How to Help Your Child Manage Type 1 Diabetes During Summer
For children with Type 1 diabetes, a lack of school structure coupled with an inconsistent summer schedule can wreak havoc on blood sugar control.
For children with Type 1 diabetes, a lack of school structure coupled with an inconsistent summer schedule can wreak havoc on blood sugar control. “If you go off your routine, your diabetes control can get off,” explains Todd Nebesio, M.D., pediatric endocrinologist in the diabetes program at Riley Hospital for Children at Indiana University Health. “We always tell families that it’s better to keep some type of routine over the summer.” To that end, Dr. Nebesio offers tips on how you can help your child manage his diabetes during summer.
Keep a log
Anyone with Type 1 diabetes knows that blood sugar is affected by what you eat, insulin levels, how much you exercise, stress levels, sleep, and even body temperature. For people without diabetes, their bodies automatically respond to fluctuations in sugar levels by secreting more or less insulin from the pancreas as needed. But for people with Type 1 diabetes (which means their pancreas does not produce insulin), they must continually figure out how much insulin to program into their insulin pump or inject into their body through a syringe in order to regulate their blood sugar. It is especially difficult to figure out how much insulin you need during the day if you’re not on a consistent schedule. For instance, kids in the summer may stay up later than usual, get more exercise outdoors, and eat differently. These things can alter blood sugar.
To get a handle on diabetes management, Dr. Nebesio says it’s crucial to keep a running log of your child’s blood sugar levels, the foods she eats, and any other important factors (such as exercise). “We tell kids to test their blood sugar and write down their sugar levels at breakfast, lunch, dinner, and bedtime—and to keep a log book,” says Dr. Nebesio. This record can help you and your child figure out how much insulin she needs in certain situations. And note that if your child is staying up later than usual, she should test her blood sugar an additional time before bed and adjust her insulin accordingly. “You don’t want a sugar low—a hypoglycemic event— during night,” says Dr. Nebesio.
Factor in extra activity
“When kids are running around and playing in the heat as opposed to sitting in class all day, this can affect sugar levels and make them lower,” notes Dr. Nebesio. “You may need to either reduce your insulin dose in those instances or eat more food to compensate for the change in sugar levels.” Dr. Nebesio advises parents and kids to remember that you need an extra 15 grams of carbohydrates for every hour of activity. So if you know your child will be really active, bring extra snacks to offset the sugar lows.
Be careful with new foods
“Most kids are creatures of habit and eat the same thing every day. But during the summer, if you’re out more and if you’re at a new restaurant, you have to remember that you don’t know what’s in their pizza sauce,” says Dr. Nebesio. It can be very tricky for kids and adults to estimate how much sugar or other carbohydrates are in a new meal. If you know you’re going to a national chain of restaurants, Dr. Nebesio suggests you look online before you head out because a lot of those places list their nutrition information. He also recommends apps such as CalorieKing.com, which offer a wide range of foods and their nutrition information.
Prepare for pump holidays
If your child wears a pump to deliver insulin to the body continuously throughout the day and night, it’s important that she wear that pump pretty much all the time. Of course, if your child wants to go swimming, she’ll need to take the pump off and you’re going to need to plan those activities carefully. “We usually recommend that you can be off your pump for no more than an hour,” says Dr. Nebesio. “If the pump is off for too long, your body will start breaking down fat, which can cause your body to produce ketones.” So if your child is taking a dip in the pool, be sure to reattach the pump shortly after getting out of the water. You may even want to consider ditching the pump and using insulin shots for longer stretches if you plan to be at the beach for a week or on a cruise for vacation. It may be easier than detaching and reattaching the pump frequently.
Wear a medical ID
“We encourage kids to wear medical IDs—such as necklaces or bracelets that identify them as having diabetes—so that if they are ever out without their parents and there is an accident in which they need medical treatment, people will be sure to know they have diabetes and will be treat them appropriately,” says Dr. Nebesio. This holds especially true when kids aren’t in school and under the watchful eyes of teachers and adults who know them.
Take care of your supplies
Perhaps your child is used to keeping his blood glucose meter and other diabetes supplies in his locker or desk at school? If so, during the summer he’ll need to get in the habit of keeping his supplies on or near him. Also, remember that insulin and glucose meters don’t do well in hot environments. It’s best to keep insulin and meters at room temperature but if you know you’re going to be outside on a hot day, you may want to carry a cool pack for your diabetes gear.
Dr. Nebesio says that while parents may be anxious about sending their child with diabetes off to summer camp, it can be a great experience for kids. Many children with diabetes choose to go to camps that have a nurse or someone there who is knowledgeable about diabetes. And other children with diabetes choose to go to camps that are exclusively for children with the condition. In Indiana alone there are several camps for children with diabetes: Camp John Warvel, which is sponsored by the American Diabetes Association and affiliated with the Riley Hospital for Children; Camp Until a Cure, No Limits Diabetes Camp, and INdependence Diabetes Camp at Camp Carson.
“We have kids from all over the country who come to Indiana to the diabetes camps, and they bond and form friendships for their entire lives,” says Dr. Nebesio. It’s also a unique opportunity for children with diabetes to be around other children dealing with the similar issues. “It’s even helpful for kids to see other kids on pumps to help them decide if it’s right for them or not,” adds Dr. Nebesio.
-- By Rachel Rabkin Peachman