Diabetes Management Overview

Although there is not yet a cure for diabetes, it can be managed. Children with diabetes can learn about eating right, exercising, taking insulin and/or other medications, checking their blood glucose, and managing their stress.

The goal in managing diabetes is to keep blood glucose levels within a target range.  

  • The best target range for a child with diabetes depends on many things, including their age, how long they have had diabetes and the adult supervision of their care.
  • Your child's  diabetes provider will determine your child's target numbers.

The following things affect blood glucose level and must be managed to keep it in the right range:

  • Food: The carbohydrates in food raise the blood glucose level. Diabetics need to balance the food they eat with the insulin they make or take by injection. The more carbohydrates are eaten, the more insulin is needed.
  • Exercise. Exercise lowers blood glucose levels. Extra snacks or lower insulin doses are often needed when people with diabetes are very active. For children with type 2 diabetes, daily activity is very important to help the body use glucose efficiently.
  • Medicine. Insulin lowers blood glucose levels. People with diabetes may inject insulin with a syringe two or more times each day, usually before a meal or at bedtime. Some people use an insulin pump—a small machine that adds insulin to the body every few seconds, all day and night. Some people with Type 2 diabetes take pills and some take insulin.
    • Type 2 diabetes may be treated with medicines taken by mouth along with diet and exercise. These oral medicines are not insulin. Some medicines help the body make more of its own insulin. Some help the body to use its own insulin better, and some help the body use glucose more efficiently.
    • Some children with Type 2 diabetes have to take insulin injections to help control their blood glucose levels. This does not mean that they have Type 1 diabetes. When children with Type 2 diabetes are overweight, weight loss is the most important part of the treatment.

Self Monitoring of Blood Glucose

People with diabetes have to test their blood glucose levels at home to figure out:

  • If their blood glucose is too low
  • If their blood glucose is too high
  • How often their blood glucose is in the target range
  • How much insulin they need to take.

The number of times blood glucose has to be tested is not the same for every child with diabetes. It depends on the type of diabetes, how frequently they are not in their target range, and the level of blood glucose control they want to maintain.

The usual way of testing blood glucose is to place a drop of blood from a fingertip on a special strip that uses a chemical reaction and a special machine (glucose meter) to measure the amount of glucose in the blood. New methods allow people to check their glucose levels continuously, but they still have to do some fingerstick tests to make sure the continuous glucose monitor is working properly.

Putting it all together

Getting blood glucose in the target range most of the time takes a lot of practice. A person with diabetes can change their blood glucose by adjusting three things:

  1. Eating carbohydrates will increase their blood glucose
  2. Exercise will lower their blood glucose
  3. Insulin will lower their blood glucose

By following instructions from their diabetes professionals, monitoring their blood glucose and learning from their own experience, people can adjust their food, activity or insulin dose to get their blood glucose in the target range.

As simple as that may sound, there are a lot of other factors that change blood sugar that are hard to include in the treatment.

  • Insulin doses are not always absorbed into the blood at the same rate.
  • Stress can raise blood glucose levels higher than normal.
  • The amount of fat in a meal can change how the carbohydrates increase blood sugar. 

It can be very stressful when a person works very hard to manage their diabetes, but they do not reach their blood glucose targets.  It is very important to have realistic goals and be patient.