Diabetes and Your Child: Checking Blood Sugar

You've been told that your child has diabetes. This means that you must check their blood sugar level as advised by the health care provider. This is the only way to know if your child's management plan is working. Your child's care team will teach you how to check your child's blood sugar. You'll learn how often to check and what the numbers mean for your child. This will help you keep your child's blood sugar in a healthy range.

Blood sugar level is measured with a blood glucose meter. A meter measures how much glucose is in your child's blood. You'll use a device called a lancet to get a tiny drop of blood. Blood is most often taken from a fingertip. But you may be able to test on the arm or the heel of the hand. The drop of blood is placed on a small strip that goes into the meter. The meter then gives a reading that tells you the level of your child's blood sugar. There are several types of meters available. Your child's health care provider will help you choose a meter that best suits your child's needs.

Continuous glucose monitoring (CGM) may be a choice for checking blood sugar levels. It tracks your child's blood sugar level throughout the day and night. This can help you and your child make better choices about food, activities, and medicines. It can also find trends that can help your child's health care provider better manage the child's diabetes. Besides giving your child's blood sugar at any moment, CGM also gives you the percentage of time your child's blood sugar has been in the normal range. It also tells you when blood sugar has been too high or too low. This is called time-in-range. For most children the target is 70% and the target range is between 70 and 180 mg/dL.

CGM can help manage both type 1 and type 2 diabetes. Your child's provider may suggest a CGM device if your child is newly diagnosed and needs to take insulin. It's ideal for children who need tight blood sugar control. It also helps children who may not notice symptoms of low blood sugar. Ask your provider if CGM is right for your child.

Several CGM devices are available. They are approved by the FDA with a prescription from a doctor. It includes a sensor, transmitter, and a receiver or monitor. The sensor is a small device placed under the skin. It will measure your child's blood sugar several times a minute. A transmitter sends the information to a receiver. This may be a part of an insulin pump or a separate device.

Your child's blood sugar may still need to be checked a few times a day with a regular glucose meter to check for accuracy. The sensor under the skin needs to be replaced every 7 to 14 days.

As often as possible, your child's blood sugar should be in the target range. Target range is where their blood sugar level is healthiest. Aim to keep your child's blood sugar in target range. This will help reduce the risk of health problems, including diabetic ketoacidosis (DKA) or low blood sugar (hypoglycemia). Your child's health care provider will help you figure out what their target range should be. Fill in your child's target range here:

• On waking: Between _________ and ____________
• Before a meal: Between ________________ and ________________
• 2 hours after a meal: Between ________________ and ________________
• Bedtime: Between ________________ and ________________

Your goal is to keep your child as healthy as possible by controlling blood sugar levels. Your child's care team will work with you to set blood sugar target ranges for your child. They'll also teach you how to check your child's blood sugar. This will help you keep your child's blood sugar levels in a healthy range.

Keep a record of all your child's blood sugar readings. You can use a log book to write down numbers. Or, many meters can store numbers that you can download to a computer. Keeping a record helps you see patterns, such as high numbers after certain foods or activities. Use your child's log book to spot patterns and make adjustments to their management plan. This will help you keep your child's blood sugar in their target range more often. Be sure to bring the log book to all appointments with your child's health care provider. Smartphone apps are also available to record the blood sugar readings in a format that you and the provider can download at the next appointment.

If you like electronic record keeping, the American Diabetes Association (ADA) has a program called Diabetes 24/7. This online program provides tools to help monitor diabetes, including blood glucose levels. Your provider may also have an electronic medical record that offers the same type of tracking options.

You can use your child's log to spot patterns and find answers to problems. For example, the log can help you see what tends to happen at a certain time of day, or when your child eats a certain food. Problem-solving can be a kind of detective game for you and your child. Together, you can find clues and figure out what they mean.

Make checking blood sugar part of your child's daily routine. Make sure your child has a meter and supplies when they're away from home. To encourage your child to check regularly, make sure they know the purpose of checking. It's part of the detective work that helps you and your child make choices and solve problems.

To make finger sticks less painful:

• Use the side of the finger.
• Use a meter that needs less blood.
• Use an adjustable lancing device.
• Use a fine-point lancet.
• Don't clean the finger with alcohol—soap and water are fine. Be sure the finger is dry before getting the blood sample.

You, the diabetes educator, and your child can work out an agreement for blood sugar monitoring. It should include:

• When your child agrees to check their blood sugar.
• What kind of log your child will keep.
• A reward system for sticking to the agreement and being honest. Nonfood rewards are best. Never use skipping an insulin shot as a reward.

As your child gets older, they can take on more tasks. To do this, your child will need to learn with you to manage diabetes. If your child wants to do their own blood sugar checks, that's great! But keep in mind that things may not work perfectly at first. That's OK. You can both keep trying. Ask your health care provider about support groups for children or age-appropriate diabetes camps and programs.

Sometimes, your child will have high or low numbers. You may not know right away why this happened. Don't get upset if you see numbers that are out of range. And try not to judge your child's behavior based on these numbers. Many things can affect blood sugar levels. These include emotions such as excitement. So don't punish your child or get upset at high or low readings. Your child needs to trust that they can show you any number. If you have trouble keeping your child's blood sugar in target range, contact their health care provider. They can help you adjust your child's plan as needed.