Diabetes is not a “patent” for adults and children may also suffer from it. Diabetes mellitus in children is dominated by type 1 diabetes, which is closely related to its own immunisation, genetic factors, etc. When a child is diagnosed with diabetes, the family as a whole faces a unique set of challenges, and good home-based care is key to helping the child to manage his or her condition and develop well.
I. Characteristics and challenges of diabetes in children
Children are at a critical stage in their growth and development and have many special characteristics compared to adult diabetes. First, the dietary needs of children are complex and they need adequate nutrition to support rapid physical and brain development. Diabetes, however, requires strict control of intake of sugar, carbohydrates, etc. in the diet, which requires careful planning of each meal with a balanced nutrition. For example, ensuring that children consume sufficient proteins, vitamins, minerals, etc., while limiting the consumption of high sugar fruit, pastry, beverages, etc., is an enormous test of parents ‘ nutritional compatibility.
Second, children ‘ s self-management capacity is poor. They may find it difficult to understand the severity of diabetes, and there is often resistance to routine treatment such as blood sugar surveillance and insulin injection. Unlike adults who consciously follow medical advice, children may refuse to inject for fear of pain or forget to monitor blood sugar for greed, making control of the condition more difficult.
Furthermore, children with diabetes are more likely to experience blood sugar fluctuations. Their physical metabolism is active, and motor and emotional changes can lead to a sharp rise or decrease in blood sugar. Moreover, long-term high blood sugar can affect the child ‘ s growth and development, such as slow height growth and delayed sexual development, while low blood sugar can lead to dangerous conditions such as dizziness, inactivity and even coma, which pose a serious threat to the child ‘ s health.
II. Points for home care
(i) Catering
1. Preparation of a personal diet: consulting with a professional nutritionist to develop a suitable diet based on the child ‘ s age, sex, weight, activity, etc. Every meal is guaranteed to contain a proper amount of protein (e.g., skinny meat, fish, beans), carbohydrates (priority is given to high-fibrous whole grain), healthy fats (e.g., olive oil, nuts) and rich vegetables and fruits. For example, breakfast may consist of whole-wheat bread mixed with eggs, milk and a small amount of low-sweet fruit; lunch with scrawny cuisine, rough rice; and dinner arrangements for steaming fish, scabs and potatoes.
2. Control of food weights: Teach children to identify appropriate food weights and avoid over-eating. Small tools, such as food scales, cups, etc., can be used to help children to visualize the weight and size of food. At the same time, attention should be paid to the way food is culled, and to the extent possible, the use of healthy cooking methods, such as steaming, cooking and stew, in order to reduce the excess of heat consumed by high-oil cooking, such as fried or fried.
3. Rational arrangements for snacks: While children with diabetes need to limit their snacks, a complete ban may cause psychological stress. Some low sugar and high-fibre snacks, such as sugar-free milk, nuts, cucumbers, etc., can be selected and given in appropriate quantities between meals, with a corresponding reduction in carbohydrates intake in the regular meal to maintain blood sugar stability.
(ii) Blood sugar surveillance
1. Regular monitoring time: Generally, blood sugar monitoring is required at the time of empty abdominal, pre-eating, 2 hours after meal, pre-sleep, etc. Parents are required to help the child develop regular monitoring habits for blood sugar, such as monitoring and recording after getting up in the morning, before three meals and before sleeping. Some blood sugar recording software or forms can be used to make it easier for doctors to understand blood sugar fluctuations and to adjust treatment programmes in a timely manner.
2. The correct operation of the blood sugar unit: teaching children and other family members to use it correctly. Ensure that the blood is kept clean, generally chooses the pointy side of the finger, and that the depth of the needle is appropriate to avoid too much pain and fear for the child. After the blood is taken, the blood sample is dropped on the test paper with an accurate reading of the blood sugar values according to the instructions of the blood sugar instrument.
3. Dealing with blood sugar abnormalities: parents need to know how to respond when blood sugar is too high or too low. If the blood sugar is too high, check whether it is due to over-eating, under-movement or misdosed insulin, adjust in a timely manner, and give the child more water and increase the amount of exercise as appropriate to reduce the blood sugar. If the blood sugar is too low (generally less than 3.9 mmol/L), the child should immediately be given some sugar-bearing food, such as candy, juice, etc., in order to quickly lift the blood sugar and then observe the blood sugar changes and contact the doctor if necessary.
(iii) Insulin treatment
1. Injecting techniques: If a child needs insulin treatment, parents must, under the guidance of a medical practitioner, have a good knowledge of insulin injection methods. This includes the type of insulin, dosage calculations, the selection and rotation of injections (e.g. abdominal, exterior thigh, exterior upper arm, etc.) and the angle and depth of injections. Care needs to be taken to keep a certain distance between each injection, and to avoid repetition of injections in the same part of the body resulting in fat under the skin or condensation, affecting insulin absorption.
2. Ensuring insulin storage: Insulin needs to be stored at specific temperatures, unopened insulin should be placed in a refrigerator freezer (2 – 8°C) and the unopened insulin can be kept at room temperature (not exceeding 25°C) for about 28 days. Parents should be careful to check the life-cycle and storage conditions of insulin to avoid the effects of insulin deterioration.
3. Adjustment of insulin dosages: Insulin dosages may need to be adjusted to the child ‘ s blood sugar monitoring results, diet, motion, etc. Parents have to communicate closely with doctors to learn how to adjust insulin dosages to blood sugar fluctuations, but not to increase or decrease on their own will, so as not to cause blood sugar to go out of control.
(iv) Sport and mental health
1. Encouragement of appropriate exercise: it helps control blood sugar, improves health and enhances the self-confidence of children. Suitable sports programmes, such as walking, running, swimming, cycling, etc., are chosen according to the age and physical condition of the child. The exercise time is generally recommended for between 1 and 2 hours after the meal, for more than 30 minutes at a time, with care to avoid moving when the blood sugar is too low or too high. Sports must be accompanied by sugary food and water to prevent low blood sugar.
2. Attention to mental health: Long-term treatment of diabetes can lead to psychological stress for children, such as anxiety, depression, etc. Parents need to communicate more with their children, understand their feelings and provide adequate care and support. Children are encouraged to share their experiences with other children with diabetes so that they know that they are not alone. At the same time, they can seek the help of a psychologist to provide psychological guidance to their children and help them build confidence in overcoming the disease.
Family care for children with diabetes is a long-term and challenging task, requiring parents to have a wealth of knowledge, patience and care. Through scientific dietary management, standardized blood sugar surveillance, correct insulin treatment, and child-sensitive sports and mental health, children are helped to effectively control their condition, so that they can thrive and have a better future than healthy children.
Diabetes.
