One of the diseases found in children that parents often do not expect is “diabetes in children”, which can occur in children under 1 year old. This causes some parents to lack knowledge and have questions such as “If my child has diabetes, how should I take care of them?” How can this disease be treated? Can the child be cured of diabetes? We have answers from Dr. Nuanphong Rianmanee, a pediatric endocrinologist specializing in diabetes and growth, Child Health Center, Phyathai 2 Hospital to share with you.
“Diabetes in children” How is it treated… and can it be completely cured?
Treatment of type 1 diabetes in children
- For patients with high blood sugar levels, acidosis, and high blood ketones, the treatment is to administer insulin hormone intravenously. In this case, the patient must be in the ICU because intravenous insulin administration requires close monitoring as the dose may be too high or too low. After the blood acidity improves and blood ketones decrease, the doctor will switch the treatment to subcutaneous insulin injections instead.
Because type 1 diabetes is caused by the destruction of pancreatic cells, patients must receive insulin hormone for life, but the dose can be reduced if the patient controls their diet and exercises, allowing good blood sugar control.
This differs from type 2 diabetes, where at the beginning of treatment, doctors will prescribe oral medication along with exercise and diet control. If the patient changes their lifestyle behavior… this group has a chance to stop using medication in the early stages of type 2 diabetes.
When “your child has diabetes,” how should parents care and cope?
For parents whose child has type 1 diabetes, the doctor explained that caring for these pediatric patients involves many details regarding food. The doctor recommended the following care principles…
- Counting carbohydrate portions helps parents calculate the amount of insulin to give their child.
The hospital has nutritionists to advise on this part, helping to divide and count portions correctly and appropriately. It is important to know the suitable amount of food for the child’s age because food should not be restricted in children but given in proportions appropriate for growth. - Blood sugar testing helps control blood sugar levels within the normal range.
Blood sugar should be tested before the three main meals and before bedtime to calculate the correct insulin dose. - Insulin injections before the three main meals and before bedtime. Currently, insulin pumps are available to reduce the frequency of injections.
- Parents must know and teach their child how to handle “hypoglycemia”. Symptoms of low blood sugar include sweating, palpitations, and fainting. Blood sugar levels will be below 60.
Children at this age still need to engage in activities and play as usual. Parents should teach their child that “before doing activities or heavy exercise, blood sugar should be checked, or they should know how much carbohydrate to eat to prevent hypoglycemia.”
Another important recommendation from the doctor is to teach the child to prepare sweet drinks, candies, or bread in case hypoglycemia occurs during exercise, so these can help raise blood sugar levels back to normal.
When hypoglycemia or blood sugar below 60 occurs, the doctor recommends… stimulating blood sugar with about 2 pieces of candy, eating one piece at a time. If symptoms improve after the first piece, such as blood sugar rising to 60-70, the second piece may not be needed, and bread can be eaten instead to maintain stable blood sugar levels.
If boxed fruit juice is available, drinking half a box can replace candy. It is important to note that the patient should consume an appropriate amount because too much can cause blood sugar to rise too high again.
Because dietary control in children is more difficult than in adults, parents need to explain to their child about their diabetes, the importance of food management, blood sugar monitoring, and understand… that they can control this disease if they take good care of themselves or live with the disease while still enjoying life every day.
Dr. Nuanphong Rianmanee
Specialist in Pediatric Endocrinology and Metabolism
Child and Adolescent Health Center, Phyathai 2 Hospital
