Frequently Asked Questions About Diabetes
Will I always have to prick my child’s finger to test his blood sugar?
A fingerstick can be painful. Improvements in glucose meters allow measurements with very small amounts of blood. This has allowed children to get blood from places other than their very sensitive fingertips. The palm of the hand and the forearm are examples of these alternate sites. The method for doing alternate site testing is different from fingertip testing. It is therefore important to speak with your diabetes team before starting this.
For many people, stopping everything to check a blood glucose level is one of the most annoying parts of treating diabetes. Continuous glucose monitoring (CGM) is one way to get the most glucose information. People who monitor their glucose continuously have fewer low and very high blood glucose levels. Whether continuous monitoring actually lowers a person’s overall average blood glucose depends on their age, their control when they start monitoring and how they use the information from their monitor to treat diabetes. Blood glucose testing is still required during continuous glucose monitoring to make sure the continuous monitor is accurate.
For more information about these and other technologies, visit www.childrenwithdiabetes.com.
Can my child ever eat sweets again?
Yes, but it is important that adjustments are made to allow for eating sweets. Like all carbohydrates, sugar raises a person's blood glucose. When sugar is eaten without any other food (like in a candy or a sugar-sweetened drink), the blood glucose rises very quickly. That is why these items are used to treat low blood glucose episodes.
None of our current treatments can properly balance the glucose rise from these pure sugar foods. If sugar is eaten with a meal that also contains fat and protein, the blood glucose rises more slowly. Therefore, occasional sweet treats can be included in the diet of a person with diabetes if insulin doses are adjusted to allow for the sugar content and the treat is eaten at the time of a meal. Because of the low nutritional value of most high sugar foods, it is not a good idea for most kids to substitute a high sugar treat for a serving of a complex carbohydrate (like bread, pasta, vegetables) at a meal.
Will my child have to take insulin forever?
It is very important to know the type of diabetes your child has. Children with Type 1 diabetes are deficient in insulin and will need insulin by injections or by continuous infusion pump until a better treatment is invented.
In the early stages of diabetes, a “honeymoon” occurs when the pancreas still produces some insulin. During this time, very small doses of insulin may be needed. This can result in hopeful parents believing that insulin treatment is no longer necessary or that their child has been miraculously cured. It is very dangerous to stop insulin treatment.
- Always speak with your diabetes care team before stopping insulin injections.
- With time, insulin production by the pancreas will stop completely and insulin doses will need to be increased.
- The injury to the pancreas in Type 1 diabetes is permanent.
If your child has Type 2 diabetes and has been started on insulin, it is possible that insulin may be gradually replaced by an oral medication. Many people believe that the only reason they need insulin is that they have not looked after the condition well enough. This is often not true. Type 2 diabetes results from 2 problems occurring at the same time: 1) partial insulin deficiency and 2) weak insulin activity, called insulin resistance.
- Children with a relatively mild insulin deficiency, but severe insulin resistance may be able to come off insulin if they can become less resistance to insulin by maintaining good blood glucose control and following healthy eating and activity guidelines.
- Children who have a more severe insulin deficiency may need insulin, no matter how well they manage diabetes.
Will my child’s diabetes go away?
No, it will not. Although children with diabetes and their families often wish and think that the diabetes has gone away, once a child has diabetes, it is always there.
For children with Type 1 diabetes, the diabetes seems to go away during the "honeymoon" period when the blood sugars are almost always within normal range. This happens because the child’s own insulin-making cells (beta cells) start working more and the pancreas starts regulating the blood sugar more than it did before the child started taking insulin.
As a parent, you may think that the doctors have made a mistake and that your child does not really have diabetes. This honeymoon period does end after a time, however, and your child's body will not make any more insulin.
For children with Type 2 diabetes, the diabetes seems to disappear if blood sugars are controlled through diet, exercise and/or medication. But the diabetes actually is being controlled, it is not truly gone. To keep the diabetes under control, the child must still monitor their blood sugar levels, watch their diet, exercise and take their medicine.
When will we have a cure for Type 1 diabetes?
The hope for a cure is alive and well at Children’s and throughout the world. Thousands of brilliant people have dedicated their careers to finding the cure for type 1 diabetes and millions more commit their time and money to make the research possible.
Currently, there are three promising approaches:
1) Artificial pancreas: would automatically deliver the correct amount of insulin when the person with diabetes needed it—similar to a healthy pancreas in a non-diabetic person.
2) Transplantation: two options are being explored.
3) Prevention: current strategies to prevent type 1 diabetes involve a 2-step process.
- Pancreas transplant: when a whole healthy pancreas is transplanted from a donor to a diabetic person.
- Islet transplantation: islets (insulin-producing cell clusters) are injected into a diabetic person through a minimally invasive procedure.
People who are likely to get diabetes must be identified.
- Special research blood tests are available to identify antibodies in the blood that indicate the immune process that causes diabetes has started.
- Healthy family members of people with type 1 diabetes are the ones most likely to have abnormal results.
- Other high risk markers for future diabetes may someday include gene testing. Most of the experimental treatments aimed at preventing diabetes focus on stopping the destructive immune process.
Treatment must be given to stop the process that causes diabetes.
- Some of these treatments are currently being tried in people with newly diagnosed type 1 diabetes to see if the honeymoon periods can be extended.
- Exciting, new proposals examine methods to increase the ability of healthy insulin-producing cells to multiply and replace damaged cells.
- It is possible that a successful prevention therapy may be combined with a transplant therapy to cure diabetes.