What is Type 1 Diabetes Mellitus

Type 1 diabetes mellitus is a long-term (chronic) disease. It happens when the pancreas does not make enough of a hormone called insulin. Insulin lets sugars (glucose) go into cells in the body. This gives your child energy. If the body does not make enough insulin, sugars cannot get into cells. This causes high blood sugar (hyperglycemia).

Type 1 Diabetes Mellitus, Diagnosis

Your child’s doctor will set treatment goals for your child. These goals will tell you how high your child’s blood sugar and A1c (hemoglobin A1c) levels should be.

Follow these instructions at home:

Questions to ask your child’s doctor

• You may want to ask these questions:
  • Do my child and I need to meet with a diabetes educator?
  • Where can I find a support group for children with diabetes?
  • What equipment will I need to care for my child at home?
  • What diabetes medicines does my child need? When should I give those medicines?
  • How often do I need to check my child’s blood sugar?
  • What number can I call if I have questions?
  • When is my child’s next doctor’s visit?

General instructions

• Give over-the-counter and prescription medicines only as told by your child’s doctor.
• Keep all follow-up visits as told by your child’s doctor. This is important.

Contact a doctor if:

• Your child’s blood sugar is higher or lower than his or her goal numbers. Your child’s doctor will tell you when to get help if this happens.
• Your child gets a very bad illness.
• Your child has been sick for 2 days or more, and he or she is not getting better.
• Your child has had a fever for 2 days or more, and he or she is not getting better.
• Your child cannot eat or drink.
• Your child feels sick to his or her stomach (nauseous).
• Your child throws up (vomits).
• Your child has watery poop (diarrhea).

Get help right away if:

• Your child’s blood sugar is lower than 54 mg/dL (3 mmol/L).
• Your child gets confused.
• Your child has trouble thinking clearly.
• Your child has trouble breathing.
• Your child has moderate or large ketone levels in his or her pee (urine).

Summary

• Type 1 diabetes (type 1 diabetes mellitus) is a long-term (chronic) disease. It happens when the pancreas does not make enough of a hormone called insulin.
• Your child’s doctor will set treatment goals for your child.
• Keep all follow-up visits as told by your child’s doctor. This is important.

Type 1 Diabetes Mellitus, Self Care

When your child has type 1 diabetes (type 1 diabetes mellitus), you must make sure your child’s blood sugar (glucose) stays in a healthy range. You can do this with:

• Insulin.
• Nutrition.
• Exercise.
• Other medicines, if needed.
• Support from your child’s doctors and others.

How to stay aware of blood sugar

• Check your child’s blood sugar every day, as often as told.
• Have your child’s A1c (hemoglobin A1c) level checked two or more times a year. Have it checked more often if your child’s doctor tells you to.

Your child’s doctor will set personal treatment goals for your child. Your child’s blood sugar and A1c levels should stay as close to his or her goal numbers as possible.

How to manage high and low blood sugar

Signs of high blood sugar

High blood sugar is called hyperglycemia. Know the signs of high blood sugar. Signs may include:

• Feeling:
  • Thirsty.
  • Hungry.
  • Very tired.
• Needing to pee (urinate) more than usual.
• Blurry vision.

Signs of low blood sugar

Low blood sugar is called hypoglycemia. This is when blood sugar is at or below 70 mg/dL (3.9 mmol/L). Signs may include:

• Feeling:
  • Hungry.
  • Worried or nervous (anxious).
  • Sweaty and clammy.
  • Confused.
  • Dizzy.
  • Sleepy.
  • Sick to the stomach (nauseous).
• Having:
  • A fast heartbeat.
  • A headache.
  • A change in vision.
  • Tingling or no feeling (numbness) around your child’s mouth, lips, or tongue.
  • Jerky movements that your child cannot control (seizure).
• Having trouble with:
  • Moving (coordination).
  • Talking.
  • Sleeping.
  • Passing out (fainting).
  • Getting upset easily (irritability).
  • Crying more often than usual.
  • A big change in behavior.

Treating low blood sugar

To treat low blood sugar, have your child eat or drink something sugary right away. If your child can think clearly and swallow safely, have your child follow the 15:15 rule:

• Have your child take 15 grams of a fast-acting carb (carbohydrate). Some fast-acting carbs are:
  • 1 tube of glucose gel.
  • 3 sugar tablets (glucose pills).
  • 6–8 pieces of hard candy.
  • 4 oz (120 mL) of fruit juice.
  • 4 oz (120 mL) regular (not diet) soda.
• Check your child’s blood sugar 15 minutes after he or she takes the carb.
• If your child’s blood sugar is still at or below 70 mg/dL (3.9 mmol/L), have your child take 15 grams of a carb again.
• If your child’s blood sugar does not go above 70 mg/dL (3.9 mmol/L) after 3 tries, get help right away.
• After your child’s blood sugar goes back to normal, have your child eat a meal or a snack within 1 hour.

Treating very low blood sugar

If your child’s blood sugar is at or below 54 mg/dL (3 mmol/L), your child has very low blood sugar (severe hypoglycemia). This is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

If your child has very low blood sugar and cannot eat or drink, your child may need a glucagon shot (injection). You will be taught how to check your child’s blood sugar and how to give a glucagon shot. Ask your child’s doctor if your child needs to have a glucagon shot kit at home.

Follow these instructions at home:

Medicine

• Give insulin and other diabetes medicines as told.
• If your child’s doctor says you should give your child more or less insulin and medicines, do this exactly as told.
• Do not let your child run out of insulin or medicines.

Food

Make sure that your child:

• Makes healthy food choices. These include:
  • Chicken, fish, egg whites, and beans.
  • Oats, whole wheat, bulgur, brown rice, quinoa, and millet.
  • Fresh fruits and vegetables.
  • Low-fat dairy products.
  • Nuts, avocado, olive oil, and canola oil.
• Follows instructions from his or her doctor about what not to eat or drink.
• Drinks enough fluid to keep his or her pee (urine) pale yellow.
• Keeps track of carbs that he or she eats. You and your child can do this by reading food labels and learning food serving sizes.
• Follows his or her sick day plan when he or she cannot eat or drink normally. Make this plan with your child’s doctor so it is ready to use.

Meet with a food specialist (dietitian). He or she can help you make an eating plan that is right for your child.

Activity

• Have your child exercise as often and as long as told by his or her doctor.
• Make sure that your child always has a 5–15 gram carb snack available before, during, and after exercise.
• Talk with your child’s doctor before your child starts a new exercise. Your doctor may need to tell you to change:
  • How much insulin or medicines you give to your child.
  • How much food your child should eat.

Body care

• Stay up to date with your child’s shots (immunizations).
• Have your child’s eyes and feet checked by a doctor as often as told.
• Check your child’s skin and feet every day. Check for cuts, bruises, redness, blisters, or sores.
• Have your child:
  • Brush his or her teeth and gums two times a day.
  • Floss one or more times a day.
  • Go to the dentist one or more times every 6 months.
• Have your child’s blood tested by a doctor every year.

General instructions

• Give over-the-counter and prescription medicines only as told by your child’s doctor.
• Share your child’s diabetes care plan with people who care for your child at school and at home.
• Check your child’s pee for ketones:
  • When your child is sick.
  • As told by your child’s doctor.
  • When your child’s blood sugar is above 240 mg/dL (13.3 mmol/L) for 2 tests in a row. If this happens and your child has moderate or large ketone levels in his or her pee, call your child’s doctor.
• Have your child carry a card or wear jewelry that says he or she has diabetes.
• Have your child avoid alcohol and tobacco.
• Keep all follow-up visits as told by your child’s doctor. This is important.

Questions to ask your child’s doctor

• Do my child and I need to meet with a diabetes educator?
• Where can I find a support group for children with diabetes?

Where to find more information

To learn more about diabetes, visit:

• American Diabetes Association (ADA): www.diabetes.org  
• American Association of Diabetes Educators (AADE): www.diabeteseducator.org  

Summary

• When your child has type 1 diabetes (type 1 diabetes mellitus), you must keep your child’s blood sugar (glucose) stays in a healthy range. You can do this with insulin and other medicines, nutrition, exercise, and lifestyle changes.
• Check your child’s blood sugar every day, as often as told.
• Share your child’s diabetes care plan with people who care for your child at school and at home.
• Keep all follow-up visits as told by your child’s doctor. This is important.