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Do's and Dont's - General Information

Blood pressure
Your child's blood pressure should be checked at least once a year, at his or her annual review for diabetes.

Blood glucose
Blood glucose can be tested several ways. Your child may be asked to test at home by urinating on a strip and determining blood glucose level based on strip colour change. However, because glucose typically does not appear in the urine unless levels are quite high (10 mmol/L or higher), it provides less accurate results than blood testing.

Long-term testing
During your child's annual review for diabetes, your doctor should perform an HbA1c test. This test measures the amount of glucose that has been carried in the blood for the past 2-3 months and provides your doctor with information needed to determine your child's long-term diabetes control.

Avoiding hypos
As explained on page 4, a person with type 1 diabetes does not produce insulin and so needs to inject it. When insulin is injected, glucose is taken up by the body's tissues so it can be used. However, if too much insulin is injected then the glucose level can drop lower than it should. A blood glucose level below 4.0 mmol/L is defined as hypoglycaemia or hypo. There are several ways to combat hypos, and your diabetes nurse should be able to advise you about this. In general, it is a good idea to make sure your child always has a source of sugar (such as a carton of orange juice or glucose tablets) on his or her person. Ideally a complex carbohydrate source - such as a cereal bar - should be carried as well and should be eaten after the simple carbohydrate to provide a more sustained rise in blood glucose.

Reducing the risk of future health problems
Over time, a high blood glucose level can damage the body, affecting a number of organs. The best way to prevent this is to keep blood glucose well controlled.

Exercise
Before your child starts a new exercise regime, talk to your diabetes team to check if it is suitable. Remember:

  • Exercise needs to be regular - little and often is far better than infrequent and strenuous
  • Set achievable goals - start slowly and build up gradually
  • If ill or injured, your child should not exercise
  • Always have carbohydrate snacks easily accessible when your child exercises
  • Your child should test before and after activity

Illness
When a person is ill, particularly during a fever, the body needs more energy, and therefore glucose, to fight the infection. Normally extra insulin is produced to cope with the rise in glucose, but in those with diabetes the body cannot meet the extra demand for insulin. This happens even when appetite has been completely lost and the person cannot eat at all.

Many people with diabetes make the mistake of thinking that, because they are eating very little, they should cut down or even stop their insulin. This is wrong. In fact your child may need more insulin than normal.

Testing and illness

Measure the blood glucose level regularly: When your child is ill you must measure their blood glucose regularly - at least four times a day. Record the results, as you may need to discuss them with your child's GP or healthcare team

If sugars are rising: You may need to increase testing to every two hours so you can spot in plenty of time if you need to adjust the insulin dose. Your child may need extra soluble insulin between the usual insulin injections

Measure ketone levels: If you have been given a meter that measures ketones as well as blood glucose then you should test their level if your child's blood glucose is over 16.7 mmol/L or if he or she is vomiting. These will tell you if there is a risk of diabetic coma

Insulin adjustment
With regular blood glucose testing you should be building a better picture of how everyday life affects your child's blood glucose. If the glucose level is consistently high or low at certain times of the day, you may be able to adjust the insulin dose to correct the situation.

Different insulin regimens
There are lots of different insulins and many insulin regimens. They can vary from long-acting insulin injected just once a day (often by people with type 2 diabetes who take tablets during the day too) to very short-acting insulin that is injected at every mealtime coupled with a longer acting injection twice a day or at night. To know which insulin you should adjust to correct your child's levels you need to find out more information about the particular regimen that your child is taking. The nurse or doctor at your clinic will be able to give you this information.