Diabetes in Children and Teens

Finger sticks to check blood sugar are an important part of daily care for diabetes. For many children, having fingers pricked repeatedly is a source of discomfort and stress—and it can be stressful for family and caretakers as well. Improvements in glucose meters now allow measurement with a tiny amount of blood. That means children can be pricked somewhere other than their sensitive fingertips, such as the palm of the hand or the forearm.

Talk to your child’s healthcare team before you begin. Continuous glucose monitoring (CGM) may be an option, but blood glucose testing will still be needed to make sure the CGM measurement is accurate.

Most children with diabetes will need insulin injections throughout their lives. If your child has Type 1 diabetes, they will need insulin by injection or a continuous infusion pump until a better treatment is developed. Insulin pumps can make life easier for many children. Some children with Type 2 diabetes may not need insulin if their condition can be managed through diet and other methods, but this is not always possible.

Sometimes in the early stages of diabetes, very small doses of insulin may be needed. You may begin to think your child no longer needs it, but never stop giving insulin without talking to your child’s doctor and healthcare team. Not giving insulin can lead to diabetic ketoacidosis (DKA), which means that there are high levels of ketones (acid) in the blood. If not treated, it can be life-threatening.

For grandparents, babysitters, friends, schoolteachers and day care providers, we offer our Caregiver Class. Everyone who takes care of a child with diabetes needs to know the basics of managing it, and this class shows them how. The class covers topics like how to give insulin, count carbohydrates, test blood sugar, test for ketones and help a child stay active safely.

The class can be attended virtually or in person.

If you are attending in person, class is held at the:

Center for Advanced Pediatrics
Teaching Kitchen Classroom, First Floor
2174 North Druid Hills Road NE
Atlanta, GA 30329 

Register for a class or get more information.

If you have any questions, please contact the diabetes education department at 404-785-KIDS (5437).

This is a computer-based training for anyone interested in learning about diabetes care.

It all starts in the kitchen: learning how to eat, cook and shop for the right ingredients, as well as when to eat.

The Teaching Kitchen in the Center for Advanced Pediatrics offers an encouraging wellness environment for children living with chronic illnesses. Classes are community based and family centered, and kids and adults can learn the health—and often cost-saving— benefits of preparing their own meals.

The Teaching Kitchen is a chance for kids and adults to take classes taught by a chef, who is accompanied by a registered dietitian or educator, in addition to volunteers. Teaching Kitchen classes are a fun and educational experience, as they are hands-on, and demonstrations are conducted weekly, monthly, quarterly and seasonally.

Each course’s curriculum provides:

• Nutrition education.
• Meal-planning tips.
• Culinary skills.
• Food safety.
• Food variety.
• Social interaction.
• Financial management.
• Recipe handouts.
• Food tastings.

The Type U app, created by Children’s Diabetes Education Program, is designed to support families after a new diabetes diagnosis. You can access diabetes education, community resources and helpful tools to build confidence in caring for your child. Talk with your child’s diabetes care team for instructions on how to download the app.

• Appetites can vary from day to day.
• Toddlers want independence—food battles are common.
• Babies eat and sleep when they want. Finding the right treatment schedule can be a challenge. Low blood sugar reactions in babies and toddlers can be hard to detect.
• Babies may become anxious and flinch, anticipating a heel/finger stick whenever they are picked up.
• Toddlers may fear shots and finger pricks.

Tips for this age:

• Talk to your child’s healthcare team about insulin dosing and meal planning to allow for daily changes in appetite. This can help keep blood sugar stable and can reduce stress and worry when your child is not hungry or refuses to eat.
• Do not force-feed your child. Talk to your child’s diabetes team if food battles are frequent.
• Give your toddler choices. Let them choose between two snacks or, if possible, where an insulin shot will be given.
• Let your toddler play doctor and “check” their doll or teddy bear’s blood sugar with an unloaded lancet device before checking their blood sugar.
• Set up a “diabetes station” in your home, and do all shots and blood tests there when possible. That way, your child can feel at ease and have no fear of shots in the rest of the house. Make their bed a safe haven—no shots in bed.
• Use a meter that requires the least amount of blood. Try using plastic pipettes to transfer blood from your child’s heel or finger if you are having trouble getting the blood sample on the strip.
• Try to distract your child to ease their fears of shots and blood tests. Patting or squeezing another part of their body or handing them a favorite toy may work.
• Have insulin ready before bringing your child to the room where the shot is given.
• Try to get your toddler on a meal and snack schedule with the rest of the family, allowing enough time for them to be hungry and ready to eat.

• Your child is spending some time away from your family. They may become frustrated or confused when other children do not have to be treated for diabetes.
• Your child may believe diabetes is a punishment.

Tips for this age:

• Preschoolers are eager to please. Now is the time to shape good eating and diabetes management habits.
• Educate caregivers about managing insulin, meals and blood tests. Discuss the day’s blood sugar management when picking your child up.
• Make sure your child gets to take part in parties, trips to restaurants and visits with friends so they are not left out from everyday fun activities that their friends enjoy.
• Follow a schedule for meals and snacks to help control appetite and blood glucose levels.
• Be one step ahead and plan what, when and where your child’s next meals and snacks will be. The quickest choice might not be the best for your child.

• Your child is making friends and relationships outside the family.
• At this age, you will need to handle self-care to be sure checks and injections are done on time and correctly.
• Your child is beginning to understand what diabetes is and can explain it in simple terms.
• Your child may recognize when their blood sugar is low and can ask for help.
• Your child may worry about being different and may hide the diabetes or act like they do not have it.
• They may feel disappointed or like they have failed if their blood sugar is out of range.

Tips for this age:

• Join a diabetes support group so your child can meet others their age with diabetes.
• Teach basic nutrition to your child, and read books about diabetes together.
• Look into camp or other social activities with other children who have diabetes.
• Always look for opportunities to catch them doing something right, and praise them for it.
• Avoid labeling blood glucose results as “good” or “bad.” Use “high” and “low” instead. Stress that if it is high or low, you just need to take steps to fix it.
• Try to show support and a positive outlook on diabetes management. Your child takes their cues from you.

• Your child is learning quickly and may know the day-to-day routine, such as what to eat and when to take insulin.
• They are building confidence about daily self-care but are not ready to do the tasks correctly and on time without supervision.
• Peer pressure is high at this stage. Your child may worry about fitting in and may not want to do checks, injections or other care with friends watching.
• Your child may lie to you about blood sugar levels and what they eat at school.
• Your child may not fully realize the risk of poor control and may not be concerned about diabetes complications.

Tips for this age:

• Allow your child to do the diabetes tasks they feel comfortable with while you supervise and manage their diabetes.
• Talk to your child regularly about diabetes. Discuss the best ways to get the results you both want.
• Supervise your child while injecting insulin, making food choices and doing blood sugar checks.
• Praise them when you catch them doing something right.
• Find ways to fit in overnight parties, fast food trips and other activities their friends enjoy.

• Your child may worry about puberty, how their body is changing and how they look.
• Hormonal changes can affect blood sugar levels.
• Peer pressure may be hard to resist, and your child is more likely to eat outside of the diet plan.
• Your child may become secretive and may not want to talk about their diabetes with you.
• Your child can draw up insulin and may have the math skills to calculate insulin. At this age, they are too immature and impulsive to do it on time. You will need to supervise.
• Arguments about meals and snacks may be more frequent, and your child may sneak food.

Tips for this age:

• Use an alarm or other reminder so your child can check blood sugars without direct supervision. Review the monitor daily to make sure the check was done on time and that your child is correctly reporting the results.
• Help your child solve some diabetes-related problems with suggestions and questions of your own. Keep teaching your child about diabetes management—they’re still learning.
• Set rules, and grant privileges when your child follows them correctly.

• Teens want to spend more time away from home, and some are able to manage diabetes well for short periods, such as a trip to the mall.
• Teens may be able to do nearly all of the diabetes management tasks but still need parents to check the blood sugar monitor daily and oversee meals. You will still need to do some tasks for your teen because at this age, they are busy and easily overwhelmed.
• They may be moody and rebellious and may not want to admit they need help.
• Make sure to check their blood sugar before your child drives, every time. Make sure your teen can manage their diabetes responsibly before they get their driver’s license.

Tips for this age:

• Stay involved in all decisions about insulin adjustments, and talk to your child’s healthcare team.
• If your child’s diabetes is not well controlled and they resist your help, consider family counseling.
• Alcohol and drug use can be especially dangerous for teens with diabetes. Make sure that your child knows the risks and that their real friends will understand.

• Your teen is busy with social activities, school and maybe a job. They may forget about diabetes tasks, so you need to stay involved.
• Your child may be ready to visit the doctor alone to prepare for more independence as they move on to college or work.

Tips for this age:

• You may still need to plan most meals and check the blood sugar monitor weekly to verify that blood sugars are checked on time. Keep teaching your child how to manage low and high blood sugar, and make sure they take proper steps to lower or raise it.
• Enforce the rules about diabetes care, and allow more freedom as your child shows responsible behavior.
• Teach your older teen about health insurance issues and how to get prescriptions filled.
• Take your teen grocery shopping, and let them plan some meals.
• Help them be assertive and confident so that they can face peer pressure more easily. Consider counseling if your child needs help becoming safely independent.