Your child has been newly diagnosed with type 1 diabetes and we are aware that you may be feeling emotional, confused and shocked about the diagnosis and may have many questions about what is happening and where to go from here.
Everything that you will need to know about diabetes and managing it will come in time but for now we will be teaching you the basics to manage your child’s diabetes in the next few days. The rest of the information regarding the diagnosis will be done in follow up appointments in the next few days and weeks and you will be in daily telephonic contact with the doctor or your educator. There is a lot to learn about managing your child’s diabetes in the beginning and you cannot possibly learn it all in one day.
YOUR CHILD IS FIRST AND FOREMOST STILL A CHILD BEFORE THEY HAVE DIABETES AND DIABETES NEEDS TO FIT INTO THEIR LIFESTYLE NOT THE OTHER WAY ROUND. You and your child are not alone in managing this condition, of course you have to do all the daily working in managing good blood glucose control, but our diabetes team will help you every step of the way.
This manual is designed to help you with all the basic survival tools to look after your child, but each day will be a learning experience. Simply defined it is lack of insulin secreted from the pancreas, resulting in high levels of sugar (glucose) in the blood. When your child has diabetes it means that they have too much glucose (sugar) in their blood. Diabetes is not currently curable; however with proper management such as insulin injections and blood glucose testing, proper meal plans and regular exercise your child can have a normal long happy life, both physically and emotionally. Your child should be eating meals that are balanced with carbohydrates (sugars and starches), fats and protein (mostly meat). Carbohydrates are broken down in your child’s stomach, converted to glucose and absorbed into the blood stream as one of the major sources of energy for the body.
The pancreas senses the rise in blood glucose levels and secretes the right amount of insulin to move the glucose out of the blood stream into their cells. Quite simply insulin is secreted every time we eat and a slow release in the background between meals. As your child does not produce insulin anymore they rely on their insulin injections to provide meal time coverage and the background insulin needs. This is a snap shot of your body during the night when your liver is releasing stored glucose back into your blood stream to supply a constant amount of glucose to the brain while you sleep.
When food enters your stomach, the carbohydrates get broken down into glucose and the glucose gets absorbed into your blood stream and your blood glucose level starts rising.
If your pancreas is working, it samples the amount of glucose in the blood stream and produces the right amount of insulin and releases the insulin into the blood stream The insulin opens the cells and allows the sugar in and blood sugar will come down. If you do not have insulin you have no problem getting the carbohydrate into the blood stream but have no way of opening up the cells to let the sugar in and your blood sugar levels stay high.
High blood sugar gets filtered by the kidneys and glucose ends up in the urine, therefore it causes increased urine flow and your child will urinate a lot and therefore drink a lot to catch up. When your body cannot use glucose for energy it will find another source of energy and you will get these other sources of energy from your body breaking down your muscle and you will loose weight and feel weak and tired and you will also break down fat and produce ketones which makes you sick.
There are 5 main food groups that make up a balanced healthy diet in order for your child’s body to get all the vitamins, minerals and nutrients they require to function at its optimum. The main food groups can be divided into 3 nutrient groups which have individual effects on the body.
Proteins – These nutrients are our bodies’ growth foods and have little effect on the blood glucose levels.
Fats – These foods are also energy foods in the body; however they have twice the amount of calories than carbohydrates and therefore are to be kept to a minimum, in order to protect the heart and other vital organs. The rate of absorption of glucose in and out of the blood stream is called the glycaemia index (GI). High GI (HGI) foods are absorbed quickly into the blood stream and tend to raise blood glucose levels quickly. Intermediate GI (IGI) foods are absorbed at a gradual rate and have less of a rise on the blood glucose values.
Low GI foods (LGI) are absorbed very slowly into the blood stream and tend to keep blood glucose values more stable for longer periods than HGI and IGI foods. There are different ways to measure carbohydrates and relate them to the effect they will have on your blood glucose level, this concept is called carbohydrate counting and is a very useful tool to use. Carbohydrates are divided in two main groups and the sugar group is further divided in 3 groups. Most foods have nutritional information on the packaging, so these are easy to read and determine. Diabetic products are not usually encouraged as they are poorly marketed, costly and they only remove sucrose form the product but still have other glucose products in them, therefore they are not completely free ( Unless the total carbs on the nutritional label says 0 grams) and will still raise the blood glucose levels. Your child’s Diet needs to be individualised and you should see a dietician who understands children with diabetes to structure something for your child individually. Sugar is allowed in small to moderate amounts and will make up part of your carb value at meals. Proteins get broken down into glucose very slowly in the blood stream and only 50-60% of protein gets converted to Glucose, making it an ideal food for your child to eat as a snack or as the main portion of a meal. Testing your child’s blood glucose levels regularly, will help you to achieve daily blood glucose targets and it is your only tool to help you administer the correct dose of insulin or see what changes need to made to food or exercise etc.
Before each meal and at bedtime, and at any other time you think you may be low or very high. If you are having problems with higher or lower blood sugars email or fax through the last 3-4 days results and insulin doses being used and we can help you make adjustments. The risk of long term diabetes complications is related to overall blood glucose control that is above ranges for many years. Push the plunger all the way down –if using pens, hold for 10 sec and if using syringes hold for 2 sec. Let go of your pinch before pulling out the needle, this will prevent the insulin from leaking out. If they are having lots of issues with injections or have a severe needle phobia we can use insulin ports to deliver insulin through. Most often when you have a low blood glucose value your body will give you warning signs – here are some symptoms, it’s also best that you recognise your individual symptoms and treat a low blood glucose values as soon as possible.
Don’t get into the habit of over treating low blood sugars and getting a high blood sugar thereafter by feeding them too much. Give the above treatment and recheck blood glucose values again after 15-20 min if they still complain of feeling low. NB Insulin must be given before a meal if your child was low, you will fix the low blood glucose and then give the normal dose of insulin before that meal, you will need insulin to store that food eaten in the cells of the body otherwise the next blood sugar will be high – they will not go low again! If your child is confused and unable to swallow – rub condensed milk, syrup, honey or glucose syrup onto the gums if that does not raise the blood glucose levels Glucagon needs to be used. Blood glucose values need to be checked every 3 hour for next 6 hours after a severe episode.
High blood glucose values above target along with high HbA1c’s over many years can lead to complications associated with diabetes. When a diabetic child is ill, it is a very unstable time as blood glucose values may fluctuate erratically. Diabetic children need there insulin when they are sick, sometimes even larger doses, even if they do not want to eat, insulin must NEVER be skipped and the types of foods or liquids may need to be adjusted along with the amount of insulin.


Encourage your child to eat their usual meal or something from the list below if there stomach is upset or they are having difficulty eating. If your child is vomiting and there are no Ketones they need to have small sips of fluid every 15 minutes to avoid dehydration. Medicines for fever, pain, decongestants, runny tummy or nausea, coughs and colds may contain small amounts of sugar.
In the absence of insulin your body cannot use your glucose for energy provided by the food you eat.
When Ketones are detected you should contact your Dr, Educator or the 24 hour emergency hot line, so they can advise you on clearing the Ketones. Diabetes camps are one of the best experiences that a child with diabetes can have and it is advisable that you allow your child to be involved in this experience, especially when they are newly diagnosed. Camp is a place for your child to learn self-confidence, independence from mom and dad, to be with other kids with diabetes, and simply to have a great time as well as have the opportunity to make lifelong friends.
We interact with each other, learn teamwork, make friends, survival skills and time to play, be creative and do some rhythm workshop and have lots of FUN, FUN, FUN!! The purpose of this note is to let you know the implications of diabetes and how it may affect me at school. If there are any questions please write them down and I will get my parents or my doctor to answer them for you. The main dangers that arise from diabetes at school are low blood glucose values or hypoglycemia.
If I experience a low blood glucose value during class I will need to test my blood glucose values and I will need to eat foods that have glucose in them to raise my blood glucose values again. If I am unconscious or have a seizure from a low blood glucose value I will need to be injected with the following injection called glucagon that will increase my blood glucose values.
When I wake up please give me sips of juice or coke and check my blood glucose every 5-10min. There may be some side effects 30 min after the injection such as: Nausea,vomiting, bloating and headache. Sweet PotatoesSweet potatoes are excellent sources of beta carotene and soluble fiber that regulate insulin response and help stabilize blood sugar. The final destination of a journey is not, after all, the last item on the agenda, but rather some understanding, however simple or provisional, of what one has seen. In these modern times, with the plethora of blood-sugar-related diseases, we need tools like GI and GL to help us understand ways to control blood sugar. The self-testing, graphic approach to food testing developed in the balance of the newsletter is a less scientific but a more dynamic way to explore postprandial (post-meal) blood glucose levels (BGLs). GI measures the blood glucose impact of foods eaten in isolation, yet we rarely consume foods this way. GI readings vary with the individual—blood sugar and insulin reactions are more extreme for diabetics, for example (See Charts 2A and 2B).
GIs are calculated in the science lab as the day’s first meal after a 12-hour fast and using a fixed serving that includes 50 grams of carbohydrate.  Most of our daily calories, however, are consumed in combination and throughout the day, when our blood sugar is affected by other foods that we have eaten earlier, as well as by our level of activity. Of the following numbered charts, the first three are based upon scientific research journal articles (Charts 1, 2A, 2B), while the last four (Charts 3-6) are constructed from my own self-testing of foods4 using a simple blood glucose monitor. Chart 1:  Blood Sugar Curves of White Bread Compared to Bread with Added Fiber, Sourdough, and Vinegar.
Chart 3:  Instant Oatmeal, Whole Oats (Soaked and Not Soaked), and Whole Oats Combined with a Protein and Fat. To fully appreciate the impact of two back-to-back carbohydrate breakfasts please notice that the scale used for Chart 6 is twice that of Charts 3-5. Resetting the Table–to Control Blood Sugar (For a discussion of other strategies, see April 2011). Ramekins filled with condiments like nuts and seeds (GI=0).  Nuts and seeds provide healthy fats, fiber, vitamins, minerals, and antioxidants, while they slow digestion and curb blood sugar. Sourdough bread or whole-grain bread with whole kernels; butter from grass-fed cows and organic nut and seed butters such as tahini and pumpkin seed butter. A pitcher of water and glasses for all—sometimes we mistake hunger for what is in fact thirst.  You might flavor the water with a little lemon juice or other flavoring. Because 12-hour fasting, pre-meal blood sugar reading can vary, all data points at time zero prior to the first morning meal were indexed to zero in order to illustrate the change from a neutral starting point. I use the label “traditional” carbohydrates, just as we call unrefined fats, “traditional” fats.
Put your shoes by the doorTake a minute to put a pair of slip-on shoes and socks near the door so you aren’t tempted to go outside barefoot. To provide even greater transparency and choice, we are working on a number of other cookie-related enhancements. Your child is unique and you will learn in time how diet, exercise and different life situations affect your child’s blood sugar levels.
There is a “genetic predisposition” (inherited factor) that needs to be present for the process to start and a viral infection can be the external trigger required to start the immune attack.
The food your child eats’, especially carbohydrates are broken down into glucose and stored in their cells for energy now or later so that your child can perform their daily activities like, learning, running, swimming and playing and more importantly having fun. This is usually achieved by using 2 or 3 kinds of insulin, usually a long acting (background insulin) and a rapid acting insulin (meal time insulin). Half of the protein we eat gets converted to glucose over a long period of time so it has a gradual rise on the blood glucose levels.
Fats are needed for cell growth and protection for organs and are a very important part in children’s growth and development. The following pictures are a few examples of the main carbohydrates consumed and they are all measured in 1 carbohydrate value. Below are a few typical foods that have been measured in 1 carbohydrate value they may not necessarily have nutritional information on them and they may need to be learned with time.
Complications are obviously one of your concerns as a parent, but if you and your child work hard at getting the blood glucose values as close to target as often as possible so complications can be prevented. Injecting in the same area too often will cause scar tissue and lumps in the area and the insulin absorption is then unpredictable and poor. Areas that can be damaged from high blood glucose levels are the: eyes, kidneys, heart and feet.
Anti-nausea suppositories can be given every 6 hours, if your child needs a second suppository call your Dr.
I know this may make you feel scared or worried to have me in your class as there are a lot of misconceptions about my condition. I would like to explain my diabetes and I am sure you will see that I can lead a normal life jut like any other child in your class. If you suffer from high blood sugar levels, you may take advantages of sugar lowering properties of these foods.
They are a slow burning fuel and because of their low sugar, they are excellent for diabetics or sugar-sensitive disorders. As the sweet potato digests slowly, it causes a gradual rise in blood sugar so you feel satisfied longer. The second factor—the postwar shift from traditional to refined carbohydrates—is largely due to the growing role of the commercial food industry and processed, convenience foods.  Convenience foods must have a long shelf-life, so food companies rely upon refined flours and oils, which do not go rancid.


Visual pictures of postprandial blood sugar behavior, while less scientific than GI measurements, are nevertheless powerful learning tools, providing a real flavor for how our body reacts when we eat different kinds of foods.
This chart illustrates the second meal effect– that what we eat at one meal affects postprandial blood sugar behavior at the next. What we do to our children when we give them a sugary cereal or a Pop-tart for breakfast extends beyond this first meal to affect their blood sugar, hunger, concentration, and desire to overeat throughout the rest of the day. One of the best herbs and spices to moderate blood sugar.  It can be sprinkled on hot cereals and desserts such as puddings, custards, and stewed fruits. Make sure your slippers are in a handy location too, so you’ll remember to wear them inside to avoid injury.This is just one of many simple, quick tips that can be done in minutes to better manage your diabetes and help prevent complications. It is intended for general information purposes only and does not address individual circumstances. Sometimes a viral infection can trigger diabetes in some children, but you could not have stopped diabetes from happening. Insulin directs the uptake of glucose into the cells either to meet immediate energy needs or to store it for later use. These foods make excellent snacks between meals and will not require extra insulin, further more it can be eaten when blood glucose values are high in order to prevent them from raising further. They raise the blood glucose values and are the foods groups that need to be kept under control in order to manage diabetes. Unless you are sick, then it necessary for you to test more often, especially when you have ketones, then you will need to test hourly.
The HbA1c is a way to measure this; it looks at the amount of glucose attached to your red blood cells. The high blood glucose levels damage all the small nerves and arteries to the organs mentioned above, however if you and your child manage your diabetes effectively you will not develop diabetes complications. Cortisone and or steroid containing medications cannot be taken, they increase Blood glucose levels aggressively the list is below.
HOWEVER once your child has the above symptoms but starts to vomit and have difficulty breathing it can no longer be managed at home - the Dr needs to be contacted and your child will need to be admitted. Even if you have normal blood sugar levels, you should consider these foods that regulate blood sugar. No part of this web site including text, pictures or web site design may be reproduced in any form by any means without prior written authorization. Do a quick body scanAs you dry off from your shower each day, inspect your body from head to toe.
It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health.
If undetected or untreated your child could develop DIABETIC KETOACIDOSIS (DKA), this is a medical emergency and they will need to be hospitalised. Avocados should be eaten immediately after cutting, otherwise they will change color due to oxidation.CinnamonCinnamon is high in fiber and magnesium and contains a natural compound, polyphenol, that mimic the effect of insulin significantly lowering blood sugar. This is why diabetes and obesity often go hand-in-hand (90% of diabetics are either overweight or obese). David Ludwig regarding high-glycemic foods and overeating, cited in the Recommended Reading section at the conclusion of this newsletter. Never ignore professional medical advice in seeking treatment because of something you have read on the BootsWebMD Site. In between meals and during fasting low levels of insulin regulate the amount of glucose produced from the liver (your body’s main glucose store).
Children, especially very young children have different targets to adults as they don’t always detect there low blood glucose values and very low HbA1c‘s are not suitable for them and they are individualized to the child.
It is also helpful in lowering cholesterol.Strudies reveal that taking half a teaspoon of cinnamon daily can lower blood sugar level by 20 percent, the improvement can be seen after just 20 days. Every year we are closer to a cure and the tools and knowledge we have to manage diabetes improve. Very high levels of cinnamon could lead to hypoglycemia (sugar dropping to very low level). You can get recommended cinnamon dose in capsule form or from cinnamon foods.CherriesCherries contain red-pigmented antioxidants and are high in soluble fiber and low in calories, which can help raise your body's insulin output. Early morning, remove the pieces of okras from the glass and drink that water before breakfast.Do it daily, you should see remarkable reduction of your sugar. It is also strongly anti-inflammatory.Garlic Raw garlic can raise insulin production and increase insulin sensitivity and in turn can lower blood sugar. Prepare emergency snack packsPut a few glucose tablets and sweets (for example jelly babies) into bags. Benefits of garlic.Eating bittergourd (Karela) stimulates pancreas and regulates blood sugar level.
NutsNuts are "slow-burning" foods that provide sustained energy due to their good fats and protein content. Eating a handful of nuts can lower insulin resistance, according to Harvard researchers who discovered that eating nuts can lower the risk of developing type 2 diabetes by 20 percent.Examples of healthy nuts are Almonds, Brazil Nuts, Cashews, Macadamia Nuts, Peanuts,Pecans, Walnuts, etc.
If you are allergic to certain nuts, you should not eat them.Onions The high sulfur and flavonoid content of onions can cause a significant reduction in blood sugar level. Skipping a meal, taking too much diabetes medication and exercising harder than usual without eating can trigger it. Take a 2-minute testPut your glucose monitor on your bedside table to remind you to check blood sugar first thing in the morning and before bedtime, if your doctor advises.
Checking before and after exercise can help you learn how it affects your levels and it may help you avoid dangerous drops in blood sugar levels.  Make insulin work for your lifestyleIf your days are fast-paced and meal times are unpredictable, ask your doctor about rapid-acting or fast-acting insulin.
These rapidly acting insulins can be taken just before eating and have an effect on your blood sugars within 30 minutes. Diabetes UK has plenty of low glycaemic index suggestions, meaning they aren't likely to cause spikes in blood sugar. Put a list on your fridge so it's at the ready when you make your shopping list, plan meals or look in the fridge for something to eat. Drink plenty of water and other non-alcoholic fluids to help your skin stay hydrated and healthy. Remember your medical alert braceletPut your medical alert bracelet or pendant near your watch, rings or other jewellery you wear every day. In an emergency where you’re confused or unable to speak, it can save critical time by letting others know about your diabetes. Exercise in spurtsExercising 30 minutes a day is an important part of managing your diabetes, but it can be difficult to fit into a busy lifestyle. Assemble a first-aid kitDiabetes complications can turn a minor injury into a major problem.



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Comments

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    Author: seker_kiz
  2. 31.10.2014 at 19:17:58


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    Author: Brad