Your diabetic child will express their needs quite differently in different stages of development. But the common thread is that you must oversee their diabetes management at all times.

Infancy

Although rare, type 1 diabetes occasionally emerges in babies.

Parents obviously need to manage all aspects of the baby's care, with particular focus on avoiding episodes of hypoglycemia; in severe cases, a prolonged drop in blood sugar can damage a developing brain. Unfortunately, a baby can't tell you that he feels nervous or dizzy--or any of the other classic symptoms of hypoglycemia. The best advice is to test the baby's glucose often.

However, you still need to be on the alert; signs of hypoglycemia to look out for may include
  • jitteriness
  • irritability
  • lethargy
  • seizures
  • bluish skin
  • breathing problems
  • feeding problems
Toddlers (1 to 3 years)

It is a fact of early childhood: Kids sometimes scream, kick, and fuss. Tempting as it may be to disregard a child's temper tantrum, that's not an option when the child has diabetes.

Toddler with diabetes
The trick to managing a toddler's
diabetes is to maintain constant
vigilance without interfering
with the child's development.

That's because it may be difficult to tell the difference between "normal developmental opposition" (the term psychologists use for everyday wailing and throwing of toys) and a bout of hypoglycemia. A child may act cranky and difficult if his or her blood sugar has dropped, so doctors encourage parents to check glucose levels just to be sure.
 
On the other hand, parents must guard against becoming overly protective and treating the child as though he or she belongs in a bubble, which could hinder natural development.

Preschool and Early School-Aged Children (3 to 7 years)

At this age, a child still lacks the physical coordination, mental development, and maturity to manage daily care. However, this is the time to get the child involved by having him or her take part in testing glucose levels, keeping records, and learning how to count carbohydrates. Doing so not only serves as an introduction to the skills he or she will need but will also build confidence.

Keep in mind, though, that even if your child is a little chatterbox, he or she may still not be able to articulate, or even recognize, the symptoms of low blood sugar. You may need to learn to decipher certain phrases, such as "I'm hungry" or "I feel funny," which could be a child's code language for "I think my blood sugar is low."

School-Aged Children (8 to 11 years)

By this age, children can start to inject insulin and test their glucose, but only with adult supervision. Studies show that relying on a child to manage diabetes on his or her own at this age often results in poor glucose control. The insulin pump is an increasingly popular option for kids at this age, and even younger, though it also requires adult oversight.
 
Depression and anxiety are normal responses among kids diagnosed with diabetes in this age range, though those problems often fade after six months or so. Still, preadolescent children begin to develop a sense of their place in society and may feel that having diabetes makes them "weird" or "different." It's important to encourage kids to participate in school activities, make friends, and have normal, healthy relationships.

Adolescents

By teen-hood, a child has developed considerable manual dexterity, mental ability, and -- hard as it may be to believe at times -- maturity. That means he or she can assume much of the responsibility for diabetes management. In fact, the growing streak of rebellion and independence many teens display (often in unfortunate haircuts and unfathomable fashions) may lead the adolescent with diabetes one day to blurt out, "I don't need your help, I can do this myself."

However, your son or daughter does still need help, especially with the finer points, such as when and how much to adjust insulin doses. Research shows that teens who continue to work with their parents maintain better glucose control.

It's important to keep in mind, however, that butting in too much -- when it comes to the teen's diabetes management or anything else -- can lead to sour relations. Studies suggest that glucose control suffers when teens and parents squabble.

As children grow and age, their insulin requirements change. That's especially true during puberty, when hormonal havoc causes a phase of insulin resistance, dramatically increasing the required dosage. This lasts until they develop a stable health pattern, which is earlier for women than for men. Lifestyle behaviors, such as excessive consumption of carbohydrates or excessive exercise, also play a role.

For more information on diabetes, try the following links:
  • Diabetes and Children: If your child has diabetes, he or she will have different needs than an adult. Find out how to manage your child's disease.
  • Managing Childhood Diabetes: In this article, you will learn more about the obstacles your family will face helping your child stick to a diabetes treatment plan.
  • Diabetes Treatment: Living with any form of this disease means keeping a steady blood-sugar level. Find out how to treat the main types of diabetes.
  • Diabetes: This disorder in the blood can affect most of your organs. Learn how it works here.
ABOUT THE AUTHOR:

Timothy Gower is a freelance writer and the author of several books. His work has appeared in many magazines and newspapers, including Prevention, Health, Reader's Digest, Better Homes and Gardens, Men's Health, Esquire, Fortune, The New York Times, and The Los Angeles Times.

ABOUT THE CONSULTANTS:

Dana Armstrong, R.D., C.D.E., received her degree in nutrition and dietetics from the University of California, Davis, and completed her dietetic internship at the University of Nebraska Medical Center in Omaha. She has developed educational programs that have benefited more than 5,000 patients with diabetes. She specializes in and speaks nationally on approaches to disease treatment, specifically diabetes.

Allen Bennett King, M.D., F.A.C.P., F.A.C.E., C.D.E. is the author of more than 50 papers in medical science and speaks nationally on new advances in diabetes. He is an associate clinical professor at the University of California Natividad Medical Center and cofounder and medical director of the Diabetes Care Center in Salinas, California.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.