If your child has recently been diagnosed with type 1 diabetes, you’ll need to be very involved in her care. It’s a lot to take in and make into a routine, but you’ll both catch on.
To understand how treatment works, it helps to know a little about what causes type 1. People with this condition don’t make insulin, a hormone that the body needs to turn food into energy. It’s typically made by the pancreas, but in people with type 1, the pancreas doesn’t work properly. Without insulin, sugar (also called glucose) stays in the bloodstream instead of moving into the cells. It can make blood sugar levels become dangerously high.
High blood sugar is managed by taking insulin. But how much a person needs varies because blood sugar levels change throughout the day. That means you or your child will need to check her levels often to figure out how much insulin is needed. Your child's health care team will teach you how to do this.
Your child may need her blood sugar checked as many as 10 times a day, including before meals, before bedtime, before exercise, and any time symptoms indicate that blood sugar could be shifting too high or too low.
If her blood sugar falls too low, she’ll need to eat a carb-rich food (like juice or candy) or use a product such as a glucose tablet or gel. If it drops dangerously low, she may need a glucagon injection.
Your child may need insulin to correct high blood sugar three or four times a day. There are different kinds and different ways of giving it to your child.
Types of Insulin
Your child's doctor will likely prescribe two types of insulin: one that has to get adjusted before meals and another that has a fixed (unchanging) dose.
Rapid-acting starts working about 15 minutes after you take it, peaks in about an hour, and lasts for 2 to 4 hours.
Short-acting (sometimes called regular) starts working in 30 minutes, peaks 2 to 3 hours later, and lasts between 3 to 6 hours. You figure out the dose based on your child's current blood sugar levels and how many carbohydrates she is going to eat.
Intermediate-acting starts working in 2 to 4 hours, peaks 4 to 12 hours later, and lasts for 12 to 18 hours.
Long-acting starts working several hours after an injection and lowers glucose evenly over a 24-hour period. Your child may take this once a day, such as before bedtime.
There are several ways that you can give your child insulin. Your child's doctor will advise you, but you'll probably start out using syringes or insulin pens.
Syringes are used to draw insulin out of a container and inject it into the body.
Insulin pens look similar to writing instruments. You dial up the correct dose and attach a needle that you use to inject insulin into the body.
Inhaled insulin is a new type of rapid-acting insulin that you breathe in. In people with type 1, inhaled insulin (called Afrezza) can only be used before meals and has to be used in combination with injectable long-acting insulin.
Insulin pumps are the methods of choice for many people with type 1. An insulin pump is a wearable device that stays attached to your body via a catheter. It gives you a steady dose throughout the day and can also give you an extra surge (called a bolus) before meals. You'll still have to check blood sugar (just as you would when using a syringe or a pen) before meals so that you can tell the device how much insulin you need at that time. Some new pumps also have monitors to alert you of highs and lows, but you set the dosage. Others can display information from a continuous glucose monitor, which tracks the levels every few minutes, 24 hours a day.
The Future for People of Type 1
Researchers are looking for new, better methods for treating type 1. A promising idea is the artificial pancreas. Throughout the day and night, the device automatically checks blood sugar levels and gives insulin based on those readings. It's not known when these devices may be available.