You will need a glucose meter, alcohol pads, sterile finger lancets and sterile test strips.
If your insurance plan doesn't pay for glucose meters, ask your doctor which meters he or she recommends. For someone who has severe diabetes, continuous blood sugar monitoring may be a viable option.
The following are some suggestions on when to do SMBG testing and how to use the results to improve your blood sugar control. If you get blood from your fingertip, try washing your hands in hot water to get the blood flowing.
Recommendations for the best time of day to test your blood sugar depend on your medicine, mealtimes and blood sugar control. Portions of this article were developed as part of an educational program made possible by an unrestricted educational grant from LifeScan, Inc., makers of OneTouch Blood Glucose Meters. Portions of this article were developed by the American Academy of Family Physicians in cooperation with the American Diabetes Association. This site complies with the HONcode standard for trustworthy health information: verify here. 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. The fasting blood sugar (FBS) test is used to measure the amount of sugar, called glucose, in a sample of your blood after fasting.
If you are not already diabetic, your FBS was probably measured to screen you for presence of diabetes or pre-diabetes due to symptoms suggesting hyperglycemia or hypoglycemia, due to the presence of set of risk factors, as part of a regular physical or during pregnancy. If you are a pre-diabetic, your blood sugar can be brought down to normal levels with simple lifestyle modifications. If you are a diabetic, your goal is to maintain your blood sugar within the target range specified for you by your doctor. Healthalyze can determine optimal times for you to test your blood sugar and remind you when to go for a screening. One of these tests is called an A1C test, which reflects your blood sugar (or blood glucose) control over the past 2-3 months. Using a blood glucose monitor to do SMBG testing can help you improve control of your blood sugar levels. Food and Drug Administration (FDA) has approved meters that work without pricking your finger. With these systems, blood sugar is measured constantly through a sensor placed beneath the skin that transmits information. Testing times are based on the kind of medicine you take and on how well your blood sugar levels are controlled. When you are sick, even without eating, your sugar levels may run high, so testing is important. Continue testing more often until you have maintained your SMBG goal values for at least 1 week, or until your doctor advises you that more frequent testing is no longer necessary.


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. While people with pre-diabetes may not need medications, they are at much higher risk for developing diabetes in the near future. However, your doctor may personalize your target range based on specific co-existing medical conditions and your understanding of hypoglycemia or low blood sugar. Hypoglycemia can cause anxiety, dizziness, drowsiness, seizures, unconsciousness and a variety of other symptoms. If you are not a diabetic or pre-diabetic, get yourself screened at appropriate intervals with an FBS (or another test recommended by your doctor) to keep track of your sugar levels. It can also help you track your blood sugar and recommend lifestyle modifications to manage your condition. Testing your A1C level every 3 months is the best way for you and your doctor to understand how well your blood sugar levels are controlled. Different meters work differently, so be sure to check with your doctor for advice specifically for you. However, with some meters, you can also use your forearm, thigh or the fleshy part of your hand. You may also want to keep track of what you have eaten, when you took medicine or insulin, and how active you have been during the day. 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.
This test is used to determine if your blood glucose level is within a healthy range and is thus able to screen for, diagnose, and monitor high blood glucose (hyperglycemia) or low blood glucose (hypoglycemia), diabetes, and pre-diabetes. Every person who has diabetes should have a blood glucose monitor (also called a home blood sugar meter, a glucometer, or a glucose meter) and know how to use it. You'll also check it more often when you feel sick or stressed, when you change your medicine or if you're pregnant. If undetected or untreated your child could develop DIABETIC KETOACIDOSIS (DKA), this is a medical emergency and they will need to be hospitalised.
It is the preferred method for diagnosing diabetes  because it is easy to perform, convenient, and less expensive than many other tests. If you want to pay a little more money, you can get a meter that stores the results in its memory. Talk with your doctor about what is a good range for your blood sugar level and what to do if your blood sugar is not within that range.
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.
Every year we are closer to a cure and the tools and knowledge we have to manage diabetes improve.



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