Diabetes Health Center

continued...

Your child needs to see his or her doctor every 3 to 6 months. During these checkups, the doctor will evaluate and adjust your child's treatment. The doctor will do a hemoglobin A1c or similar test (glycosylated hemoglobin or glycohemoglobin) to check your child's blood sugar control over the previous 2 to 3 months, and a blood glucose test.

If your child's LDL cholesterol is less than 100 mg/dL (2.60 mmol/L) and there is no family history of high cholesterol, the doctor will do a cholesterol (LDL and HDL) test every 5 years. If your child's blood pressure is consistently high and not reduced with weight control or exercise, the doctor may consider medicine.

When your child has had diabetes for 5 years, the doctor will start yearly screening tests for protein in the urine, which points to diabetic nephropathy. At that same time, your child needs to see an ophthalmologist for yearly dilated eye exams (ophthalmoscopy) to check for signs of diabetic retinopathy.

Treatment for high blood sugar emergency

If your child does not take enough insulin, has a severe infection or other illness, or becomes severely dehydrated, his or her blood sugar level may rise very high and lead to diabetic ketoacidosis. Diabetic ketoacidosis is almost always treated in a hospital, often in the intensive care unit, where caregivers can watch your child closely and give him or her frequent blood tests for glucose and electrolytes. Insulin is given through a vein (intravenous, or IV) to bring blood sugar levels down. Fluids are given through the IV to correct the electrolyte imbalance. Your child may stay in the hospital for a few days until blood sugar levels are back in the target range and electrolytes have normalized.

What To Think About

A 10-year study, and its follow-up study, showed that keeping blood sugar levels within a target range helps decrease the chances of developing diabetes complications, such as eye, kidney, heart, blood vessel, and nerve damage. As a result of this study, experts recommend that people with diabetes carefully control their blood sugar levels. This is often called strict or tight blood sugar control.

When a child has diabetes, keeping blood sugar levels within a target range helps the child grow and develop normally, but it increases the risk for frequent low blood sugar episodes. Your doctor will figure the safest range for your child's blood sugar level.

For some children, using an insulin pump may help keep their blood sugar levels within a target range.

Diabetes: Should I Get an Insulin Pump?

Diabetes: Living With an Insulin Pump

If your child has frequent low blood sugar levels, especially at night (nocturnal hypoglycemia), the doctor may suggest continuous ambulatory blood glucose monitoring. This means your child wears a special monitor that records his or her blood sugar level continuously for 24 to 72 hours. The monitor stores the results, which allows you to look for patterns of high or low blood sugar levels.²

Scientists are looking for pain-free ways to give insulin and test blood sugar levels. Under development are improved insulin pumps, and better needles and lancets. New glucose monitors may be worn continuously and be able to signal insulin pumps when the rate of insulin needs to be changed. Scientists are also studying ways to prevent or decrease complications from diabetes. If you're interested, talk to your child's doctor about participating in any of these studies.