Your Child's Diabetes Care Team

Type 1 diabetes is a life-changing diagnosis – for your child and your family. But diabetes doesn’t need to take away your child’s freedom, or disrupt your usual family life. With a little help from your child’s diabetes care team, you can help your child manage type 1 diabetes, and stay as healthy and active as possible. It may require planning and dedication, but by working with a supportive healthcare team, you can help your child lead a long and healthy life. 

All members of your child’s diabetes care team should work to balance your child’s schedule, skills, preferences and lifestyle.  This is a continuous cycle that should occur as your child advances with each stage of their life. Maintaining the balance between blood glucose control and an emotionally healthy lifestyle is essential to your child’s normal growth and development. 

Your child’s care team can:

  • Teach you the basics about diabetes
  • Help create a diabetes medical management plan (DMMP) for your child
  • Develop a healthy meal plan for your child and your family
  • Adjust your child’s insulin dosages
  • Make physical activity recommendations to help control glucose levels
  • Help you and your child cope with the type 1 diabetes diagnosis

Your child’s diabetes care team should include:

  • Physicians. Your child should have a pediatric endocrinologist, a physician who specializes in diagnosing and treating children who have endocrine system diseases like diabetes. You should schedule routine check-ups with your child’s pediatric endocrinologist every three months. At each  visit, you will talk about your child’s blood glucose values, insulin dosages, and growth and development.

    Keep in mind that seeing a specialist doesn’t replace the need for your child to see a pediatrician or primary care physician. You should continue to see these professional too. And it’s important that you and your child feel comfortable asking your doctors questions, and that you understand their answers. In addition to seeing you at routine visits, your physician may refer you and your child to other members of your diabetes care team.
  • Certified diabetes educator (CDE). This specialist is trained in helping you and your child learn about diabetes basics, including how to:
    • Check blood glucose levels
    • Treat high and low blood glucose levels
    • Use an insulin pump or give insulin injections
    • Adjust medications for exercise and sick days
    • Develop self-care skills
    • Use problem solving skills to manage diabetes
    • Review and update your child’s DMMP
  • Registered dietitian nutritionist (RDN). This person is an expert in nutrition and meal planning. They can help you understand your child’s nutrition needs based on weight, lifestyle, medication and other health goals. A RDN can also help you and your child create a healthy meal plan, as well as learn techniques to adjust the meal plan based on sports, holidays, special events and other activities. As your child grows and develops, his or her meal plan should too. For this reason, it’s a good idea to consult a RDN at least once a year.
  • Mental health professional. It can be hard adjusting to a type 1 diabetes diagnosis. The emotional and physical energy needed to manage the disease can take a toll on your child, your family and you. There may be times when you need to ask for help with the personal and emotional side of living with diabetes. Make sure you talk with your child’s physician about how your child and family is coping. He or she may refer you to one of these mental health professionals:
    • A social worker who can help you find resources to help with your medical or financial needs
    • A clinical psychologist who can assist in a time of heightened stress
    • A psychiatrist who can prescribe medication to treat emotional problems
    • A marriage or family therapist who can help you with personal marriage or family problems
  • Eye doctor. The American Diabetes Association recommends scheduling an initial appointment with an eye doctor who is an expert in diabetic retinopathy once your child starts puberty, or after your child turns 10 years old (typically three to five years after onset of diabetes). Then, if your child doesn’t have any changes in his or her eyes – or if the changes are minor – an annual visit to the eye doctor is sufficient. Of course, if your child is experiencing non-diabetes-related changes in his or her eyes, he or she should see an ophthalmologist or an optometrist regularly, as recommended by his or her primary care physician.
  • Pharmacist. A pharmacist has a wealth of knowledge on medications, including how they interact with one another and what side effects they have on the body. Your pharmacist can help you learn about diabetes-control medicines and diabetes-related supplies, as well as commonly used over-the-counter medications. He or she can also help you determine the most cost-effective medications and supplies for your child. It’s important to find a pharmacy you like and stick with it. This way, the pharmacist can keep an accurate and up-to-date profile of your child’s medical history, allergies and medications.
  • Dentist. Children (and adults) who have diabetes are at increased risk for some gum diseases like gingivitis and periodontal disease. The excess blood sugar in your child’s mouth can also lead to more cavities. Your child should see the dentist every six months. Make sure to let your dentist know your child has diabetes. It’s best to schedule your child’s routine dentist appointments immediately after breakfast to help avoid hypoglycemia (drops in blood glucose levels).
  • School or daycare personnel. As a parent, you might feel nervous about sending your child to daycare or school for the first time. You may feel even more anxious if your child has type 1 diabetes. But the schools nurse, teachers, bus drivers and administrators can help you and your child prepare for the first day in the classroom. Make sure you notify these school personnel about your child’s condition. They will need to  know about your child’s  glucose monitoring and eating and medication routine, as well as how to recognize, and treat, symptoms of high and low blood glucose levels. These details should be a part of your child’s annual DMMP. 

Keep in mind that you and your child are the captains of your care team. All team activities should focus on helping you and your child manage his or her type 1 diabetes. In many cases, the roles and responsibilities of the team members overlap, so you should feel comfortable talking with everyone.