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In sum, managing diabetes is a matter of juggling three things: food, exercise, and medication (insulin if your child has type 1 diabetes; insulin and/or other medications if your child has type 2). All three have a major impact on diabetes control. What is "Control?" Being in control means keeping the blood sugar from going too high (hyperglycemia) or too low (hypoglycemia). Your child (or you!) will feel her best when her diabetes is in control. Not being in control can be like riding a roller coaster-- blood sugar levels can swing from very high to dangerously low in a matter of hours. Both hypoglycemia and hyperglycemia can be harmful. What is "Hyperglycemia?" Hyperglycemia (high blood sugar) causes many of the symptoms of diabetes that you're already familiar with-- extreme thirst or hunger, frequent urination, fatigue, and so on. Long-term hyperglycemia is linked to increased risk and severity of diabetic complications. What is "Hypoglycemia?" Hypoglycemia (low blood sugar) is caused by too much insulin or too little sugar in the blood. It's a side effect of treating diabetes. Common symptoms of hypoglycemia are dizziness, sleepiness, irritability, shakiness, and hunger. Symptoms vary a lot from person to person, though. It'll take you some time to identify and recognize your child's symptoms. When your child has symptoms of hypoglycemia, she should do a blood check, eat or drink something with sugar (a fast-acting carbohydrate) right away, and then eat a snack (unless a meal is scheduled within the next 30 minutes). So, What About "Goals of Control?" The goal of being in control, then, is to avoid prolonged hyperglycemia or frequent hypoglycemia. To define what is "in control" for your child, the doctor (or other diabetes care provider) will give you a target blood glucose range. (This range varies from person to person, but average ranges fall around 70 to 120 mg/dl.) You, your child, and your diabetes care team will try to keep her blood sugar within this range as much as possible. When her blood sugar is in this range most of the time, her diabetes is considered to be under control. Each person's target range is different, and you should expect your child's range to change as she grows. "Pobody's Nerfect!" Remember that old bumper sticker? "Pobody's Nerfect?" It's important to emphasize to your child that she will probably experience times of hyperglycemia or hypoglycemia, even if she is generally in good control. No treatment plan is perfect, and no plan can predict the body's reaction to the many aspects of life-- such as exercise, sickness, particular foods, or emotional stress. So, one high or low reading is not a reason to panic. Diabetes care is very much a long-term commitment-- control over the longer term is the goal. Because everyone with diabetes experiences hypoglycemia or hyperglycemia at times, your child and those who spend time with her need to know and watch for the symptoms of both conditions.
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