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    Diabetic children

    6% of the population is diabetic; from that group only 8% are children or young adults.

    Almost all of the children are diagnosed with type 1 diabetes. The diagnosis is confirmed by frequent urination, excessive thirst, considerable weight loss, high blood sugar level (>11 mmol/l) and presence of ketones in the urine.

    The parents must be present and involved until the child is mature enough to show that he can make wise choices.

    Newborn up to 2 years old

    Task (tests and injections)

    - At the age of 2, the child can participate in simple tasks, such as, wiping clean his finger for the test

    - The parents should get the child to choose between two places he prefers to get his injection or taking his blood glucose test

    - The child should be holding a doll or a favorite toy.

    - The parents should play with the child, by first pretending to inject the doll and then injecting the child

    - The child should be held firmly for the injection to keep the site uncovered

    - The parents should hug their child after the injection and then go on with their daily activities

    Food and diet

    Parents should:

    Gradually incorporate some foods

    Have a diet and food suited to the child’s age

    Serve frequent small meals

    Consult medical staff for adjustments or changes in food

    Have meals and snacks taken at regular hours

    Strategic management

    Parents should:

    Ignore the child’s temper tantrums so that the child will not be rewarded for his bad behavior

    Establish limits. Do not permit ifs and buts. That can make the procedure a lot more difficult

    Discard hypoglycemia: take a blood test for all different symptoms (bad mood, drowsiness, etc.) and treat it accordingly.

    Preschoolers: 3 to 6 years old

    Task (tests and injections)

    Parents should:

    Use a game to reduce fright (the toy or doll gets tested and the injection)

    Reinforce the importance of the injection area rotation

    Get the child to choose his injection area

    Food and diet

    Parents should:

    Encourage a well balanced diet

    Serve attractive and colorful foods

    Do not reprimand small spills

    Permit food adjustments for Halloween, birthdays and special occasions

    Encourage the child to participate in preparing meals and snacks

    Have a food exchange chart on the fridge door and let the child choose new proper foods

    Strategic management

    Parents should:

    Offer a choice when  possible

    Reassure the child that the treatment is not a punishment

    Establish a limit to bad behavior

    Give the child the possibility to express himself, accept and answer

    Keep the routine and parental authority to a simple level, with no big demands

    Keep a daily routine schedule

    Give the child some control

    Rethink the signs and symptoms after a hypoglycemia. The treatment and prevention should be explained to the child’s understanding level

    For activities, teach them to take extra food

    Always keep sugar with them in case of emergency

    Inform the preschool teacher, the babysitter and school personnel of your child’s illness

    Reinforce the importance of always caring a good I.D. (Medic Alert bracelet or necklace)

    Primary school: 6 to 12 years old

    Tasks (tests and injections)

    From the age of 6 to 8 years old, the child can take his own tests and read the results, under adult supervision

    From 9 to 10, the child can learn to prepare his insulin and inject it always under an adult’s supervision

    Food and diet

    Parents should:

    Plan food adjustments for vacation days, parties and school outings

    Consult a dietician for a diet evaluation

    Plan meals and snacks in time and with no distractions (T.V., being late for work, etc.)

    Strategic management

    Parents should:

    Concentrate their efforts on practicing the tasks so that the child may be proud of his accomplishments and capable of doing so.

    Frequently give the child simple explanations and keep a constant supervision

    Inform the school or the babysitter concerning hypoglycemia

    Encourage the child to attend the diabetic summer camp

    Teach the circle of acquaintances in recognizing and treating hypoglycemia properly

    The child should always carry on him a proper I.D. (Medic Alert bracelet or necklace)

    Teenagers

    Tasks (tests and injections)

    All teenagers should be able to accomplish all the tasks under little supervision

    Food and diet

    For special occasions, meals can be reprogrammed or readjusted. Teenagers should respect the exchange in the different food categories. They should adjust their diet according to their activities, growth, height and weight. The diet should also be adjusted after they have stopped growing.

    Strategic management

    Parents should:

    Recognize and accept the growing need of independence of their teenager, not only in regards to diabetes, but also concerning all aspects of their lives

    Avoid criticizing all the time. The teenager has enough mood swings

    Know that teenager have a very important self image issue. Congratulate them on the tasks that they have accomplished

    Give them the permission to make decisions concerning their treatment

    While being interested and available, gradually encourage the teenager to self manage his diabetes

    Teenagers should:

    Recognize, treat and prevent hypoglycemia

    Be able to contact the right person if he needs information or advice

    Know what to do on sick days

    Wear a good I.D.(bracelet or chain)