Right now (Con’t)

Enlist food favorites.

After dosing rapid-acting insulin, it’s important to eat some food containing carbohydrate, but fussy eaters may refuse. Rose’s solution: Find a food item with the number of carbs your child is supposed to eat per meal, and make sure you have it at the ready. When her daughter Adalyne turned her nose yp at lunch or dinner, Rose would whip up a serving of oatmeal with about 30 grams of crabs.

Description: Enlist food favorites

Enlist food favorites

Set your alarm.

Prepare to check yout child’s blood glucose during the middle of the night (2 to 3 a.m.) as you adjust overnight insulin, to catch or prevent any hypoglycemic episodes and to log patterns. Overnight checks are also important if your child is ill ot physically active in the afternoon or evening. While there’s nothing you can do to prevent exhaustion from those interrupted nights, there are steps you can take to make the process easier. For starters,buy a headlamp, says Rose. It left her hands free for testing her daughter’s blood glucose in the dark.

Description: Prepare to check yout child’s blood glucose during the middle of the night (2 to 3 a.m.)

Prepare to check yout child’s blood glucose during the middle of the night (2 to 3 a.m.)

Many children, including those of the parents interviewed for this article, sleep right through nighttime checks. You will have to wake them, however, if their blood glucose dips too low. In that case, it helps to have a quickly digested source of glucose, such as glucose gel or juice, nearby.

Check blood ketones. On sick days (even with normal or only slightly elevated glucose levels) or when blood glucose gets too high – usually over 250 mg/dl – you’ll need to check your child for ketones. They are waste products that build up when there’s not enough insulin available in the body. Left unchecked, high levels of ketones can lead to diabetes ketoacidosis and even death. Most people with type 1 diabetes check ketones using a simple urine test, but the process is a bit more difficult for babies and toddlers who haven’t been potty trained. Talk with your provider about blood ketone tests that work similarly to blood glucose meters. But keep in mind, they’re less commonly prescribed than urine ketone test kits and may not be covered under your insurance.

Very soon

Inject with less pain. Most diabetes experts will tell you that needles today are tiny, and that’s true – they’re shrunk considerably since the advent of insulin. But that doesn’t mean shots are always painless. That said, there are steps you can take to make an insulin injection inflict as little pain as possible. Many parents rely on ice for injections. Numbing gel (available over the counter or by prescription) is a good option for insulin pump infusion set insertions, but it can take up to an hour to work.

Description: Are you using room-temperature insulin?

Are you using room-temperature insulin?

If your child is complaining about the pain of an injection, first consider your technique. Are you using room-temperature insulin? Injections hurt more when insulin is cold. Open vials or pens at room temperature can be used for 30 days. Cold insulin will also result in more air bubbles, increasing pain. (And you lose insulin to the air bubbles, a significant amount when it comes to child-sized doses.) Are you quickly poking the needle through the skin and keeping the barrel steady? When the tip of the needle rests on top of the skin, the nerves become irritated and pain is magnified.

The type of insulins you use may matter, too. Insulin glargine (Lantus) has a tendency to sting because of the preservatives in it. If it’s causing your child enough of a problem, talk with your endocrinologist, says Maahs, because he or she may prescribe insulin detemir (Levemir) instead.

Let ‘em play.

Gee encourages the kids she works with to participate in what she calls medical play. If your hospital doesn’t offer the activity, guide your kids through it at home by teaching them to give mock blood glucose tests and insulin injections (just make sure the syringe is empty and the needle is removed) to their stuffed animals. Even using a lancing device on a doll or toy can help kids see there’s nothing to fear.

Get rid of the guilt.

True, a diabetes diagnosis requires you cram a semester’s worth of knowledge into just a few days, but for most parents, studying up on the how-tos of diabetes management isn’t the biggest source of stress. That’s reserved for feeling guilty about testing their little one’s blood glucose and giving insulin injections. “When you’re pricking her finger, she just doesn’t understand,” says Red Maxwell, whose daughter Cassie, now 16, was diagnosed with type1 diabetes at 18 months old. “That can be really traumatizing for a parent because you’re hurting your child – the opposite of your instincts.”

Description: Get rid of the guilt

Get rid of the guilt

The key to shaking off the guilt, says Gee, is to change the way you view testing and injections. “In the first two weeks,” says Rose, “[my daughter] was very resistant to it, and it often took two of us to check her blood sugar, one of us to restrain her and one of us to test her. I had to separate it in my mind that every shot I was giving her was prolonging her life.”

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