Parenting – What’s Best For Your Child and What’s Best For You

Parenting & Diabetes - Diabetes Supplies - Diabete-ezy

Helping your child to manage their diabetes can be exhausting and is often overwhelming. That’s why it’s essential for parents of children with diabetes to take care of themselves and to put into place coping mechanisms that work for them. Here, Elissa Renouf offers advice and shares some of her own experiences of how she, as a mother of four children with Type 1 diabetes, keeps calm and stays strong. Contains 23 Q&As

The moment your doctor tells you your child has been diagnosed with Type 1 diabetes, the whole world comes crashing down around you. Everything you have imagined for your child’s future now seems difficult, impossible even. I have had four, healthy, happy boys diagnosed at different times of my life yet the wave of emotions that comes each time is the same.

 

Reality Check.

You grieve for your child and for the life you thought they would live. This grieving period is to be expected and is totally understandable. However, your child may not initially share this sense of sorrow so be mindful of showing your distress too openly. I found that with each diagnosis it took me about six weeks to come to terms with the harsh reality of it all and get back into the swing of everyday living. You need to realise that your life won’t ever be the same (or at least until they’ve flown the nest). That said, once you get past all of the initial shock and adjust to your new way of living, it does become easier.

 

Seek Support.

It’s not easy…but it does get easier. I know what it’s like to walk along the street feeling that no-one around you has nay idea of what you must do to keep your child healthy. This includes getting up at one in the morning to test their BGLs and how they put up a fight when you give them injections. Remember, you are not alone – every day there are hundreds of parents fighting the same battles as you.

 

Some find that the best way to cope is through a support network – this could be their own family or friends, other families dealing with diabetes, organisations such as JDRF or online forums. If you look to friends or family, however, don’t be surprised if they’re not fully understanding of how you’re feeling. Unless you’re living with diabetes 24/7 it’s hard to explain to others just how extremely draining it is. While they’ll try their best to help make you feel better, you may just end up reliving your problems, which can sometimes make you feel worse.

 

Lighten Your Load.

Some families have found great support in seeing a diabetes educator. If you take this option, listen to what they tell you and take on board the information you find helpful. As a parent, there is constant pressure that you should be doing more for your child – I know the guilt I feel when a visit to the doctor reveals less-than-ideal BGLs. Remember, your doctor probably doesn’t live with a child with Type 1 for 24 hours a day.

 

You’re the one doing the hard yards, and doing the best you can is all that matters. Try not to let your sadness overwhelm you – you need to be strong, not only for your child but also for your family. I found that acceptance of the hand I’d been dealt helped me to take charge and live a fulfilling life.

Diabetic Living Magazine. Issue 51, 2014. Download this article as a pdf here.

I know better than anyone that there’s more than one side to diabetes. Among the immediate challenges are the insulin injections. If you thought taking your children to the doctor every few years to get their shots was stressful, you’ll now have to deal with the prospect of needles several times a day, which is especially difficult with a recently diagnosed child.

Kids can find it very hard to accept that needles are a regular and permanent part of their lives. They’ll cry and resist, their tears and anxiety making you feel as if you’re being punished for keeping them healthy – or worse, that you’re responsible for their pain. No loving parent should have to feel this way.

I found that a good way to handle the stress of daily injections was to create a reward chart, which I put up on the kitchen wall so the kids could see it before, during and after every meal (when they needed their insulin). I’d award a star for each injection they had without making a fuss. Three stars equalled a reward such as a milkshake or a snack, or playing a board game after school.

Other incentives, such as cooking their favourite dinner, hiring a DVD or going to play in the park, also work well. For extra motivation, you could set them the goal of reaching a designated number of stars every month. If they reach the target, they earn a bonus reward of, say, a day at a theme park or an afternoon tenpin bowling. The reward chart is a diversionary tactic – you’re turning a painful, ‘negative’ activity into something that’s fun and positive. However, be careful with food rewards – depending on what you give them, it could mean more needles, defeating the whole purpose of the exercise!

Most parents will also have to deal with the emotional side of diabetes. Early on, your child is likely to ask themselves, ‘Why me?’ and will turn to you for answers. Don’t sugarcoat the truth. I explained everything clearly from the very beginning. Children are smarter than you think, and if they suspect you aren’t telling them everything, they will imagine the worst.

Talking to your child as an equal rather than a kid is a good way to help them feel better about themselves and will, hopefully, make managing their diabetes easier. You can’t hide diabetes from your child; the way to go is to just accept it and move forward. Also, be prepared for a period of blaming yourself. After each of my four boys’ diagnoses, I found myself grieving, believing that the future I’d imagined for them was now going to be different. This is completely natural and you do get over it. The most important thing to remember, even when you feel you’re hurting your son or daughter with those needles, is that it’s not your fault. In fact, you’re helping them to learn to live the healthiest life possible, and that’s a precious gift.

Diabetic Living Magazine. Issue 50, 2014.

Like any other mother, I try to handle whatever life throws at me and to give my children the best start in life. Of course, sometimes it’s not as easy as it looks. Having to be switched  on 24/7 can have its downfalls and impact negatively on my health, which in turn can affect my kid’s wellbeing. And if a carer doesn’t look after themselves, they won’t be able to care for others properly. This is why they really need to take time-out regularly to recharge their batteries, but to also feel no guilt about doing so.

It took me a couple of years to realise just how important this is. However, after three of my sons were diagnosed with Type 1 within a two-year period, it started to really impact on my life and state of mind, so a counselor recommended I take time-out to rediscover who I am as a person and suggested I visit a health retreat for some R and R.

Knowing that I needed a break, Steve encouraged me to go while he looked after the kids. I booked into a place on the Gold Coast that seemed to be offering what I needed, but having never been away before, I was apprehensive. Despite my misgivings, it turned out to be one of the best weeks I’ve ever had. There was good food, great exercise and, most importantly, for the first time in many years I remember who I was outside of being a carer – it felt fantastic.

I realised it’s like servicing your car. As a carer, you may think you can’t afford to look after yourself, but preventative health actually works out cheaper in the end. While it isn’t always an option (or affordable!) to go away for a week on my own, I do make a point of regularly taking a break to look after my own needs. It may be having a coffee with a friend, going for a walk in the park on my own, or sitting under a tree for an hour with a good book. I might even plan a weekend away with girlfriends. Spending time with my animals always makes me happy, too. We have several farm animals and three dogs. They help bring me back to just being and enjoying the moment.

Over the years, my family has come to recognise how much I benefit from taking time-out for myself. So much so that when they see signs that I’m becoming stressed, they’re the ones who suggest I arrange to do something fun, or that I book into the health retreat again. It’s a win-win situation, as the more relaxed and energised I feel, the better equipped I am to support my family with their everyday challenges. It makes for a more positive vibe all round.

Diabetic Living Magazine. Issue 47, 2013.

Well, our three months are up and we’re due back at the diabetes clinic. Finding out your kids’ HbA1c results and how well controlled their sugars have been can be really nerve-wracking – I always feel I’m about to be judged on how good a parent I’ve been. I beat myself up, thinking that I should have done more, got the kids to test more, recorded more results, watched more closely what they were eating and scrutinised more carefully how they were programming their pumps. More, more, more, more!

It’s a huge mental challenge looking after a child with diabetes, without the added challenge of guilt. Guilt, I feel, is something that just goes with the territory – no matter how involved or well-organised you are. As parents with the responsibility of overseeing and supporting our kids to be their diabetic best, there are times when we’re too hard on ourselves. Instead of feeling we’ve failed because our child’s BGLs are out of whack or we miss signs of an approaching hypo, we need to remind ourselves of our daily successes. So seek out a close friend or family member who really knows what it takes to look after your child, ask them if you’re doing a good job and you can pretty sure their honest response will be, ‘Most definitely!’

When we’re being harsh on ourselves, we should take a step back and ask ourselves if it’s the kids with the condition… or us. Diabetes is unpredictable, and so is life. We don’t live in a perfect world and there will be times when we’re thrown a curved ball that we just couldn’t have anticipated – when your kid has a hypo away at school camp, overdoes it on the sports field or overdoses on chocolate cake at a party.

This can, understandably, raise your stress levels, but your reaction can make your child anxious, too, upsetting their blood sugars even more. As parents, we need to get out of our heads and stop worrying about the negatives, accept the hand we’ve been dealt and move forward. Kids pick up a lot from watching our behaviour so, if you have a positive outlook, they’ll know no other way.

Don’t feel judged on your child’s HbA1c – doctors and educators know how hard it can be to manage diabetes and are there to help. If there’s room for improvement, look to the future and choose one thing you can change in the next three months. The other day, my 20-year-old, Sam, came home from the clinic with the news that he could reduce his HbA1c by 0.2 per cent with just one more test a day.

The most important thing in my life is having happy, positive children – even if it takes a little bribery to keep them on track. But although I’ve promised mine a monetary reward if they can get their HbA1c in the sixes, unfortunately I haven’t had to pay up yet!

Diabetic Living Magazine. Issue 45, 2013.

When it comes to diabetes management, I’m a big believer in encouraging people to educate themselves on everything to do with this condition. Your healthcare provider can offer you the proper guidance, education and self-management tools from the outset, which will ultimately help to control your daughter’s BGLs and reduce the risk of high BGLs and severe hypos. However, no-one knows your daughter’s diabetes like you or her. In the end, your healthcare provider’s advice and knowledge is invaluable, but that doesn’t mean you can’t ask about a suitable alternative. While they are very well informed, they can’t always know everything about your daughter and your lifestyle, so never be afraid to speak up.

Diabetes is a lifelong condition. It involves making certain life, treatment and management changes, which is why keeping informed and empowered gives you the ability to be the ultimate judge on what works for your daughter and the whole family. Quality healthcare is a team effort. Asking questions and providing information to your healthcare provider will help improve your daughter’s care, build trust and can lead to better results. While, clearly, we need to accept professional guidance if we are barking up the wrong tree, there is no harm is exploring new therapies or techniques that appeal to you and your daughter, for example, insulin pump therapy or the option of the DAFNE (Dose Adjustment For Normal Eating) program.

Your healthcare provider shouldn’t automatically dismiss your, or your daughter’s, interest in a new therapy, if you can see benefits. It’s sometimes necessary to question whether you’re getting the service you need. Are they up to speed with new developments, or do they believe that the tried and tested path is always the best? If they do dismiss these ideas, ask them to give you solid reasons why. If they can’t, then it’s appropriate to ask them to look into it. Don’t just take no for an absolute answer.

Remember, there are other options and opinions and it is worth taking the time to investigate and listen. It’s okay to politely challenge your daughter’s healthcare provider, or even feel you can source a new specialist if you don’t believe your daughter is getting the support or up-to-date management she needs.

In my household, as you imagine, with five diabetics all with different needs, keeping sane and happy means investing the time to find out what works best for each individual, and taking control!

Diabetic Living Magazine. Issue 44, 2013. Download a copy of this article as a pdf here.

1. Allow your child to make decisions on their foood choices.

Cakes, lollies, soft drinks – they can have them all (within reason), as long as they remember to put in the required insulin to cover that food. I found it best not to baby my sons too much when it came to their diabetes. It was up to them to choose between having extra insulin to cover the treat, or to go without the sweet food.

2. Never use diabetes as an excuse.

People with Type 1 can still play sport, attend birthday parties and eat what they want, like everyone else – they just need a little special consideration from time to time. Don’t hold your child back from anything you think they won’t be able to handle, as kids are often a lot smarter than we give them credit for. I have three – nearly four – teenage boys, and sport plays a big part in their lives. They all have insulin pumps and play a range of sports such as football, rugby, tennis and cricket. I have instilled in my kids to never use their diabetes as an excuse for anything. They’re now quite independent and capable of knowing when to test and when to give themselves extra insulin.

3. Step in to help where you can.

Constant testing and injecting can be monotonous for your child, and may leave them feeling burnt out or frustrated. You can help by doing simple jobs for them, such as setting up their blood glucose meter so it’s ready to test, or priming their needles. It may not seem like much to you, but this is a huge help to them, making them feel supported.

4. Listen to advice that’s beneficial for you.

In my experience, educators and endocrinologists have a wealth of tips and info on managing diabetes, but not all of it will be appropriate for your child. Being familiar with your child’s day-to-day needs will help you know which advice is relevant.

5. Stay positive when you help your child.

This will have a lasting effect, not only on your child, but also on your family and the way they look at diabetes for the rest of their lives. You child’s HbA1c result can make you feel as though you’re being judged on how good a parent you’ve been for the past three months – I know it does for me. However, it’s important to understand that, despite constant testing and insulin adjustments, keeping your child’s levels between 4-8mmol/L is often impossible, no matter how hard you try.

A book that helped me stay positive and get through the early years of diabetes diagnosis is The Power of Now, by Eckhart Tolle. It taught me to forget yesterday’s problems, not to worry about tomorrow, and just live in today. Often, you can’t change the situations you’re faced with, but how you handle them can make all the difference.

Diabetic Living Magazine. Issue 40, 2012. Download a copy of this article as a pdf here.

Towards the end of term, I find that my children often show signs of burnout as their energy reserves run low. This is especially true as the end of the school year approaches, when activities such as exams, assignments, sport, music and even the longer days can wear them down to the point of exhaustion. Outside interests like catching up with friends or extra sport can just suck that last bit of energy out of them.

 

This is something many students experience. But when they also have diabetes, it may be the final straw that tips them over the edge. When my kids are tired, they’re liable to get stressed out. Not only are they unable to work well at school but also – and more worryingly – their diabetes management slackens off because they just don’t have what it takes to stay on top of it. Stress can also send their BGLs all over the place, which can cause them even more stress.

 

To prevent all of this, I try to make sure that they go to bed at an appropriate hour, as sleep is one of the most important antidotes in combating the exhaustion that leads to stress. I work a little closer with them in helping to manage their diabetes, which may be as simple as setting up the meter for them to do a BGL test or even programming their levels and carb serves into their insulin pump.

 

If I see my kids are still tired and not coping, I step in fast to make sure they have some time to themselves to recharge their batteries. This may mean skipping a sports training afternoon so they can go straight home after school, or allowing them a day off so they can just veg out. I find this really does the trick and they wake up the next morning with a little more spring in their step.

 

As you can imagine, ours is a busy household – four of our five children are at school, with three of our boys playing football of some sort and each of them playing musical instruments. My daughter does athletics, dances and also plays piano. Our eldest son is an electrical apprentice and Steve and I are both working. So there’s a lot of potential for stress and it’s not just an issue for the kids! Parenting a child with diabetes is a full-on job and, as parents, we also need to look at our own workloads and pressures, then consider whether we are the ones who really need to take some time out to recharge our own batteries.

Diabetic Living Magazine. Issue 35, 2011. Download a copy of this article as a pdf here.

I encourage my kids to enjoy their friendships in the daytime, as sleepovers are not allowed. This way there is no drama in turning down invitations, where other families have limited understanding of dealing with the needs of children with diabetes. As your daughter becomes more adept at managing her condition, you may feel comfortable in negotiating sleepovers terms – agreeing to it on the condition that she tests her BGLs and eats sensibly. Or you could send over your own food and explain she can only eat this.

Diabetic Living Magazine. Issue 26, 2010. Download a copy of this article as a pdf here.

Moodiness is all part of adolescence, but it sounds like your daughter is having a real difficulty coming to terms with her diabetes and may need outside help. Depression is not uncommon among people diagnosed with diabetes, so tell your GP about your concerns and discuss the possibility of counseling. Your GP can then talk about this at her next appointment.

Diabetic Living Magazine. Issue 26, 2010. Download a copy of this article as a pdf here.

Encourage your son to pack his own lunches with your help. This way, he gets a say in his food choices, but you offer guidance. Also, talk to him about what you can do to make him feel less different. Inviting his friends for a sleepover may give them a better understanding of diabetes. It would also be a good idea to make an appointment with his diabetes educator to discuss your sons needs and how best to manage them.

Diabetic Living Magazine. Issue 25, 2010. Download a copy of this article as a pdf here.

I don’t know what the psychologist suggested, but what worked with my boys was a reward chart. If they took their injections with out any drama, they’d get a sticker on the chart. After five stickers they’d get a reward like going to the park or having a friend over to play. If there is something your son's really keen on, you could make this his reward for getting 25 stickers. It’s a really effective distraction that has helped my kids achieve some great goals.

Diabetic Living Magazine. Issue 23, 2009.

Ask your mother-in-law to provide sugar free lollies or save sugary sweets for when your daughter needs a blood sugar top-up. Maybe she doesn’t realise the work that goes into keeping blood glucose levels under control. If she knew a few lollies could mean an extra insulin injection, she may feel differently.

Diabetic Living Magazine. Issue 23, 2009.

We have a psychologist at our diabetes clinic and she has been helpful when I’ve needed to discuss issues affecting my boys. She is also there to talk to kids or young adults on their own. There may be issues behind your daughter’s stress that she may feel more comfortable talking over with a psychologist or counselor rather than a parent or friend. Your GP can also suggest someone and provide a referral.

Diabetic Living Magazine. Issue 22, 2009.

It sounds like the ‘honeymoon period’. This is when the pancreas kicks in again - usually for a short time after the insulin regimen has started. It can last from a couple of days to a couple of months. As a parent of a newly diagnosed child you would of course like to think the diabetes is going away, but it’s highly unlikely. Eventually you’ll find that the insulin dose will increase and the honeymoon period will cease.

Diabetic Living Magazine. Issue 21, 2009.

Explaining to your daughter the damage that can be done to her body if she eats foods containing gluten is very important. If my children with coeliac disease go to a friends place or party, I always take some party food with me to place on the table for everyone to eat. This helps them to feel normal and hopefully discourages them from eating the wrong food.

Diabetic Living Magazine. Issue 18, 2008.

I am quite a tough mother when it comes to the kids spending time outdoors. When they haven’t been outside for a while I place a ban on all screens for the day – No TV, computer, or Nintendo DS. Try that - you may be surprised how they occupy themselves.

If this still doesn’t get them moving, I tell my kids they have to go outside and are not allowed inside for an hour. It may seem tough but sometimes you have to be in order to be a good parent. I would also encourage them to play a team sport – they can be with friends and get some regular exercise as well.

Diabetic Living Magazine. Issue 16, 2008.

We do night tests because we can catch hypos early and correct any high levels, which reduces the risk of long-term complications. Our kids are still growing and developing so what I do now will help them grow into healthier adults. Steve and I began this system where we take it in turns – one week on, one week off. From Friday to Friday, the person who is ‘on’ has to do the 9:30pm and 1am test. This way the other person can have the week off to catch up on sleep. If you can get this type of support it will make you feel a lot better.

Diabetic Living Magazine. Issue 15, 2008.

I sympathise - every time I tell someone my kids or Steve has diabetes, I have to explain it. I say Type 1 is caused when the beta cells in the pancreas stop producing insulin, usually affecting people under the age of 30 who then require insulin injections for the rest of their life. Type 2 is caused when the pancreas doesn’t produce enough insulin – due to either heredity reasons, poor diet, obesity or lack of exercise. It is treated through diet and or tablets and or insulin.

I feel the medical profession should look at the names they have given to this disease and call, for example, Type 1 ‘autoimmune diabetes’ and perhaps have two different names for Type 2: ‘lifestyle diabetes’ (if caused by obesity and inactivity) and ‘hereditary diabetes’ (if caused by genes). This may help the community to better understand the needs of people with diabetes.

Diabetic Living Magazine. Issue 15, 2008.

There is no secret, you just have to do it. I have to accept it and try to be as positive as I can. By being positive, I can teach my kids to be positive too and how to best look after themselves. Plus, I can be more open to understanding the ups and downs of managing their diabetes. I try never to blame myself for a hypo or a high they may have. Instead, I try to learn from the situation. I forget yesterday, I don’t think about tomorrow, I just concentrate on today. I go by this Winston Churchill motto – 'A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.'

Diabetic Living Magazine. Issue 13, 2008.

It's important to seek medical advice as soon as you suspect something so you reduce the risk of complications caused by high blood glucose. We first thought there was a problem when our son Charlie asked for his drink bottle to be refilled when he’d already had more water than usual. We used Steve’s blood glucose monitor and tested Charlie - his blood glucose was 21mmol/L! We washed his finger and retested incase he had sugary food on his finger. The result was 20mmol/L, confirming our suspicions. We called the hospital who asked us to come in straightaway. If we had left it a few days, he may have needed time in intensive care. Instead Charlie spent two nights in hospital, mostly for education, them he was home running around as normal.

Diabetic Living Magazine. Issue 12, 2007.

When Charlie, our fourth child, was diagnosed with Type 1 at three, I felt I could handle this challenge, but was still very upset for Charlie at the loss of freedom he faced in dialing with this for life. I felt a little self-pity too, having to take on managing his illness, plus rearing five children under nine. Having watched my husband, Steve, coping with diabetes, I knew I was up to the task and would do my best to help Charlie in a positive way.

 

The first 4-5 weeks were the hardest. There was so much to learn about diabetes. One day, while feeding my animals (70 of them at this time), Steve called and I had a meltdown, explaining I would have to get rid of my much-loved pets to manage Charlie’s diabetes properly. But we found our feet, got into a routine and things settled down. I still have my pets, plus more – 101 in total.

 

While Stevens’ Type 1 had helped us garner a lot of diabetes knowledge, attending our hospital's new-patient clinic was a great help. I learnt that all my feelings of being upset and overwhelmed were very normal. Four of my five kids now have Type 1 and each time a child was diagnosed I'd attend a new-patient clinic. It's been a huge benefit in helping me handle and fully understand everything we should do to cope the best we can. I would urge parents to take advantage of any diabetes information days in their area because they bring you up to date on new developments to improve day to day care.

 

I believe diabetes is as hard as you want it to be. As a family, we treat it very seriously but very positively. Diabetes is not going to disappear, so the only way to truly cope is to embrace and accept it. I’ve tried to never use or allow my kids to use diabetes as an excuse. I try never to say things like, ‘you can’t eat that’ or ‘you’ve got to eat this.’ Its important a child with diabetes eats all their dinner but if, as a parent, I’m saying “you have to eat everything because you have diabetes’, they’ll hate their diabetes. But if it’s a family rule that everyone eats everything on their plates, then that's just the family rule! And there won’t be any negative feelings.

 

As for not being able to eat certain foods, I let my kids eat everything, including ice cream, lollies and soft drinks as ‘sometimes foods’. This way they can still feel normal. I substitute the ‘sometimes foods’ for a routine food of similar carb value or give the kids a choice: they can have an extra insulin injection to cover the carbs or go without. It always amazes me to see a three year old choose an extra needle so they can have an ice cream. But making it their choice gives them some control – after all, it’s really theirdiabetes.

Diabetic Living Magazine. Issue 29, 2010. Download this article as a pdf here.

Every family has different ideas about play dates, sleepovers and diabetes. At some stage we have to allow our children to become more independent and take on more responsibility for managing their diabetes and themselves.

 

Soon after my son was diagnosed with diabetes, he was invited to an afternoon play date at a friend's house. Although I felt quite anxious, I agreed, but took him there well prepared. I provided a carbohydrate snacks for the boys to share, as well as a blood glucose meter and some jelly beans. When I dropped my son off I gave his friend's mum a quick rundown on when and how to use the tester and interpret the results. I also explained about hypo symptoms and treatment. The personalised diabetes management plan provided backup information on dealing with an emergency. As well phone numbers for Steve and myself so they could always ring if they needed to check in with us. The result was a positive experience of all involved.

 

I found it was much easier for my boys, and me for that matter, if their friends came over to us for the first sleepover. This way I didn’t have to feel bad about asking the family to test the boys at 1am. After a couple of successful experiences I then had the confidence to let them go on sleepovers, although I’ve always given the host parents a copy of their diabetes management plan and provided the boys with extra food just in case.

 

As my kids have matured they have taken on more responsibility in their diabetes management at home, giving me confidence that it's second nature to them when they are out and about. Usually, I find that when they do go to their friend’s places they stay up later anyway, so I get them to either text or phone me with their levels before bedtime. Once they are around 13-14 years of age, though, they know their own bodies and I am happy for them to make their own decisions on what they need to do.

 

Since my boys have gone onto insulin pumps it's taken a lot of stress out of leaving them with someone or having sleepovers. It's so much easier for the kids to correct a high level that have to talk the carer through giving an injection. It's a relief to feel a sense of assurance that everything is under control, even when I’m not there to keep an eye on them.

Diabetic Living Magazine. Issue 32, 2010.

I know how you must have felt. Illness can really throw a child’s body out of whack. And the risks of diabetic ketoacidosis (DKA) were explained to me while my boys were first diagnosed. If one of them was out of sorts I knew I had to be on the alert for symptoms such as excessive thirst, increased urination, tiredness, nausea, restlessness, fruity-smelling breath, and tummy pains. Because blood glucose levels are likely to go high when a body is fighting infection, I was primed to carry out frequent tests and if the doctor advised it give them extra insulin injections. This way we managed to avoid DKA for a long while, but when it happened I was taken aback by the speed with which a child can go from being mildly unwell to very ill.

 

DKA happens when a lack of insulin means the body can't burn glucose for energy and instead breaks down fat, which releases chemicals called ketones into the bloodstream. This causes the blood to become more acidic and the imbalance can be life threatening, needing immediate treatment.

 

My first experience of this occurred after our boys moved onto insulin pumps, although this has been a great success overall. The difference with a pump is that it only administers short acting insulin, so if they don’t receive enough of it they can develop DKA very quickly. Unbeknown to us, one of our boys had a kink in the cannula delivering insulin to his body and his supply was cut off. After only a few hours he had symptoms of ketoacidosis, and even though we were correcting his high blood glucose levels, the lack of insulin delivery meant that they kept on rising. By the time we changed and revisited his cannula, he was feeling very unwell. So we called our endocrinologist for advice.

 

He explained to us how to adjust our sons insulin dosage to bring his levels down to normal, warning us we should take him to our hospital emergency department if there was no change within a couple of hours. We continued to test his blood glucose levels and kept him well hydrated and his levels slowly came back to normal, with his pump performing fine. Checking a sick child for DKA can easily be done at home with either urine test strips or a simple finger-prick (Abbott Diabetes Cares Optium Xceed blood glucose meter also tests for ketones), putting you in the picture and fast tracking urgent treatment.

Diabetic Living Magazine. Issue 33, 2011.

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