The Pediatrician’s Role in Caring for a Child With Type 1 Diabetes

Young people with type 1 diabetes (also known as type 1 diabetes mellitus) face many challenges in their lifelong quest to manage their disease. With help from their pediatrician and a team of endocrinologists and diabetes specialists, along with support from parents, caregivers and school personnel, young children and teens with type 1 diabetes can understand and learn how to maintain their blood glucose levels and live full, healthy lives.

Managing type 1 diabetes is a lifelong undertaking

Type 1 diabetes accounts for over 90% of diabetes in children and adolescents worldwide. In the United States, it is estimated that up to 3 million children have type 1 diabetes, and about 18,000 are newly diagnosed each year. These children will require lifelong management of their diabetes, starting at the age of diagnosis through their life span. Insulin therapy that matches diet and exercise will be the mainstay of these children’s lives during childhood, into adolescence, and through their adult years.

Pediatricians play a key role in the overall health of their patients, including type 1 diabetes education

Lauren Adler_02R WEB72
Lauren Adler, MD, FAAP

The integrated efforts of parents, school nursing and administration staffs, and healthcare providers are all needed to help these children learn how to manage their diabetes. Pediatricians often take the lead in this effort, working as a team with endocrinologists and diabetes specialists who typically are the primary providers of diabetes care. The role of the pediatrician also includes educating parents about how best to manage type 1 diabetes in their child.

When caring for a child with type 1 diabetes, a pediatrician’s goal is to ensure healthy growth and development (both physical and emotional) and to gradually encourage self-care (with parental supervision) in order for the child to achieve healthy independence.

During school and daycare, childcare providers and nurses share the responsibility of providing healthy diet and medical supervision of insulin therapy and blood glucose monitoring and management of hyper- and hypoglycemia.

A child’s age greatly affects the management of his/her type 1 diabetes

After many years of managing the care of children with type 1 diabetes in our Westchester Health Pediatrics practice, we have observed that effective care is challenged by the age of the child and the associated unpredictability of his or her diet, eating habits and physical activity.

The young child with type 1 diabetes is subject to more viral illnesses such as vomiting and diarrhea which can affect their dietary intake and predispose them to both hypoglycemia and diabetic ketoacidosis (DKA). These may be further complicated by their inability to communicate due to their young age. Hence, astute parents and pediatricians are crucial for the meticulous monitoring of the child’s care and the prompt diagnosis and treatment of illnesses that can trigger hypoglycemia or DKA.

Adolescents with type 1 diabetes pose their own special challenges as they begin to drive and to potentially engage in risky behaviors such as drinking alcohol, smoking and sexual activity. They are also at risk for eating disorders and psychiatric issues, as well as non-compliance with blood sugar monitoring and the administration of their insulin. Again, parents and caregivers need to be vigilant in identifying these issues and providing appropriate therapy and guidance.

The federal 504 Plan protects diabetic children against discrimination

To make sure children with diabetes get the specialized care they need, there is a federal law in place that protects them against discrimination for their disabilities, called a 504 Plan. This outlines the plan the school will follow to ensure students with diabetes are medically safe while receiving their education. Your child may be eligible for accommodations under a 504 Plan if he or she has a physical or mental health disability that limits one or more major life functions.

If your child has diabetes, we’re here to help

If your child has diabetes, or if you would like him/her to be tested for it, please contact us at Westchester Health Pediatrics. We’re also happy to talk with you about any concerns or questions you might have about managing your child’s diabetes, and we look forward to meeting you and your child.

By Lauren Adler, MD, FAAP, Lead Pediatric Physician with Westchester Health Pediatrics, member of Northwell Health Physician Partners