Regular medical checkups
Your child needs to see his or her doctor every 3 to 6 months. During these checkups, the doctor will evaluate and adjust your child's treatment. The doctor will do a hemoglobin A1c or similar test (glycosylated hemoglobin or glycohemoglobin) to check your child's blood sugar control over the previous 2 to 3 months, and a blood glucose test.
If your child's LDL cholesterol is less than 100 mg/dL (2.60 mmol/L) and there is no family history of high cholesterol, the doctor will do a cholesterol (LDL and HDL) test every 5 years. If your child's blood pressure is consistently high and not reduced with weight control or exercise, the doctor may consider medicine.
When your child has had diabetes for 5 years, the doctor will start yearly screening tests for protein in the urine, which points to diabetic nephropathy. At that same time, your child needs to see an ophthalmologist for yearly dilated eye exams (ophthalmoscopy) to check for signs of diabetic retinopathy. If your child is at low risk for vision problems, your doctor may consider doing follow-up exams less often.
Treatment for high blood sugar emergency
If your child does not take enough insulin, has a severe infection or other illness, or becomes severely dehydrated, his or her blood sugar level may rise very high and lead to diabetic ketoacidosis. Diabetic ketoacidosis is almost always treated in a hospital, often in the intensive care unit, where caregivers can watch your child closely and give him or her frequent blood tests for glucose and electrolytes. Insulin is given through a vein (intravenous, or IV) to bring blood sugar levels down. Fluids are given through the IV to correct the electrolyte imbalance. Your child may stay in the hospital for a few days until blood sugar levels are back in the target range and electrolytes have normalized.
What to think about
For some children, using an insulin pump may help keep their blood sugar levels within a target range.
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
If your child has frequent low blood sugar levels, especially at night (nocturnal hypoglycemia), the doctor may suggest a continuous glucose monitor (CGM). A CGM reports blood sugar at least every 5 minutes, day and night. It sounds an alarm if blood sugar levels are moving out of range. The monitor stores the results, which allows you to look for patterns of high or low blood sugar levels.