Introduction
Insulin dependent diabetes is one of the commonest chronic diseases that affects children.
For this kind of diabetes the only treatment is insulin and it has to be given by injection.
This leaflet is to tell you about:
- Insulin
- Blood tests
- HbA1c - what does it mean?
- Exercise
Insulin
Early days - when diabetes develops the insulin production by your body gradually decreases until
after about 6-12 months when there is no insulin made. This means that at first it may not need a lot
of insulin by injection to look after your diabetes. However after that 'honeymoon' time it is likely
that you will need approximately 1 unit per kg per day, sometimes a little more. That means for someone
weighing 25kg, it would be expected that they would require about 25 units of insulin per day.
Insulin schedules
As you grow the total amount of insulin needed to look after your diabetes will increase.
For much of childhood this can be with 2 injections each day, but many older children find that 3
(and sometimes even 4) injections each day allows more flexibility. To help guide you through the
different schedules the Children's team suggests the following:
Insulin Schedules
| Age |
No. of injections |
Type of Insulin |
Time of injection |
| Pre-nursery |
1 |
Insulatard |
Before breakfast |
| Nursery and Primary |
2 |
Mixtard 30:70
Mixtard 30:70 |
Before breakfast
Before tea |
| Secondary |
3 |
Mixtard 30:70
Mixtard 50:50
Mixtard 20:80 |
Before breakfast
Home from school
Before bed |
| OR |
| Secondary |
3 |
Mixtard 30:70
Actrapid
Mixtard 20:80 |
Before breakfast
Before tea
Before bed |
The different schedules shown for the older children can be chosen according to that most
suiting your own lifestyle.
Blood tests
You will have your own kit to test your blood sugar. This is a test that you can check whenever you feel
that you need to know more about what is happening with your diabetes. There are sometimes when you will
find it really useful to know what your blood sugar is:
e.g. If you feel unwell; If you are exercising a lot; If your insulin dose has changed
The blood sugar test is YOUR test to help you find out more about how
HbA1c
This is the blood test done when you come to clinic. You will find that the Diabetes team members will
pay quite a lot of attention to this result. This is because it can give you an idea of how close to normal
your blood glucose has been over the previous weeks.
The more your blood sugar is in the normal range the lower your HbA1c.
Why is this so important? Studies have shown that keeping near normal blood sugars allows better
health through a lifetime of diabetes.
The target HbA1c for the children's diabetes clinic is less than 8.5%.
Exercise
Taking regular exercise is healthy for everyone.
Having diabetes will not stop you from doing most sports. Usually simple adjustment of what you are
eating, or sometimes a change in insulin dose will keep your blood sugar stable. With time you will
know best what happens to your blood sugar when you exercise. If you do a lot of exercise it is important
to discuss it with the Diabetes Team so that your insulin schedule can be tailored to your needs.
Low blood sugars can occur several hours after vigorous exercise, but with care can usually be avoided.
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