The goal of diabetes management is to keep blood glucose levels as close to normal as possible. For children with diabetes, that often means using some form of medication.

Insulin

A child with type 1 diabetes must inject insulin several times a day to control his or her blood glucose levels. A growing number of children with type 2 diabetes use insulin, too. At first, you may find the nuances of insulin bewildering. What's the difference between rapid-acting and short-acting insulin? Why doesn't a daily injection of long-acting insulin do the trick? What do all these terms -- onset, peak, duration -- mean?

Insulin injections
Most children with diabetes need to inject insulin several times a day,
a task that is beyond their powers of self-management.

Very often, shortly after starting insulin injections, the child may experience a period of reduced insulin need called the "honeymoon period." During the honeymoon period, the remaining beta cells continue to produce insulin. Insulin doses may become very low, but it is important to continue the injections during this period because even low doses of insulin appear to help prolong this "honeymoon."

Your child's diabetes-management team will help you plan precisely how to replace this critical hormone. Together, you will determine:
  • how much insulin your child requires every day, based on body weight and age.

  • which type of insulin, or what combination of insulin types, best suits your child.

  • which delivery system -- syringe, insulin pen, or pump--makes the most sense.

  • which injection sites will work best and how to rotate them.
Diabetes requires an extraordinary amount of self-management, which is way beyond the ability of young children. How, you may wonder, will you ever trust your child, who can't tie her own shoes or make his own bed, with a needle and vial of insulin?

Although you will likely be involved in your child's daily diabetes maintenance until he or she leaves the nest, you'll be relieved to know that children gradually assume greater responsibility for controlling blood sugar as they get older. Your role in their diabetes management and your major concerns will change over time.

Oral Diabetes Medications

Metformin (Glucophage) is the only oral diabetes medicine approved by the Food and Drug Administration for use in children. Metformin does not increase insulin levels; it works by causing the liver to release less glucose into the blood and making cells more sensitive to the actions of insulin.

Metformin can cause side effects, including vomiting, constipation, and heartburn, as well as a "full" feeling in the belly. If your child finds the side effects unbearable, talk to his or her physician. However, metformin's side effects often fade over time.
 
Although other oral diabetes medications are not approved for children, they can be prescribed "off label" if a physician feels that a child with type 2 diabetes will benefit.

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.
  • Diabetes Medication: Insulin is the most well-known but not the only form of diabetes medication. This page will give you details on many other forms.
  • 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.