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the child likes to eat and any additional questions that would make you feel comfortable caring for the child when she is in your home. You also might have playdates with the parent present until you feel more knowledgeable about the care involved. The majority of youth with diabetes have type 1. A child with type 1 diabetes does not make insulin as cells in the pancreas are damaged — which usually leads to a total lack of insulin production. Insulin must be given through injections or an insulin pump to control blood glucose levels. Insulin taken by injection or pump does not cure diabetes. A child with type 1 diabetes will always need insulin as diabetes is a chronic illness that does not go away. Type 2 diabetes has been shown to be on the increase in youth. The increase may be due to the rise in obesity and decrease in physical activity. A child with type 2 diabetes does make insulin but the body may not use it properly so the blood glucose level may be elevated. The child needs to adhere to a management plan that may include diet and exercise alone or may require oral medications and/or insulin injections. All children and teens with type 1 and type 2 diabetes must monitor food, medication and activity lev- els carefully to keep blood glucose levels as close to normal as possible. The extent of involvement in diabetic
self-care by children and teens depends on their motor development, ability to understand their individualized treatment plan and emotional maturity. The family and school should encourage and sup-
Ready, Set, Grow
Children and teens usually test their blood sugar four times a day
port their capabilities and willingness to participate.
School-age children gradually assume
more involvement with insulin injections and blood glucose testing with adult supervision. They still need help with de- cision making about insulin adjustments as the amount of insulin a child receives depends upon the blood glucose level at meal time, the amount of carbohydrates that will be consumed at the meal and the expected level of physical activity. Children and teens usually test their blood sugar four times a day and either receive multiple injections per day or administer insulin as needed through their pump. The goal for children and teens is to establish positive diabetes-related behavior patterns and maintain glucose levels as near to normal as possible. When diabetes is poorly managed and poorly controlled, it can lead to serious short- and long-term health outcomes. The short-term complications of poorly controlled diabetes are hypoglycemia or hyperglycemia. Hypoglycemia or low blood sugar may
be the result of too much insulin, delayed food, not enough food consumed at meals or missed meals, or excessive physical activity that was not planned for. Too-low blood glucose levels can result in an
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