Raising Awareness of Diabetes in Children - Part 3: Treatment of Type 1 Diabetes

by: Angie Mettille, RN, BSN, CDCES

When Type 1 Diabetes is diagnosed, children require a comprehensive treatment plan to manage their condition effectively. The Symptoms and Diagnosis of Type 1 Diabetes in Children were discussed in previous articles published in The Standard, Part 1 (November 6) and Part 2 (November 13).

Since the pancreas produces little to no insulin in Type 1 Diabetes, as discussed in Part 2, children with Type 1 Diabetes must receive insulin through injections or an insulin pump. Oral medications are currently not an option for Type 1 diabetes treatment, nor are the newer weekly injectable medications popular for treating Type 2 Diabetes.

There are different kinds of insulin available to help manage blood sugars throughout the day. Long acting insulins are designed to keep blood sugars lower over 24 hours. Short acting, or meal time insulin, is designed to act quickly with a shorter duration to decrease blood sugar spikes after eating meals or snacks.

Blood sugar monitoring is also vital to the treatment of Type 1 Diabetes. There have been advances in the way one can check the amount of sugar present in their blood, reducing the need to poke their finger multiple times a day. Continuous Glucose Monitors (CGM) involve a sensor that can detect blood sugars for 10-14 days and can be connected to a smartphone or handheld reader device. This allows people to check their blood sugars with less pain and needle pokes. These devices can also be integrated with an insulin pump, allowing the two systems to communicate about blood sugar levels and appropriate insulin doses, improving safety for those using them.

Nutrition is crucial. Learning how to maintain a balanced diet and meal plan are essential parts of diabetes management. A diabetes educator or dietician will assist with developing a meal plan that includes carbohydrates, proteins and fats while considering the individual’s unique insulin regimen.
Regular exercise will help improve sensitivity to insulin and overall health. Maintaining a healthy weight and adequate muscle mass can improve glucose levels and decrease the amounts of insulin needed to achieve this.

Breckan Stewart of Waukon was diagnosed with Type 1 Diabetes in January of 2017. “I was a very active 11-year-old, and basketball was in full swing. I was also playing volleyball and doing gymnastics. The days leading up to my diagnosis, I was extremely confused about why I was feeling so rundown; it was flu season, and I didn’t think much of it. For a week I had no appetite and was losing weight; I was severely thirsty and always had to use the restroom. I remember teachers at school telling me that I didn’t look good, and my parents were also concerned. The day before I was diagnosed, I had a basketball tournament. I was usually the first girl down the court, but I was now being lapped and couldn’t understand why. That evening, I couldn’t sleep and was in extreme discomfort. I was crying and couldn’t get myself to move. My friend’s mom brought me to my aunt, who then brought me to the hospital, where they confirmed that I had Type 1 diabetes.”

Breckan was quickly started on insulin after receiving her diagnosis, adding. “I’ve been taking short and long-acting insulin shots since my diagnosis. I’ve decided to continue with the shots due to being involved in athletics and not wanting anything attached to me. Insulin shots have been more convenient for me with my busy schedule.”

Breckan also monitors her blood sugar closely, saying, “I absolutely did not want a CGM when I first became diabetic, and it took several years to talk me into getting a CGM. My mom forced me to try it because I yet again didn’t want anything to be connected to me. I’m very grateful that she did because it has helped me manage my blood sugars better than finger pricks. I can now see my blood sugar at any moment just by opening an app on my phone.”

Angie Mettille, VMH Diabetes Nurse Educator states, “Breckan has had wonderful family support, helping her adapt to life with diabetes. As the years have passed, she has been helping others in the community cope with their new diagnosis of diabetes by her willingness to answer their questions and supporting them through the many challenges. She is now attending Clarke College, studying to be a nurse, and I know she will continue to help countless others in the years to come.”

“I have so much love and compassion for all children who are Type 1 Diabetic (T1D),” Breckan adds, “Diabetes has many ups and downs; the ride can be a little bit crazy. One quote that I’ve stood by since that first week in the hospital as a newly diagnosed diabetic is ‘If God brings you to it, he will bring you through it.’”

Meeting with a diabetes educator routinely is recommended in addition to clinic visits. Family members of the child and maybe even close friends can be involved with education so everyone close to that child can be aware of the warning signs of a dangerous medical situation. Young children usually need support with insulin injections and blood sugar monitoring. The best time for diabetes education with all patients living with diabetes, both Type 1 and Type 2, is:
1. When diabetes is first diagnosed.
2. Following an annual exam with a physician for a review of a treatment plan.
3. If complications arise such as vision changes, cardiac disease or stroke, kidney disease, neuropathy, persistent infections, or wounds that are not healing as they should.
4. Any changes in healthcare treatment, such as different medications, insulin delivery systems such as an insulin pump, or inquiry of continuous glucose monitoring.

Managing Type 1 Diabetes involves a multidisciplinary approach. Support from family and healthcare providers is key to helping children thrive and live a long and healthy life.

For more information, contact the Diabetes Education Department at Veterans Memorial Hospital at 563-568-3411 ext. 172.