A Comprehensive Approach to Managing Diabetes in Children and Adolescents

Diabetes management in young people requires a multifaceted approach that goes beyond just controlling blood sugar levels. The American Diabetes Association’s (ADA) guidelines provide valuable insights into caring for children and adolescents with diabetes, emphasizing the importance of personalized care, regular monitoring, and lifestyle modifications. 

Nutrition: More than just counting carbs

While carbohydrate content is crucial for insulin dosing, the ADA guidelines point out that “meals with higher content of fat and protein can cause early hypoglycemia and delayed postprandial excursion.” This means that high-fat or high-protein meals can affect blood sugar levels in complex ways, requiring adjustments to insulin dosing strategies. The guidelines note that nutritional management should be tailored to each child’s needs, considering “family habits, food preferences, religious or cultural needs, finances, schedules, physical activity, and the youth’s and family’s abilities in numeracy, literacy, and self-management.”

Physical activity: finding the right balance

Exercise is crucial for overall health, with the recommendation of 60 minutes of moderate to vigorous intensity aerobic activity daily. It’s also recommended that children engage in vigorous muscle-strengthening and bone-strengthening activities at least three days per week. However, managing blood sugar during exercise can be tricky. The guidelines stress the importance of “frequent glucose monitoring before, during, and after exercise” to prevent and treat any blood sugar fluctuations. 

Monitoring children’s conditions: Setting glycemic goals

The  ADA’s guidelines suggest individualized A1C goals, typically aiming for less than 7% for most children and adolescents with type 2 diabetes. However, they acknowledge that “even less stringent A1C goals (such as <8%) may be appropriate for individuals with a history of severe hypoglycemia, limited life expectancy, or where the harms of treatment are greater than the benefits.”

Beyond blood sugar: addressing other health concerns

Diabetes management for youth isn’t just about diabetes. The guidelines also emphasize the importance of monitoring for other health issues, including: 

  • Cardiovascular health: “Intensive lifestyle interventions focusing on weight loss, dyslipidemia, hypertension, and dysglycemia are important to prevent overt macrovascular disease in early adulthood.”

  • Kidney health: Regular screening for kidney function and albumin in the urine is recommended.

  • Mental health: Monitoring the psychological impact of diabetes and stress the importance of mental health support.

By taking a wholistic approach to diabetes care with children and adolescents, healthcare providers and families can work together to improve overall health outcomes and quality of life for young people living with diabetes.

Source: American Diabetes Association Professional Practice Committee. Children and Adolescents: Standards of Care in Diabetes—2024. Diabetes Care 1 January 2024; 47 (Supplement_1): S258–S281. https://doi.org/10.2337/dc24-S014

Pumper Car Team