As a sports coach, before/after school carer or vacation carer, you may be responsible for looking after a child with type 1 diabetes. Children with diabetes should be able to participate in all activities along with other children, however there are important things as a carer that you need to know.
What causes type 1 diabetes?
Type 1 diabetes is not related to lifestyle or caused by eating too many sweets. It’s not possible to catch diabetes from somebody else.
How is type 1 diabetes treated?
Insulin may be given by injection via a syringe, pen or insulin pump. Insulin is really important and should not be missed. Parents may plan for the child not to need any injections while they are in your care, or they may organise for the child to give their own insulin, if they are able.
The child must have the right insulin, in the right dose, at the right time and eat soon after their insulin injection. You may be asked to supervise the child giving their insulin, in which case simple instructions from the child’s parents are important for guidance.
Testing BGLs is an important part of diabetes care that can help parents plan the day to day management of their child’s diabetes. Even if the child with diabetes knows how to test, it is helpful for carers to also know how to perform a blood glucose test. If you are prepared to assist, the child’s parents can show you how to use the blood glucose meter and carry out the test. If you agree to assist with blood glucose testing, make sure you wear gloves and take care with sharps. For infection control, testing should only be carried out on the child with diabetes not on anyone else.
The child with diabetes may need to carry out blood glucose tests at the following times:
The child’s parents will advise you about their child’s BGLs, and in what situations they may need to be contacted.
Hypoglycaemia (low BGL or hypo) occurs when the BGL drops to less than 4mmol/L or when hypo symptoms are being experienced at a level close to 4mmol/L.
What causes a hypo?
What are the symptoms of a hypo?
Young children may not say “I’m having a hypo”, they may use other words like – “I feel funny”, “I feel wobbly”, “I’m tired”. BGLs less than 4mmol/L should be treated even when there are no symptoms.
If in doubt, do not waste time doing a blood glucose test.
Mild – Moderate Hypo Treatment
1. Give any one of the following (you may need to coax the child to eat or drink):
Symptoms usually disappear after 10-15 minutes, however if the BGL remains low and symptoms are still present, repeat the treatment and stay with the child. A child having a hypo should never be left alone.
2. Follow up with extra carbohydrate food, such as fruit, a sandwich or biscuits. If a hypo occurs just before a scheduled meal or snack, follow with that meal or snack.
Following a hypo, you may find that the child is not able to rejoin the activity immediately. It can sometimes take longer than 15 minutes to completely recover from the hypo.
Severe Hypo Treatment
A Hypo Kit
Sometimes BGLs can go too high. This can be when the child is:
Sometimes high BGLs happen for no reason at all.
If the child’s BGL is above 15mmol/L and they’re feeling OK, they can join in all activities, but really active sports are not recommended. They should drink plenty of water and do another test if they're not feeling well.
If the child’s BGL is above 15mmol/L and they're feeling sick, they might have ketones, which means that their diabetes is out of balance. High BGLs and ketones can make them really unwell, give them stomach pains, make them thirsty and want to go to the toilet a lot. In this situation, it’s important to contact the child’s parents for advice. If the child starts vomiting, seek advice immediately.
Despite what many people think, there is no special “diabetic diet” for children with diabetes. A child with diabetes in your care should be encouraged to have the same healthy food choices as recommended for all children. Regular meals and snacks containing carbohydrate (eg. fruit and fruit juice, breads and cereals, milk and yoghurt, pasta, rice, potatoes, biscuits) may need to be included every 2-3 hours depending on the child’s insulin plan. Children with diabetes should also be included in parties and special occasions when in care. Parents should be alerted to any activities outside the normal routine that may affect food intake, meal times etc. It’s a good idea to discuss the child’s individual needs with the parents.
All children, including those with diabetes should be encouraged to be active. In children with diabetes, physical activity can have varying affects on BGLs. Physical activity usually lowers BGLs by helping insulin to work better. Sometimes physical activity can cause BGLs to be high, usually from stress or excitement. It can affect children differently, so it’s a good idea to discuss any planned activity or changes to regular activities with the parents, as this may require them to make adjustments to the insulin dose.
During physical activity, the child with diabetes may have to:
It’s important for children with diabetes to join in all activities with other children, however, it’s vital that their additional needs are taken into consideration.
When to seek advice…
• If the child has a severe hypo
Parents should provide sufficient information on their child’s diabetes management. Should you feel that you require further information, contact Diabetes Australia in your state or territory.