Basal Bolus Safety Skills

Learn more about how to explain a type 1 diabetes diagnosis to your child.

Diabetes 101

What is type 1 diabetes?

• It is a disease that attacks your child’s pancreas and destroys important cells called beta cells.
• The beta cells stop making insulin.
• It is the second most common chronic illness in children.

What is insulin?

• Insulin is a hormone made by the beta cells in the pancreas.
• It allows sugar (glucose) to enter the body’s cells to give them energy.
• Your child needs this energy to think, play and work.

What happens without insulin?

• Sugar (glucose) is not able to enter the body’s cells to give energy.
• The sugar builds up in your child’s bloodstream.
• The blood sugar will go higher. Things will start to happen that are dangerous to your child’s health.
  • Your child’s body begins to break down fats to get energy (since the body isn’t getting energy from sugars).
  • Fat breakdown causes ketones.
  • High levels of ketones in the body will make your child very sick.
  • The kidneys try to send the extra sugar in the blood out of the body in urine.
  • This pulls water from the body and causes your child to urinate.
  • Your child will drink and urinate more as the blood sugar increases.
  • This leads to dehydration.

What is the treatment?

• Insulin by injection is the only treatment for type 1 diabetes.
• Insulin injections will replace the insulin your child no longer makes.
• There is no pill form of insulin.
• Meal planning and exercise also help control diabetes.

How did my child get type 1 diabetes?

• The exact cause is not known.
• There is a genetic (hereditary) risk.
• There is also an unknown trigger that causes the beta cells to die.
• You and your child did not cause this.
• There is no way you could have prevented it.

How will diabetes affect my child’s life?

• Your child is still the same.
• Your child can still do everything they used to do. This includes:
  • School
  • Sports
  • Driving a car
  • Going to college
  • Having children in the future

What is type 2 diabetes?

• The blood sugar is high but for different reasons.
• Insulin is still made by the pancreas, but does not work well (insulin resistance).
• People who are overweight, not active and have diabetes in their family are at risk for type 2 diabetes.
• Meal planning, exercise, pills and insulin injections are used to control type 2 diabetes.

Diabetes daily care

• There are diabetes tasks you and your child will need to do every day.
• You will receive a daily schedule to guide you.
• This involves:
  • Checking blood sugars at least four times each day
  • Giving injections of insulin before each meal/snack and at bedtime
  • Eating healthy meals and snacks
  • Exercising daily
• Your child needs to wear medical alert identification at all times.
• We will teach you and will be here to support you.

Why does my child need to wear a medical alert identification at all times?

• In an emergency situation, paramedics can provide the right treatment to your child.
• Have your child wear a bracelet or necklace.
• An infant or toddler should NOT wear a necklace because it is a choking hazard.
• Have your infant or toddler wear a bracelet or a medical alert ID on his shoe.
• Put a medical alert on your child’s car seat in case of a car accident.

Will my child have to go to the hospital more often?

• Most children are only admitted to the hospital when first diagnosed.
• Your child will not be sick more often than other children.
• Your child should not miss more school than other children.
• Your child will not have trouble fighting infections.

Can my child have children in the future?

• Yes, your child can have children.
• Pregnant women with diabetes are watched closely by their obstetricians to prevent problems during the pregnancy.

What are the chances of my other children or grandchildren getting diabetes?

• There is a 1 in 20 chance of a brother or sister getting diabetes.
• There is a 1 in 20 chance your grandchild will get diabetes.

What is good diabetes control?

• Blood sugars in target range most of the time (70% to 80% of the time).
• Your child and family take care of the diabetes while continuing to do the things they have always done.

Ideal blood sugar ranges

• Below are ideal blood sugar ranges for before meals:
  • Younger than 6 years: 80 to 180
  • 6 to 12 years: 70 to 165
  • 13 years and older: 70 to 150
• Aim to keep the blood sugar in range most of the time.
• Staying in range most of the time helps keep your child healthy.

What is the normal blood sugar range for people without diabetes?

• Blood sugars that are 70 to 110 before meals are normal for people without diabetes.
• It is not possible for someone with diabetes to always have blood sugars in this range.

What is the “honeymoon period?”

• Right after diagnosis, your child’s pancreas may still be making a little insulin.
• The amount of insulin given by injection will be lower.
• It is easier to control blood sugars during this time.
• The honeymoon may last several months to two years.
• When it is over, the blood sugars will go higher and your child will need more insulin.

What is my role as a parent of a child with diabetes?

• Learn how to become the best manager of your child’s diabetes. At first, you will contact the Diabetes Center at CHOP if there is a situation new to you or you have questions. Eventually you will know how to do a lot yourself.
• We will help you learn how to make decisions about food, exercise and insulin.
• Always make sure your child has diabetes supplies.
• Always make sure that your child’s diabetes care is done.
• Always make sure your child wears a medical alert identification.
• As your child gets older, help them learn to manage their diabetes independently.

What is my child’s role?

• They should help you by doing what they are able to do at their age.
• A young child may choose the finger for blood sugar tests.
• A school-aged child can learn to count carbs and record blood sugars in the log.
• An older child can learn to give injections.
• A teen can learn to put all the pieces of diabetes care together. However, parents still need to supervise their teens.
• Your child/teen must always wear a medical alert identification.

Find out what to expect from your child at different stages of development.

What is the role of the Diabetes Center?

• We will teach you how to take care of your child’s diabetes.
• We want you to become the expert in their care.
• In the beginning, we will walk you through all the decisions.
• As you learn more, you will make the decisions about your child’s diabetes care.
• As you become more confident, we will support your decisions.
• You can check in with us when what you have tried hasn’t worked.
• We will teach you how to manage your child’s diabetes during sickness or when they has ketones.
• We will help you prepare your child for independent diabetes management as they get older.

How often will we see our diabetes team?

• Plan to bring your child to appointments every three months.
• Plan to attend more education classes over time.
• At times, you may need other appointments for nutrition or family support.