Kids and teens living with diabetes Information for children and young people living with diabetes Whether you’re a kid, a teen or in between, if you’re dealing with diabetes you’re a hero! There’s a lot of information on our website; some of it gets complex. You can always talk to us if you need some help understanding it. What is diabetes? If you’re new to diabetes, first, find out about diabetes and how it affects your body. Diabetes, also known as diabetes mellitus, happens when the glucose in your blood stays high. Everybody has glucose in their blood. It’s in the food we eat. Food provides energy and glucose for our muscles, organs and brain to work, think and play. When you have diabetes, the glucose needs help to move out of your blood and into the cells of your body (those found in your muscles, organs and brain). For the glucose to get into your cells, it needs insulin. Insulin is made in an organ called the pancreas, which is found behind your stomach. People with diabetes either cannot make insulin or the insulin made does not work properly. Insulin is like a key. It ‘unlocks’ the doors of your cells, allowing glucose to get in. Glucose gives your cells the energy they need to do their job. High levels of glucose in your blood every day can make you feel unwell. If not treated, over time the glucose can also cause damage to your eyes, feet, kidney, heart and brain. Types of diabetes There are different types of diabetes. The main types are type 1 and type 2 diabetes. Type 1 diabetes Type 1 diabetes is an autoimmune condition with no known cause or cure. If you have type 1 diabetes, your pancreas is not making the insulin your body needs. If you have type 1 diabetes you can do everything other people can do, but you also have to do a few extra things: Have insulin every day either by injection or via an insulin pump Check your blood glucose levels (BGLs) Count carbohydrates in the foods you eat. You can learn more about diabetes by watching these videos. Video: What is Type 1 diabetes? A children’s guide Video: What Is Type 1 Diabetes Video: Highs and lows Video: Diabetes Management Video: Mood Food Move Me = busting diabetes myths Type 2 diabetes If you have type 2 diabetes it means your pancreas is not making enough insulin or the insulin it is making is not working properly. Generally, you can manage type 2 diabetes by eating healthy foods and being active. Sometimes medications like tablets or insulin may also be needed. If you have type 2 diabetes, you also need to check your blood glucose levels (BGLs) and learn about carbohydrate foods. Blood glucose levels Balancing your blood glucose levels (BGLs) is important to feeling good and staying healthy. When you have diabetes, it can be hard to get this balance right. Some things lower your BGLs like insulin and physical activity. Other things raise your BGLs, like food or being ill. But remember your parents, carers, health team, teachers, and friends are there to help you when you need it. You can check your blood glucose levels on a blood glucose machine or a Continuous Glucose Monitor (CGM). Low BGLs Low blood glucose is known as hypoglycaemia, or ‘hypo’ for short. Hypos can happen for different reasons – too much insulin, not enough carbohydrates or as a result of being active. When a hypo happens, you might get confused, start to sweat, feel dizzy and could even pass out (lose consciousness). Hypos can happen very quickly and they must be treated immediately. Usually, they can be corrected by eating some lollies like jelly beans, drinking juice or soft-drink. When you live with type 1 diabetes, it’s important for you to carry a hypo kit. Your hypo kit must always be with you so you are prepared. High BGLs When your body doesn’t have enough insulin, glucose builds up in your blood and makes you feel unwell. This is called hyperglycaemia, or ‘hyper’ for short. Hyperglycaemia happens gradually. The early symptoms (thirst and going to the toilet a lot) can be mild. If your BGL is above 15mmol/L and you’re feeling alright, you can do most of the things that your friends are doing. If your BGL is above 15mmol/L and you’re feeling unwell, you might have ketones. High BGLs and ketones can make you really unwell because it means that things are out of balance in your body. When you feel like this, you need to: let someone know check your BGL more often check for ketones drink plenty of water rest. You may need extra insulin when your BGLs are high and you have ketones. If you need help or advice, ask your parents or healthcare team about what to do with your insulin dose. Your hypo kit Your parents or carers can help you put your hypo kit together. Your hypo kit should include things like: your blood glucose monitoring device so you can check your blood glucose level a fast-acting carbohydrate (e.g. fruit juice, glucose tablets) a slow-acting carbohydrate (e.g. a muesli bar or 2 sweet biscuits). If you use the food or drink in your hypo kit, let your parents know so it can be replaced. If you don’t use this monitor very often, make sure to check it on a regular basis. Your parents or carer can help you check the battery and the strips. It’s also important that your teachers know where your hypo kit is kept at school, just in case you need help treating a hypo. We recommend you keep your hypo kit with you at all times. Hypo treatment at school Video: What happens when you have a hypo at school? https://www.youtube.com/watch?v=UkowBQyeTt0 Hypo frequency Video: How many hypos do you have in a school week? https://www.youtube.com/watch?v=3jCI-j7JqtE Having diabetes at school Video: Have you had any problems with your diabetes care at school? https://www.youtube.com/watch?v=aiHfhgHD90o Talking about diabetes When you are living with diabetes it’s important that you tell your teachers and teaching assistants so they can look after you properly at school. Your friends probably don’t know much about diabetes and will be interested to hear what you have to say about it too. We know that talking about your diabetes can be really useful, so tell your friends and family how they can help. Try talking with your parents first about what you might say to your friends and teachers to help them understand the things you have to consider every day. Exams and tests When living with diabetes, there are a few extra things to consider before tests and exams. You may need a bit more time to prepare for an exam on the day to make sure you have everything you need. Being prepared is the key! Before an exam, remind your teacher you may need to access your hypo kit, your mobile phone (if on a CGM), and the bathroom during the exam time. Sport days When a person living with diabetes plays sport, their BGLs may go up or down depending on the type of physical activity. This can happen during the physical activity, right after or, in some cases, hours later. You may need to have additional carbohydrate foods before, during or after physical activity to keep your BGLs within a healthy range and to avoid a hypo. While physical activity generally lowers your blood glucose levels, sometimes it can raise them. This can happen if you play an active sport or if you feel excited or stressed about the competition. The best way to know what your BGLs are doing is to check them regularly. Before, during and after physical activity. Ideally, your diabetes management plan for school provides details on special sports and physical activity considerations. Please talk to your diabetes treating team about a sports management plan. School camps School camps are fun! Preparation is the key. Your parents will talk to your school so that you can participate in the camp program and have the support that you may need on camp. Some things to remember: Follow the camp organisers’ recommendations on the list for clothes, shoes, swimming and sleeping gear. Ensure you have enough glucose monitoring equipment and spare batteries, meter and strips (including ketone strips) for the camp. Ensure you have enough insulin (and insulin pens if you are pumping) for the duration of the camp. Also, consider the storage of your insulin on camp. Have a hypo kit with spare replacement treatment for the duration of the camp. Take along a ‘bum bag’ or similar for your gear while doing activities. Make sure your teachers and the camp directors know that: You are allowed to eat and drink on the bus (if travelling by bus) You may need access to a toilet or regular toilet stops Ensure that you have a sharps container and consider where you dispose of your strips. Take your Diabetes Action Plan for the teachers and camp organisers to follow. Ensure that your parents, teachers and camp organisers have a conversation about your camping needs. Have a diabetes management plan form signed by your diabetes treating team. Make sure the school have had some training. Chat to your friends about what signs to watch for to alert them if you are having a hypo and may need assistance and support. Information for parents and carers Diabetes at school You can find comprehensive information and resources on our website for attending school when you have diabetes. Find out more Diabetes in Schools is an information and training program designed for families and schools to help them to better support students with type 1 diabetes at school. The program provides access to range of tools, resources, information and support to help parents and schools better understand how to support students with type 1 diabetes while at school. www.diabetesinschools.com.au Support for teenagers Diabetes Australia has developed an app for teenagers living with type 2 diabetes; You & T2 to provide diabetes information and education. The You & T2 app provides teenagers with type 2 diabetes with: a diabetes education tool to support them in the management of their diabetes an opportunity to access diabetes education in a non-judgemental environment, on demand, anytime and anywhere practical, age-appropriate information that directly addresses the unique challenges faced by teenagers living with diabetes. You can access the app here: You & T2 Created in partnership with the Sydney Local Health District – NSW Health and Diabetes Australia. Transitioning to adult care Transition is the transfer from paediatric (child) to adult health care. Ideally this can happen between the ages of 12 and 20. Successful transition is very important for the long-term health and happiness of young adults living with a chronic condition. The transition of diabetes care usually happens at the same time as many other developmental and lifestyle changes. It should be seen as just one of many life transitions that a young adult makes—like moving out of home or moving from school to Uni or TAFE. Sometimes young adults don’t like where they have been transferred to—or feel that they don’t receive enough support during the transition process. As a result, they drop out of the healthcare system—only to return with serious and often avoidable diabetes-related complications. Staying connected to a health care team is the key to reducing the risk of long-term diabetes-related complications. Moving on Up resource Moving on Up is a resource designed for young people with type 1 diabetes and their parents or carers, about the transition from paediatric to adult health care services. This booklet covers how young adults can live well with their diabetes through this time, the responsibilities they have for their own diabetes care and the support they can expect to receive. More information, support and resources for young people can be found on the NDSS website. DiaBuddies DiaBuddies events and programs are organised to enable families with kids with type 1 diabetes to come together to celebrate life and form supportive connections with each other on the journey with diabetes. Find out more about the DiaBuddies community.