Health Education for Kids About Diabetes: Prevention, Management, and Support

Diabetes is a chronic condition affecting how the body turns food into energy. It's crucial for children to understand diabetes, both for prevention and, if diagnosed, for effective management. This article provides comprehensive information on diabetes for kids, covering prevention strategies, school management, essential skills, and available support systems.

Understanding Diabetes

Diabetes is a condition where the body cannot properly use food for energy. Glucose, a type of sugar, is the body's primary fuel source. A hormone called insulin is needed to move glucose from the blood into the body's cells. When a person has diabetes, either the body doesn't make enough insulin, or the body doesn't use insulin effectively. This leads to high levels of glucose in the blood.

There are two major types of diabetes:

Type 1 Diabetes: In type 1 diabetes, the pancreas, which is the organ that makes insulin, cannot produce insulin. This occurs when the body's immune system mistakenly attacks and destroys the insulin-producing cells (beta cells) in the pancreas. As a result, glucose cannot enter the cells, and it builds up in the bloodstream. People with type 1 diabetes need to take insulin every day to survive. Type 1 diabetes is the most common type of diabetes affecting children and teenagers in Australia.
Type 2 Diabetes: In type 2 diabetes, the pancreas makes insulin, but the body doesn't respond to it properly (insulin resistance) or doesn't make enough insulin to keep blood sugar levels normal. Glucose builds up in the blood, leading to high blood sugar levels. Type 2 diabetes is often associated with lifestyle factors such as being overweight and physically inactive. While less common in children, type 2 diabetes diagnoses are increasing among adolescents, particularly those who are overweight or obese.

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When there is not enough insulin in the blood, glucose levels build up and eventually 'spill over' into the urine. The body's cells still require a source of energy, and without glucose, the body's fat stores begin to break down, resulting in the production of ketones, which is an alternative fuel source.

Prevention of Type 2 Diabetes in Children

One-third of American youth have overweight, increasing their risk for conditions like insulin resistance, a major risk factor for type 2 diabetes. It's essential to promote healthy habits from a young age to prevent type 2 diabetes.

Healthy Weight Management: Young kids and teens are still growing. If they have overweight, the goal is to slow down weight gain while still allowing growth and development.
Physical Activity: Being physically inactive increases the risk for type 2 diabetes. Being active helps the body use insulin better and decreases the risk of overweight.
Family Involvement: Set a new normal as a family-healthy changes become habits more easily when everyone does them together. Starting early can help kids develop a lifetime of healthy habits.

Recognizing Symptoms and Seeking Medical Advice

If your child has been unusually thirsty and had increased urination for more than a week, see your GP. If your child shows other symptoms, take them to see the GP so the cause can be investigated. Kids who develop type 2 diabetes are usually diagnosed in their early teens. One reason is that hormones during puberty make it harder for the body to use insulin. This is especially true for girls, who are more likely than boys to develop type 2 diabetes.

If your child has any two risk factors listed above, talk to your doctor about getting their blood sugar tested.

Symptoms of type 1 diabetes can appear quickly and may include:

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Increased thirst
Frequent urination
Unexplained weight loss
Increased hunger
Fatigue
Blurred vision
More prone to infections

DKA is a medical emergency. hospital emergency department if your child is dehydrated and vomiting. Signs that your child is severely dehydrated include: dark-coloured urine, being pale, cold hands or feet, fast breathing, sunken or dark eyes.

If your child shows the other symptoms, take them to see the GP so the cause can be investigated. Your child may be referred to an endocrinologist (diabetes doctor). Your child will need to have some tests to determine whether they have diabetes.

Managing Diabetes at School

Schools play a crucial role in a child’s life by shaping their education and behaviours. For children with diabetes, managing their condition at school requires collaboration between parents, school staff, and healthcare providers.

Preparing School Staff

Beyond the day-to-day care, school staff need to be prepared in case of an emergency. Classroom teachers, the gym teacher, bus drivers, and coaches should know what to do if there’s a problem.

Share the Care Plan: Meet yearly with the school nurse (and other staff who are involved in routine care) to review your child’s diabetes care plan. Check in more often if the plan changes.
Educate Key Staff: Teach key staff about daily care, especially for younger kids. Explain about your child’s target glucose range. Show them when to check blood sugar, how to give insulin, and how to use any devices (like a blood glucose monitor, CGM, or insulin pump).
Emergency Supplies: Everyone should to know where to find your child’s diabetes to-go kit and emergency supplies.
Essential Information: Give the school a copy of your child’s care plan and emergency contacts. It’s also a good idea to give written permission for school staff and the diabetes care team to communicate. If a problem happens, the school can get your child’s health information quickly. Give teachers and coaches fact sheets about diabetes and extra snacks to keep on-hand.
Recognizing and Treating Highs and Lows: Prepare school staff for highs and lows. All adults who supervise your child should know how to use your child’s diabetes to-go kit. They should be able to identify and treat hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar). Teach them the basics and what to do in an emergency.

504 Plans and IEPs

Schools are required to make sure every child can get an education. If a child has a special health need, like diabetes, the school can create a plan to make sure the child's health and education needs are met. 504 plans and IEPs are types of formal plans that can be used to set goals and measure progress.

504 Plan: A 504 plan helps to make sure a child with a health condition or special need can fully participate in all school activities like their peers.
IEP (Individualized Education Program): An individualized education program (IEP) can be used if a child with a medical condition needs extra support inside or outside the classroom.

Essential Skills for Children with Diabetes

As children grow, they can learn to take on more responsibility for managing their diabetes.

Diabetes Care: Teach your child in an age-appropriate way about their care plan. Kids who are old enough to be involved in their care should know the basics, like how to check their blood sugar and what to do if it is too high or too low.
Using Supplies: Your child should have their diabetes to-go kit with them at all times. Older kids should know how to use it and when to refill it.
Self-Advocacy: Help your child know when and how to speak up, like if they don’t feel well, or if they need to have a snack or go to the restroom during class.
Emergency Preparedness: Be sure your child knows who they can count on to help during or after school (such as teachers, the school nurse, or a coach).

Treatment and Management of Diabetes

When children are first diagnosed with type 1 diabetes, the initial focus will be treating the dehydration and acidic blood. Insulin will be given, to replace the missing insulin from the body. They will usually be required to stay in hospital for a short period of time.

Type 1 diabetes is a chronic (life-long) disease that has no cure. The treatment of type 1 diabetes involves the replacement of insulin. Insulin can be replaced in the body either via insulin injections or with insulin pump therapy.

Testing blood glucose levels is a crucial part of managing diabetes. It provides information on how much glucose is currently in the bloodstream and is the only way to know if the body is getting the correct amount of insulin that it needs. glucose levels is with a tiny needle that pricks a finger. A drop of blood is then analysed quickly on a small machine (glucometer) to give a result.

While your child is in hospital, they will begin to have diabetes education, which can then be finished as an outpatient after they are discharged from hospital. These education sessions will be with a diabetes nurse educator, dietitian, and social worker. You will be given a Diabetes Action Plan (for what to do in an emergency) and a Diabetes Management Plan (for daily management and what to do when there is a problem) for your child. Your child will have an appointment with an endocrinologist, diabetes nurse educator and diabetes dietitian a few weeks after their diagnosis.

If the child is sick at the time of diagnosis and/or has very high blood glucose levels associated with other symptoms such as weight loss or excessive urination, insulin therapy may be started first. Another reason to start insulin is that not every child who is overweight has type 2 diabetes. Write down blood glucose results in your diary and bring to clinic. Bring your meter with you to all appointments.

Living with Diabetes: A Family Affair

Finding out your child has diabetes is never easy. However, it does get easier as you learn more about the condition and how it can best be managed. Habits like not exercising or eating junk food need to be altered!

Diabetes Overview Class: Designed for newly diagnosed kids and their families. This is a two-day program that will help you understand diabetes and how it affects the body. You will learn the basic skills needed to manage your child’s diabetes, including giving insulin, keeping records, and using and maintaining a blood glucose monitor.
Beyond Basics Class: A follow-up to the Diabetes Overview Class, this class will teach you and your child about the special care needed when a child with diabetes is sick. You must book an appointment to participate in the class.
Caregiver Class: For grandparents, babysitters, friends, schoolteachers and daycare providers. Everyone who takes care of a child with diabetes needs to know the basics of managing it, and this class shows them how.
Carbohydrate Counting Class: This class will review the basics: what foods contain carbohydrates and how to calculate the grams consumed at meals and snacks. Then, you and your child will learn how to match the mealtime insulin dose to the amount of carbohydrates eaten. The class costs $20 per person.

Age-Specific Considerations

As your child grows and develops, his views and feelings about having diabetes will change. In each stage, your involvement and attitude are critical. Until your child reaches adolescence, you will need to provide much of his care and supervise as he learns.

Babies: Babies eat and sleep when they want. Finding the right treatment schedule can be a challenge. Talk to your child’s healthcare team about insulin dosing and meal planning to allow for daily changes in appetite. Do not force-feed your child.
Toddlers: Give your toddler choices. 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. Use a meter that requires the least amount of blood. Try to distract your child to ease his fears of shots and blood tests.
Preschoolers: Your child is spending some time away from your family. Preschoolers are eager to please. Educate caregivers about managing insulin, meals and blood tests. Be one step ahead and plan what, when and where your child’s next meals and snacks will be. Avoid labeling blood glucose results as “good” or “bad.” Use “high” and “low” instead. Try to show support and a positive outlook on diabetes management.
School-Age Children: Peer pressure is high at this stage. Talk to your child regularly about his diabetes. Your child can draw up insulin and may have the math skills to calculate insulin. At this age, he is too immature and impulsive to do it on time. Use an alarm or other reminder so your child can check blood sugars without direct supervision. Help your child solve some diabetes-related problems with suggestions and questions of your own.
Teens: 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. Make sure to check his blood sugar before your child drives, every time. Alcohol and drug use can be especially dangerous for teens with diabetes. Your teen is busy with social activities, school and maybe a job. You may still need to plan most meals and check the blood sugar monitor weekly to verify that blood sugars are checked on time. Help him be assertive and confident so that he can face peer pressure more easily.

Supporting Organizations and Resources

Children who have access to quality diabetes management education at a young age can reduce their risk of diabetes-related complications.

KiDS (Kids and Diabetes in Schools): KiDS promotes diabetes education and prevention to children and adolescents through awareness, education and advocacy activities. KiDS resources have reached over 1 million children in 23 countries. Find out how you can promote diabetes education among children and adolescents in your community.
Camp Kudzu: Camp Kudzu is a nonprofit that offers camps and events just for Georgia’s children and teens with Type 1 diabetes and their families.
Diabetes Family Ambassador Program at Children’s: This program helps you and your family navigate the challenges of living with diabetes.
Kids Health Info (The Royal Children’s Hospital): Developed by The Royal Children's Hospital Endocrinology and Diabetes department. Kids Health Info is supported by The Royal Children’s Hospital Foundation.

Additional Tips for Managing Diabetes

Finger sticks: 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. Talk to your child’s healthcare team before you begin.
Sweet snacks: Your child can still have sweet snacks, but you must make adjustments to allow for it. Like all carbohydrates, sugar raises blood sugar (glucose). When sugar, such as juice or candy, is eaten without any other food, blood glucose rises very quickly. An occasional sweet treat is fine if insulin doses are adjusted to allow for the sugar content and if the treat is eaten with a meal.
Insulin: Most children with diabetes will need insulin injections throughout their lives. If your child has Type 1 diabetes, he 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. 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.
Honeymoon period: If your child has Type 1 diabetes, it may seem to go away during a brief “honeymoon” period when blood sugar may be within normal range. This happens because your child’s insulin-making cells (beta cells) start working more than they did before your child started taking insulin. You may even think that the doctors have made a mistake and that your child does not really have diabetes. If your child has Type 2 diabetes, the diabetes may seem to disappear if blood sugar is controlled through diet, exercise or medication. But the diabetes actually is being controlled-it is not truly gone.

The Future of Diabetes Treatment

The hope for a cure is alive and well at Children’s and around the world. Three promising approaches for Type 1 diabetes include an artificial pancreas, a pancreas transplant from a donor, and prevention of diabetes through risk identification, blood testing and innovative treatment.

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