CHILDHOOD DIABETES

Introduction
Diabetes in children is due to a lack of insulin, a hormone which controls sugar (glucose) in the blood. Diabetes causes the glucose in the body and in the urine to rise to high levels making a child with diabetes, before treatment, very thirsty and causing excessive need to pass urine. Most children with diabetes have to give themselves insulin by injection usually twice a day (at home) to keep their blood glucose level as normal as possible. A balance must then be kept between food intake and insulin dose. There is NO DANGER in having a child with diabetes in the Nursery. If there is too little insulin (or too much food) the glucose levels will remain too high. If there is too much insulin (or too little food or excessive exercise) the glucose levels will fall too low and symptoms will occur as described below.

Problems with Diabetes

1. If a meal or snack is delayed or the child has been unusually energetic the blood glucose level may fall too low. This is normally called HYPOGLYCAEMIA or HYPO for short. The typical symptoms of a hypo include the following:
   Lack of co-ordination, hunger, sweating, unusual behaviour, weeping, drowsiness, glazed eyes, dizziness, paleness, trembling.
   A hypo can be treated with half a can of soft drink (not diet) or a small glass lucozade or 3 glucose tablets. Recovery should occur within 5-10 minutes. After this the child should have a small snack such as a glass of milk and a digestive biscuit (or their meal if it is time for lunch.) The child may then continue their activity. (In the case of infants under 1 year of age please consult with the parents.)
2. If a child with diabetes appears to be unwell over a period of days, perhaps with increased thirst and frequent visits to the lavatory, please inform the parents - it may be due to constant high blood sugar, which needs medical treatment.

At the Nursery please remember

1. Always has a supply of sugar/glucose/sugary drink (e.g. Lucozade) easily accessible at all times.
   
2. Allow eating at prescribed times.
   
3. If you are IN CHARGE make sure that other carers know of the diabetes and encourage the child to tell friends about the condition.
   
4. When a child with diabetes is unwell he/she should NEVER be sent anywhere UNACCOMPAINED. If you need to send the child home, make sure there is someone AT HOME and that a responsible person is in attendance.
   
5. Never detain a child unless you are sure that satisfactory eating alternatives have been made. Always inform the parents if he/she is likely to be late (they may fear that there has been a hypo on the way home).
   
6. Try to ensure that children with diabetes have as normal a pre-school life as possible including outings - when at least 2 members of staff should be properly informed.
   
7. Please note that most children with diabetes need to eat a snack or a sugary drink/food before taking vigorous exercise. Try to ensure that both you and the child have supplies of these available at the PLAYING AREA.
   
8. Children with diabetes should always wear an identity chain or bracelet especially if they go on outings.
   
9. Please inform parents if hypos occur regularly.

It is not the intended to overprotect children with diabetes in any way. They should be subject to the same rules as the rest of the Nursery, given this small amount of extra care.

Always consult with your GP