Diabetes ‘n Me Blog

hen a child is diagnosed with diabetes it is commonly referred to as juvenile diabetes or type 1 diabetes.  This type of diabetes is not related to a child’s lifestyle, it is an autoimmune disease that results in the need for insulin injections for food to be turned into energy properly.  In recent years there have been an increased number of children that have been diagnosed with type 2 diabetes.  This is an alarming trend and one that can be mitigated because the link between children and type 2 diabetes is childhood obesity.

As it is fairly new that children are being diagnosed with type 2 diabetes there isn’t a lot of information or studies on it presently.  But what is known is that parents need to take action immediately.  Once a child has been diagnosed at an older age there isn’t much that can be done except to manage the disease.  But if a younger child is obese and makes healthy lifestyle changes that result in weight loss there is a chance that type 2 diabetes can be avoided.

Some of the early warning signs that your child may have diabetes include:

• A sudden increase in thirst that appears to never be satiated
• An increased need to urinate
• Dark patches on the skin – usually found in the folds of the skin, around the neckor around the eyes

As there are many other diseases and complications that can arise if your child is obese it is best to seek medical help for your child.  Between you and your health care professional, a plan can be made and put into place that will start your child on the road to a healthier weight and more active lifestyle.  Your child may be resistant at first but by involving them in the process and persistence the changes can be made.

You may be worried about the long-term effects on your child once they are diagnosed with diabetes but their immediate concerns may be quite different.  It is natural for them to focus on things they can’t have anymore or might miss out on.  Such as cake and ice cream at birthday parties, candy from Halloween, and a big dinner with pie at Thanksgiving and Christmas.  But being diabetic does not mean that you have to abstain from all sweets all the time.

Plan and plan some more.  If you know that your child is going to be going to a birthday party on Saturday afternoon, alter their food intake for that day to allow them to have a small piece of cake.  Until your children are much older, it is a good idea for you to stay with them at a birthday party in case of any emergencies.

If there is a class party at the school, volunteer to make something that the class can share and your child can have safely.  If your children’s teachers are aware of the special dietary requirements they can include sugar-free treats on special occasions.

The same holds true for Christmas and Thanksgiving as for birthday parties.  Planning ahead and adjusting meals earlier in the day will allow your child to participate in all of the festivities at holiday time that revolve around food.  There are many recipes and variations to recipes that are considered diabetic friendly.  These include cakes, pies, and other desserts.

There are things that can be done so your child does not feel deprived.  It will make the transition smoother for everyone if you can continue on with life with only while integrated the changes needed for someone living with diabetes.  But the allowances should not be made every day – keep them to special occasions only.

There are different brands of insulin that are available but in each brand there are two different kinds of insulin that are used to control juvenile diabetes.  One is known as fast-acting insulin – once it is injected it acts quickly in your child’s system.  The other type of insulin is called slow-acting or last-lasting and as the name implies it is in the child’s system longer.

For most people with diabetes a combination of the two types of insulin is required.  They can be mixed together in one syringe or they can be taken separately at different times in the day.  In children, the two different kinds of insulin will still react at different times for each individual.

For some the fast-acting insulin will begin to work immediately and could be used up in a short period of time.  In this case, they may have to have a second or even third injection of fast-acting insulin throughout the day.  These are the children who may want to consider an insulin pump to reduce the number of injections they are having in a day.  An insulin pump will also provide them with a steady amount of the fast-acting insulin as they need it.

The long-acting insulin sits in a child’s body for some time before it is put to use.  The amount of time is going to vary by child.  Ideally, once the fast-acting insulin has done its work, the long-acting insulin will take over keeping a steady supply of insulin.

The combination of the two insulins and how they work together makes planning very important.  After some time you will be able to determine how your child reacts to each of the different kinds of insulins.  Planning meals and activities around how the insulin works is important not just when the injection is given.

Life sometimes doesn’t seem fair – you love sweets and are known for your sweet tooth but now that you have been diagnosed with diabetes you are afraid you can’t have them anymore.  This isn’t entirely true.  Yes, if you previously indulged in many sweets you can no longer do that (and it may be a contributing factor to way you have type 2 diabetes).  But there are ways that you can satisfy your sweet tooth and stick to your diabetic diet.

Even though sugar isn’t the only reason blood sugars raise the combination of a high-sugar item and carbohydrates are.  There are many sugar substitutes and artificial sweeteners that are available to purchase on their own or in sweets such as chocolate and hard candies.

Another way to add sweets into your diet is to substitute them for other carbohydrates in a meal.  If you were planning on having a tuna salad sandwich for lunch instead of having the bread try eating the tuna on its own and use the saved carbohydrates on a cookie or two (depending on size and serving information).  This can be done with many different variations, but should be done in moderation – your body really will function better on those two pieces of whole wheat bread than it will on two chocolate chip cookies.

Speak with your dietician too.  A dietician is full of ideas and suggestion on how to improve your diabetic diet.  He or she may have suggestions on snacks or meals that you would not have considered to be sweet but can certainly satisfy your sweet tooth.  Such as eating a banana to satisfy a chocolate craving.  As time goes on you will begin to appreciate the natural sweet things in life too – such as a juicy apple or a fresh orange.

Because of all the risks and complications associated with poor control of blood glucose levels during pregnancy it is best to keep them in check all the time. But if there is a time during your pregnancy where it is considered more important to have your blood glucose levels under control it is when you are in labor.

If you have a very high blood glucose level while you are in labor, your baby is going to produce enough insulin to compensate for the sugar in your system. But what happens when your baby is born is he or she is no longer exposed to your high blood sugar and has an excess of insulin in their system. This will cause the baby to be hypoglycemic and can be quite dangerous for the baby.

For this reason, your baby’s blood sugar levels will be tested a few times after the birth. The test is administered immediately after the birth and when the baby is a couple of hours old. The blood is taken from the baby’s heel and is tested in the same manner as when you test your own blood with your glucose monitor.

When you go into labor, do not take any more insulin even if it is time for your next injection. When you go to the hospital be sure to bring your insulin and glucose monitor with you and advise all medical staff of your condition. Your doctor will give you more specific instructions to follow about nutrition and your blood sugar. When you pre-register at the hospital, ensure that you write down on your paperwork that you have gestational diabetes and who your care providers are. The more information you can provide the better the care you will receive when you are admitting to the hospital.

Birthday parties, Halloween, Thanksgiving, Christmas, and more are holidays and special occasions that are centered on food. For most people these are times to anticipate the celebration and the eating. For a diabetic it can be a stressful time, you want to partake in all of the good food too but most times it is not made with a diabetic in mind. If the frequency of these events is not too often, you can adjust your diet for special occasions so you too can have some of the treats available.

The hardest part about preparing for a special occasion is if you do not know what is going to be served. If this is the case, a quick call to your host or hostess can be made. Most people will not mind you asking especially if you have dietary needs that need to be taken into consideration. Once you do know what is being served, plan your meals for that day accordingly. You may want to have fewer carbohydrates with your breakfast and snack to make up for the extra ones you will have at a birthday party where pizza is being served.

Another option for special occasions is to offer to bring a dish for everyone to share. Make it something that you enjoy as a treat but still follows the guidelines for your diabetic diet.

For family favorites and traditions, be creative and look for ways to make the same dishes with less fat or sugar. You can do this by substituting regular sugar for sugar substitutes or choose whole wheat flour instead of white for the extra fiber content.

During the holidays and other occasions, closely monitor your blood sugars. Even with extra care, the change in your diet can still result in a blood sugar that is too high or low.

In order to diagnose you with gestational diabetes, your healthcare provider will order a test from the lab. There are two levels of the test that can be taken – the one hour glucose tolerance test and the three hour glucose tolerance test.

The one hour test involves taking a blood sample after you have fasted and then drinking a beverage high in glucose and testing your blood again one hour later. With the three hour version, you proceed the same except the drink has a higher concentration of sugar and your blood is tested each hour for three hours instead of one. The purpose of these tests is to see how your body reacts to and process the large amount of sugar in the drinks.

The American Diabetes Association lists the following blood glucose levels that would indicate gestational diabetes is present:

* Fasting 95 mg/dl or higher
* One hour 180 mg/dl or higher
* Two hours 155 mg/dl or higher
* Three hours 140 mg/dl or higher

If any two of the above readings come back in the ranges indicated you will be diagnosed with gestational diabetes. Once you have been diagnosed, you doctor will provide you with the blood glucose guidelines that should be maintained for the optimal health of you and your baby. They are:

* First thing in the morning – below 95 mg/dl
* One hour after a meal – below 140 mg/dl
* Two hours after a meal – below 120 mg/dl

There will be occasions when your blood sugar reading is higher than the recommended range. In that case, adjust your next meal. If you had planned on having a meal that was higher in carbohydrates it should be changed so that there is more protein. Protein helps to lower your blood sugar and carbohydrates convert to sugar raising your glucose levels.

Eating and pregnancy go hand in hand. Even though it doesn’t seem fair to be pregnant and not get to eat what and when you want it is healthier for you and your baby. The old adage of eating for two is true but many women overeat when they are pregnant and gain more weight than they should.

The more food that you eat in one sitting the harder it is going to be for your body to produce enough insulin to turn the sugar into energy. Not only is what you eat important so is the portion sizes. Your doctor or dietician will provide you with a meal plan and it is wise to follow it as closely as possible.

Since you will be eating smaller meals, you are going to need to eat more frequently to keep your energy up. The best way to do this is plan on eating six smaller meals throughout the day. You will keep a steady stream of nourishment going into your body and if you eat at the same time each day it will make it easier for your body to regulate insulin production and use.

A schedule that works for many women is to eat a small breakfast and then continue to eat approximately every two to three hours. This will include a mid-morning snack, lunch, an afternoon snack, dinner, and a bedtime snack. If you are still finding you are hungry in between meals or are finding ketones when you test your urine, consult with your doctor or dietician. They are sure to have suggestions to help you make changes that will work better for you. Such as eating more protein at meals or filling up on more vegetables (something that can be eaten as a free food at any time).

In a perfect diabetic world, you take your insulin, eat your meals and exercise and your blood glucose levels remain stable. But things happen, you take your insulin late, you eat a light meal and then spend all afternoon running errands. This is a recipe for hypoglycemia – a condition when your blood glucose levels fall dangerously low.

Hypoglycemia isn’t so much a hazard for the baby but it is for a mom with gestational diabetes. The best way to prevent this from happening is to know the signs and how you feel when you blood sugar is getting low and to carry emergency supplies with you at all times.

Some of the symptoms of low blood sugar include feeling:

* Hungry
* Nauseous
* Light-headed
* Faint

In the case of any of these symptoms, you should test your blood sugar right away and have something to eat. The best choice is a glass of juice or another food item that is considered fast-acting such as a piece of fruit or a piece of candy. Carry something with you at all times and a regular snack too. If you are out and need to eat (say you are stuck in your car during a traffic jam) it is important to have food with you.

Other precautions that you should take when you have gestational diabetes include carrying a card or another item that identifies you have diabetes and what type of insulin you are taking. The worse case scenario is you passing out and the people who come to help you need to know that you are diabetic. Make sure people at work and your family members are aware of your condition and know what warning signs to look for if you need help and when to bring your some juice or something else to eat.

In type 2 diabetes, the body is still producing insulin but it is not being utilized properly. This is known as insulin resistance. When a person is diagnosed with type 2 diabetes, there are more treatment options available to them as opposed to people diagnosed with type 1 diabetes.

Depending on the blood sugar levels in a patient, their weight and other health factors, the doctor will decide whether the diabetes can be controlled by one of the following methods:

• Diet and exercise – a healthy balanced diet with regular exercise can be used for people newly diagnosed with type 2 diabetes whose blood sugar levels are only slightly elevated
• Oral medication – is for patients whose blood sugars are higher than they should be but not to the point that necessitates an injection of insulin
• Insulin injections – a daily injection (or more) of insulin is needed when higherblood sugars are present

A type 2 diabetic may cycle through the different treatment methods throughout their lifetime. It is based on how well they are managing their diabetes and how their body is reacting to the treatment plan. Some people will never have to go past the diet and exercise portion and can gain control by maintaining a healthy body weight and eating the right foods on a diabetic diet.

Other people may start at diet and exercise but as the disease progresses may have to move from oral medication to injections over time. These changes will be determined by your doctor based on physical check-ups and the results of your daily blood sugar monitoring. If you would like to cut back on your medication or the type of treatment you are on, speak to your doctor about your goal and a plan can be put in place to better manage your diabetes.