Diabetes In Children

Blood Sugar Monitoring

Diabetes has one big advantage over other diseases: you can always tell how well your child is doing. Blood sugar levels can be checked many times a day in the home and elsewhere. This shows how much glucose is present in the blood at different times of day, so you can adjust insulin or food accordingly.

When To Test?

It is usually best to test at least four times a day.

• One test is always done first thing in the morning, when the blood sugar level should be at its lowest for the day.
• The other tests may be before lunch, before dinner, at bedtime, or after meals.

Extra Tests

You will need extra tests:

• When the child is sick or under stress. Certain hormones produced in sickness or times of stress can make insulin less efficient, so blood glucose levels may rise.
• When the child has symptoms of hypoglycemia.
• When the dose of insulin is being changed, and you need to see how well the new dose is working.

Your diabetes team may also suggest extra tests:

• If the child starts an exercise program, because exercise helps the body use glucose, so blood glucose levels may become low.
• When the child eats more than usual, for example, at a birthday party, and blood glucose levels may rise.

What You Need For Testing

Your diabetes team will advise you on what supplies you need and show you how to use them. You will probably need:

• Lancets to prick the finger. (A new laser lancing device is now available. It is less painful but expensive.)
• A small, inexpensive meter to analyze the blood.
• Test strips. Most meters require these. Some can be used alone, changing color according to glucose levels.
• A logbook.

Choosing A Meter

• Meters should store test results with the time and date.
• You may be able to upload results into your computer, then e-mail or fax them to the doctor’s office.
• Some meters allow you to send the data over the telephone.

Getting A Blood Sample

• Wash hands well.
• Use the lancet to get a good drop of blood from the side of the finger. The side has a good blood supply and is less sensitive than the tip.
• Put the blood on the test strip, where the meter will read it (or if you are not using a meter, check the color of the strip).

Numbers To Aim For

Here are the normal glucose levels for people without diabetes:

• Before breakfast: 70-110
• Before lunch, supper, and bedtime snack: 70-120
• One hour after meals: 140 or less
• Two hours after meals: 120 or less

You can see how much these “normal” levels go up and down. But you won’t be expected to match these numbers exactly! Really “tight” control, with glucose levels close to these normal numbers, brings a risk of hypoglycemia.

Long-Term Monitoring

The doctor will order a blood test about every three months to check long-term glucose control. This hemoglobin A1c test measures the amount of glucose that has stuck to red blood cells over a period of time, which can show how well blood sugar has been controlled over the previous two to three months.

The test can help in two ways:

• It gives a good measurement of long-term control.
• It can be motivating. Children can compare the results with their score in the previous test and set goals for improvement (“Normal” is 4 to 6; children with diabetes do well with a score of 7 or 8).