Kellie's Top 15 Tips for Managing Diabetes in Infants and Toddlers
By: Kellie Rodriguez, M.S.N., C.D.E., C.P.T.
1. Use heels rather than sensitive fingers to reduce the discomfort of self blood glucose monitoring (SBGM).
2. Administering insulin immediately after eating might be recommended due to the unpredictability in food behaviors at this age.
3. Never sneak up on little ones hoping not to distress them with SBGM or insulin injections, as the child may become anxious then when the parent comes closer anticipating a possible shot or blood glucose stick – instead talk them through it calmly and with a hug at the end!
4. Set up a diabetes station for checks – not at the child’s bed – leave this as their comfort area.
5. Review your technique with your health care team if injections seem to hurt. Ice or a numbing cream might be recommended to help numb the area or devices like ‘inject ease’ could help. Pumps are also utilized more frequently due to the very small doses of insulin needed in this tiny population – reduces injections to once every 3 days typically.
6. Check your child’s blood glucose level if he/she is acting out of sorts. Behavior change may be the first sign of BG changes, typically low BG levels. Other signs might include sweating, trembling, unusual unsteadiness or a particular cry.
7. Identify the required amount and type of foods / fluids to treat lows – maybe as little as 5-10 grams of carbs in infants and toddlers. An oral syringe on hand is a good idea for administering syrup type fluids if low. Never give anything by mouth if unconscious – instead turn the child on their side and call 911 immediately.
8. Identify high sugars by an increase in frequency of: diaper changes, infections, sleepiness or fussiness.
9. Remember increased activity usually lowers blood glucose levels. Toddlers in particular can have a varied activity level, therefore, more carbs may be required during times of additional activity.
10. Let toddlers assist with SBGM and insulin injections whenever possible. For instance, have them choose the site for BG checks or insulin injections.
11. Check BG more frequently when infants/toddlers get sick. There is an increased risk for BG elevation. Remember to encourage lots of fluids. Check for signs of dehydration: a reduction in wet diapers will be a sure sign as will a dry looking and sounding mouth.
12. Ask questions and ensure you have an accessible health care team to address any concerns
13. Don’t use food as rewards. Instead use stickers, toys, hugs and kisses, or play time.
14. Make diabetes a family condition. It is always best when all family members are involved in the care so that the responsibility does not fall on any one person.
15. Don’t neglect the emotional aspects of diabetes! It can be frightening to have an infant or toddler with diabetes because of an inability to let you know what he/she is feeling. Share these thoughts and feelings with other family members or friends, with your health care team or reach out to the PEP Squad (Parents Empowering Parents).