into consideration the child's cognitive, emotional, and physical status as well as the medical orders contained in the Diabetes Medical Management Plan. A team approach to developing the care plan, involving the student, parent, health care provider, key school personnel, and school nurse, is the most effective way to ensure safe and effective diabetes management during the school day.
The nursing care plan would also identify school employees assigned to provide care to an individual student, under the direction of the school nurse, when allowed by state nurse practice acts. The school nurse is responsible for training, monitoring, and supervising these school personnel. The school nurse will promote and encourage independence and self-care consistent with the student's ability, skill, maturity, and developmental level.
For more information on managing diabetes in the school setting, see Helping the Student with Diabetes Succeed: A Guide for School Personnel.
Camps and Support Groups
Local peer groups and camps for children and teens with diabetes can provide positive role models and group activities. Peer encouragement often helps children perform diabetes-related tasks that they had been afraid to do previously and encourages independence in diabetes management. Talking with other children who have diabetes helps young people feel less isolated and less alone in having to deal with the demands of diabetes. They have the opportunity to discuss issues they share in common that others in their peer group can't understand, and they can share solutions to problems that they have encountered. Often, these programs challenge children physically and teach them how to deal with increased exercise, reinforcing the fact that diabetes should not limit them in their ability to perform strenuous physical activity.
Prevention Strategies for Type 2 Diabetes ^ top Unfortunately, that's the problem with all new diabetics, my self included. Sure, it's possible to use more insulin to compensate but eventually one realizes that there is a point where even a lot of insulin is simply a lot of insulin. Too much is just too much. It's not going to be easy for him to realize this, even with a doctor saying it. It must be said and then repeated several times, just like cigarettes or some other unhealth behavior, because he's still young and life is still ahead of him. It will sink in. It just has to be repeated a lot that "too much is just too much." I happen to know several adults that thought that way, so your son is not alone in thinking that way. You must keep repeating that there will be a point where taking a lot of insulin is just not going to work and a lot is just too much to take. My brother just died from diabetes complications. Want so save your child. Tell your child that if you want to live to old age, you will take care of yourself or you will never become a parent of grandparent. I could have been an aunt. I will never be one now. |
