Caring for someone’s child who has type 1 diabetes is a big responsibility. That’s why the Pediatrics team at Joslin Diabetes Center offers caregivers classes, specifically tailored for people who watch over children with type 1 diabetes; people like teachers, grandparents and babysitters. Educator Heidi Quinn, M.S., R.D., L.D.N., C.D.E., leads these classes, along with a nurse educator from the pediatric team Today, Heidi shares her words of wisdom and advice on the Joslin Blog.
Speaking of Diabetes: What is the most important thing a caregiver needs to know about a child with type 1 diabetes?
Heidi Quinn: I think the most important thing a caregiver of a child with type 1 diabetes needs to know are the signs and symptoms of hypoglycemia (low blood sugar)and hyperglycemia (high blood sugar) and how to treat these. The signs and symptoms may vary somewhat from child to child, so it is important for caregivers to speak to the child’s parents to know the usual symptoms for that individual child. In addition, the caregiver needs to know what sources of fast acting glucose the child will accept ( i.e. juice, glucose tablets, regular soda, tablespoon of syrup or honey) to help treat a low blood glucose (hypoglycemia) and how to check a blood glucose level, administer insulin and check for ketones in order to treat a high blood glucose ( hyperglycemia). Also, the caregiver should have contact information such as names and phone numbers of whom to contact in case of an emergency.
SD: When a caregiver is preparing to watch a child with type 1 diabetes, what are the most important tools they should have on hand?
HQ: When a caregiver is preparing to watch a child with type 1 diabetes the tools they should have on hand should include:
– A blood glucose meter with test strips and lancet in order to check a blood glucose
– Insulin pen or syringe to administer insulin
– A blood ketone meter
– Rapid acting glucose sources to treat a low blood glucose
– Glucagon to treat an extremely low blood glucose level
– A list of contact names and numbers in case of emergency.
SD: What should a caregiver do if a child with type 1 diabetes starts to seem either low or high?
HQ: If a child with type 1 diabetes seems to be experiencing a high or low blood glucose the caregiver should immediately check the blood glucose using the blood glucose meter and then treat appropriately.
SD: What should a caregiver know about pumps? Insulin shots?
HQ: A caregiver should be trained by the parents or a member of the child’s diabetes care team on how to administer insulin using either pen, syringe or pump.
SD: What if a child starts to give a caregiver trouble when it comes time for getting an insulin shot? How can the caregiver calm the child down and defuse the situation while making sure the child gets the care he or she needs?
HQ: The caregiver should discuss with parents the usual routine for administering insulin i.e. does the child get to choose which finger to prick for a blood glucose check, does the child get to choose which site for insulin injection. It may be helpful for the caregiver to have the parent present for the first few times the caregiver administers the insulin to ensure they are doing it correctly, and to help the caregiver and the child feel more comfortable. If the child becomes upset during caregiver’s attempt to treat the child, caregiver should remain calm and explain that to the child that the insulin or glucose will help them feel better and keep them safe. If needed, the caregiver could provide an age-appropriate reward for cooperation (stickers, story time, playtime outside, etc.)
SD: Is there anything else a caregiver should have before parents leave the child with the caregiver?
HQ: Ideally there should be a written plan with instructions for the caregiver and when to call the parents or health care team.