Diabetes FAQ

Type 1 Diabetes

Diabetes FAQ

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The American Family Children's Hospital's Pediatric Diabetes Clinic has prepared the following frequently asked questions (FAQ) for our patients diagnosed with diabetes and their families.

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Frequently Asked Questions About Type 1 Diabetes 

I'm home sick from school! How do I keep from getting worse and developing ketones?

When should I go to the doctor when I'm sick?

American Family Children's Hospital Pediatric Diabetes: Mom, child and doctorContact your provider if:

  • The above strategies do not help
  • Vomiting and/or large ketones persist
  • You cannot tolerate fluids/food by mouth
  • You are having severe headaches or not making sense

I just had a low blood sugar and I'm out of glucagon. Where can I get more?

First things first: If you have a low blood sugar, your body needs more sugar, and it needs it fast.

  1. If you have a low blood glucose, cannot eat or drink, and do not have glucagon, you should seek medical attention immediately by having someone call 9-1-1 or going to the nearest emergency department.
  2. If you cannot eat or drink, but do have your glucagon kit available, it can dosed for emergencies or for non-emergencies.
  3. If you can eat or drink, you can treat a low sugar by drinking or eating carbs. One easy way is drinking juice, eating glucose tabs, or using glucose gel in your mouth.

After you no longer have low blood sugar, you should contact your pharmacy for a refill of the glucagon emergency kit. If the pharmacy is in need of further refills, they will contact the Pediatric Diabetes Clinic to renew your prescription. When your prescription is ready for pick-up, your pharmacy will contact you.

How do I contact the manufacturer for my pump?

How do I contact the manufacturer for my blood glucose meter?

What is type 1 diabetes?

Type 1 diabetes is the most common type of diabetes found in children, but can occur in adults. This condition is when the pancreas, an organ in your body, is no longer able to make insulin.

What is insulin?

Insulin is a hormone in your body that acts as a key. It opens up “the door” to let sugar into parts of the body where it is needed for energy. When insulin is not around, the sugar rises in your blood stream. This leads to increased urination (having to go to the bathroom), increased thirstiness and weight loss.

Why does the pancreas stop making insulin with type 1 diabetes?

First know that it is nothing that you did to cause this to happen. For reasons not completely understood, the immune system (that part of your body that protects you from infections) gets confused in Type 1 diabetes and attacks the cells in the pancreas that make insulin. It is like the linemen on a football team getting confused and sacking their own quarterback.

How is type 1 diabetes treated?

Type 1 diabetes is treated by taking insulin injections daily and learning how to adjust this dosing based on what you eat, what your goal blood sugars are, and your activity.

I've heard there are camps out there just for kids with diabetes. How do I sign up?

A group of children sitting under a treeDiabetes camps are a great way to have fun in the summer and meet new friends. As a bonus, all the campers have diabetes, so you can share your own experiences, questions and ideas! In addition to counselors and camp leaders, diabetes camps are fully staffed with a medical team.

In Wisconsin, we have:

You can search for diabetes camps across the country:

I have a bad cold. Can I take any cold medication to feel better?

American Family Children's Hospital Pediatric Diabetes: young boy taking cough syrupIn general, children or adolescents with diabetes can take cold medications (Tylenol, cough syrups, decongestants) when they are ill. However, similar to anyone taking cold medications, it is important that the age limits and doses indicated by the manufacturer on the box are followed.

Cold medicine that is given as a syrup can contain glucose and the medications themselves can raise the blood glucose. As a result, when the blood glucose is checked later, a small correction might be required to account for the possible increase in the blood glucose from the medication. Many medications, such as, cough syrup are available in sugar-free syrups that can be used.

Also, remember when you or your child is sick, it is very important that you check your blood glucose and give your insulin per your sick day plan, whether or not they take any cold relief medications.

Does alcohol have an impact on Type 1 diabetes?

  • Alcohol must be broken down in the body after you drink it. Your liver is where alcohol is broken down.
  • Your liver also stores sugar and responds to low blood sugars, releasing sugar into the blood stream. But when the liver is breaking down alcohol, it may not be able to raise your blood sugar. You have a much higher risk of a severe low blood sugar when drinking. Alcohol blocks a chemical reaction the liver needs to raise blood sugar.
  • The risk of a severe low blood sugar occurs shortly after drinking and up to 24 hours later.
  • Glucagon usually does not work if you have a low blood sugar from drinking alcohol.

What’s your risk?

You are at risk of severe low blood sugars when taking insulin (all type 1 diabetes patients).

Guidelines for Adults with Type 1 Diabetes and Alcohol

  1. If you choose to drink alcohol, limit the amount and drink with food. The American Diabetes Association recommends limits of one drink for women and two drinks for men. Sip the drink slowly.
  2. Never drink on an empty stomach. Eat a meal or a snack while drinking that includes both fat and some carbohydrates.
  3. Don’t drink within two hours of exercise.
  4. Check blood sugar frequently. Check blood sugar before going to bed and eat a snack with carbohydrates and protein if less than 140 mg/dl. Set an alarm to wake up in the morning.
  5. Always let roommates or friends know you have been drinking and when you should wake up.
  6. Wear your medical ID.
  7. Never drink and drive.
  8. It takes about two hours to break down one drink. The following are considered one drink:
    • 5 ounces of wine
    • 12 ounces of beer (light or regular)
    • 1.5 ounces of liquor (vodka, whiskey, gin, etc.)

Diabetes is expensive. Are there any programs that can help me save money on my treatment?

Use these resources to learn more about programs that may help families save money while dealing with diabetes.

What is the target blood sugar range you should aim for?

UW Health pediatric diabetes quiz: Doctor with mother and childWhat is the target blood sugar range you should aim for?

This depends a bit on each individual child, so if you don’t know, ask your diabetes provider. For most children, however, the goal is for most sugars to be in the 80 to 140mg/dl range.

 

Most children will still have occasional higher sugars and lower sugars. For the first month or so after just being diagnosed, the target is a little wider, 80 to 200mg/dl, but this is only temporary.

What is a low blood sugar and how do you treat a low blood sugar?

A low blood sugar is 69mg/dl or less. To treat a low blood sugar, give 15 grams of carbohydrate, wait 15 minutes and recheck the blood sugar. If still low, repeat. For more details, see Low Sugar: Routine Treatment. If the child is unable to safely swallow, you should not put anything in his/her mouth, but instead give a glucagon injection. For more details on giving glucagon, see Low Sugar: When You Can't EatLow Sugar: Emergency Glucagon, as well as this Glucagon website.

Which insulin is long-acting and when do you give it?

Lantus (glargine) is long-acting and lasts about 20-24 hours. It is dosed at the same time, once daily. Many families find bedtime most convenient.

It's your first day of school and you are out at recess and start feeling funny – a little shaky and dizzy. What should you do?

UW Health pediatric diabetes quiz: Girl in schoolYou need to check your sugar and if you have a low blood sugar, treat it with some carbs. If you have your meter on you, go ahead and check and treat, but it is important to tell someone (a teacher or another responsible adult) and get help ASAP. If you aren’t right near an adult, have a buddy run and find an adult to help you check your sugar.

You are about to start gym class. You will be running and active for the next hour. What should you do?

UW Health pediatric diabetes quiz: Kids in gym classSports and activity can cause blood sugars to go up (from the adrenaline) or down (from increased insulin sensitivity that comes with exercise - a healthy thing). It’s important to check your sugar before such an activity, and have Gatorade or other carb-containing beverages on the sidelines ready to treat any low blood sugars. After long, vigorous days of activity, some kids will have a delayed pattern of lower blood sugars, so if you have a field day or full day soccer meet, for example, check your sugar one extra time overnight (at around 2am) to watch for lower sugars.

You were exhausted after a busy day and completely forgot to give the bedtime Lantus. It's midnight and dad just woke up and realized this. What should he do?

Give the lantus now. As the saying goes, better late than never! Things happen and there may come a time that you forget to give the lantus. If this is the case, as soon as you remember, do give the dose. Be mindful that it will last about 20-24 hours, so keep an eye on sugars, if there is some overlap with the following evening’s bedtime dose.

It's 2:00am and the blood sugar is 480mg/dl. What should you do?

UW Health pediatric diabetes quiz: Young kid sleepingTake a deep breath. Although this is certainly a very high sugar and we don’t want the blood sugars to stay in this high of a range, one high sugar is not going to hurt your child. Treat this with your usual correction dose of insulin.

 

If you notice sugars are greater than 300mg/dl for two or three checks in a row, check your child’s urine ketones and call us if they are positive. If the sugars stay greater than 300mg/dl for more than a day or two, your child probably needs more insulin, so let us know to help make this adjustment.

It's breakfast time. Your blood sugar is low at 60, but you feel fine and breakfast is ready. You are planning on eating 45 grams. What should you do?

UW Health pediatric diabetes quiz: Kids eatingThere are a couple options. Either option is safe, and you’ll get the hang of what works for your family in each situation.

  1. You have a low blood sugar, so one great option is to treat this like you would normally, with 15 grams of carbohydrate. Recheck in 15 minutes and then dose your insulin for the 45 grams of carbs, as you normally would.
  2. Another option is to treat the low with 15 grams of carbs by simply counting 15 grams of the 45 grams of breakfast as “free.” In this case you would dose the insulin only for the remaining 30 grams.

My pump doesn't seem to be working right! How do I figure out what's wrong?