Pediatric diabetes

Your Questions Answered About Diabetes

Questions about the disease

What is Type 1 diabetes?

Type 1 diabetes is the most common type of diabetes found in children but can occur in adults. This condition is when the pancreas, an organ in your body, is no longer able to make insulin.

What is insulin?

Insulin is a hormone in your body that acts as a key. It opens “the door” to let sugar into parts of the body where it is needed for energy. When insulin is not around, the sugar rises in your blood stream. This leads to increased urination (having to go to the bathroom), increased thirstiness and weight loss.

Why does the pancreas stop working?

First know that it is nothing that you did to cause this to happen. For reasons not completely understood, the immune system (that part of your body that protects you from infections) gets confused in Type 1 diabetes and attacks the cells in the pancreas that make insulin. It’s like the linemen on a football team getting confused and sacking their own quarterback.

How is Type 1 diabetes treated?

Type 1 diabetes is treated by taking insulin injections daily and learning how to adjust this dosing based on what you eat, what your goal blood sugars are and your activity.

Questions about low blood sugar or high blood sugar

What is a low blood sugar and how do you treat a low blood sugar?

A low blood sugar is 69mg/dl or less. To treat a low blood sugar, give 15 grams of carbohydrate, wait 15 minutes and recheck the blood sugar. If still low, repeat. For more details, see Low Sugar: Routine Treatment. If the child is unable to safely swallow, you should not put anything in his/her mouth, but instead give a glucagon injection. For more details on giving glucagon, see Low Sugar: Emergency Glucagon, as well as this Glucagon website.

What do I do if blood sugar is low right at meal time?

There are a couple options. Either option is safe, and you’ll get the hang of what works for your family in each situation.

You have a low blood sugar, so one great option is to treat this like you would normally, with 15 grams of carbohydrate. Recheck in 15 minutes and then dose your insulin for the 45 grams of carbs, as you normally would.

Another option is to treat the low with 15 grams of carbs by simply counting 15 grams of the 45 grams of breakfast as “free.” In this case you would dose the insulin only for the remaining 30 grams.

What do I need to know about diabetes and exercise?

Sports and activity can cause blood sugars to go up (from the adrenaline) or down (from increased insulin sensitivity that comes with exercise - a healthy thing). It’s important to check your sugar before such an activity and have Gatorade or other carb-containing beverages on the sidelines ready to treat any low blood sugars. After long, vigorous days of activity, some kids will have a delayed pattern of lower blood sugars, so if you have a field day or full day soccer meet, for example, check your sugar one extra time overnight (at around 2am) to watch for lower sugars.

What do I do if the blood sugar reads above 400 md/dl or higher?

Take a deep breath. Although this is certainly a very high sugar and we don’t want the blood sugars to stay in this high of a range, one high sugar is not going to hurt your child. Treat this with your usual correction dose of insulin.

If you notice sugars are greater than 300mg/dl for two or three checks in a row, check your child’s urine ketones and call us if they are positive. If the sugars stay greater than 300mg/dl for more than a day or two, your child probably needs more insulin, so let us know to help make this adjustment.

What do I do if I forgot the long acting insulin?

Give the Lantus now. As the saying goes, better late than never! Things happen and there may come a time that you forget to give the Lantus. If this is the case, as soon as you remember, do give the dose. Be mindful that it will last about 20-24 hours, so keep an eye on sugars, if there is some overlap with the following evening’s bedtime dose.

Questions about what to do when sick

I'm home sick from school! How do I keep from getting worse and developing ketones?

Refer to our Sick Day Guidelines for Children with Type 1 Diabetes

Can someone with diabetes take cold medications?

In general, children or adolescents with diabetes can take cold medications (Tylenol, cough syrups, decongestants) when they are ill. However, like anyone taking cold medications, it is important that the age limits and doses indicated by the manufacturer on the box are followed.

Cold medicine that is given as a syrup can contain glucose and the medications themselves can raise the blood glucose. As a result, when the blood glucose is checked later, a small correction might be required to account for the possible increase in the blood glucose from the medication. Many medications such as cough syrup are available in sugar-free formulas that can be used.

Also, remember when you or your child is sick, it is very important that you check blood glucose and give insulin per your sick day plan, whether or not they take any cold relief medications.

Miscellaneous questions

How do I contact the manufacturer for my blood glucose meter or pump?

Glucose meters:

Insulin pumps:

Continuous glucose monitors:

I've heard there are camps out there just for kids with diabetes. How do I sign up?

Diabetes camps are a great way to have fun in the summer and meet new friends. As a bonus, all the campers have diabetes, so you can share your own experiences, questions and ideas! In addition to counselors and camp leaders, diabetes camps are fully staffed with a medical team.

In Wisconsin, we have:

  • Camp Endeavor in Madison

  • Camp Lakota, located in Rosholt

  • Camp Needlepoint in St. Croix

Find all camps in Wisconsin

You can search for diabetes camps across the country:

Camps on the Pediatric Endocrine Society website

Does alcohol have an impact on Type 1 diabetes?

Alcohol must be broken down in the body after you drink it. Your liver is where alcohol is broken down. Your liver also stores sugar and responds to low blood sugars, releasing sugar into the blood stream. But when the liver is breaking down alcohol, it may not be able to raise your blood sugar. You have a much higher risk of a severe low blood sugar when drinking. Alcohol blocks a chemical reaction the liver needs to raise blood sugar. The risk of a severe low blood sugar occurs shortly after drinking and up to 24 hours later. Glucagon usually does not work if you have a low blood sugar from drinking alcohol.

What’s your risk?

You are at risk of severe low blood sugars when taking insulin (all Type 1 diabetes patients).

Guidelines for adults with Type 1 diabetes and alcohol

  • If you choose to drink alcohol, limit the amount and drink with food. The American Diabetes Association recommends limits of one drink for women and two drinks for men. Sip the drink slowly.

  • Never drink on an empty stomach. Eat a meal or a snack while drinking that includes both fat and some carbohydrates.

  • Don’t drink within two hours of exercise.

  • Check blood sugar frequently. Check blood sugar before going to bed and eat a snack with carbohydrates and protein if less than 140 mg/dl. Set an alarm to wake up in the morning.

  • Always let roommates or friends know you have been drinking and when you should wake up.

  • Wear your medical ID.

  • Never drink and drive.

  • It takes about two hours to break down one drink. The following are considered one drink:

    • 5 ounces of wine

    • 12 ounces of beer (light or regular)

    • 1.5 ounces of liquor (vodka, whiskey, gin, etc.)

How should I handle special treats on holidays?

Holidays can present a challenge because of different schedules and special food offerings. Ask your endocrinology team to help you plan for special events. The resources below contain carbohydrate counts for foods commonly available at different holidays:

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