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DIABETIC CONTROL OF THE CHILD

  
  Goals for managing diabetes  
  Free of his symptoms of polyurea and polydipsia
Emotional and psychological development is normal
Not easily fatigued with exercise
Free of hypoglycemic attack and if present, they are few and mild in nature.		  
     
  Well controlled his health will be unaffected ,properly controlled children grow pretty well. If the child does not grow at the usual rate of 2.2 Kg. per annum or more during puberty there is every possibility of poor control. Some diabetic children may be obese, it may be either familial or diet breaking or over treatment with insulin.  
     
 

 

 
  Traveling  
  There are a few things to keep in mind to make sure your trip is a good one.  
 
  • Get all your shots ahead of time, especially immunizations. Make sure you get these at least four weeks before leaving to prevent a reaction that affects your blood sugar while you are away.
 
 
  • See your health care provider to make sure your blood sugars are controlled. Have your A1C counts, blood pressure, pulses and cholesterol checked.
 
  • Wear diabetes identification, such as a MedicAlert® bracelet. Ask your doctor for a prescription and a letter about your condition. Carry these with you at all times. If you are going to a non-English speaking country, learn how to say: "I have diabetes. Please get me to a doctor," and "Sugar or juice, please."
 
  • Plan for time zone changes, even if it is just an hour's difference. Talk to your doctor about making adjustments in your medications, meals or insulin injections. Don't do this on your own.
 
  • Bring along twice as many medications and supplies as you need. If you're delayed overnight or stuck in traffic, you may need more than you planned. In other countries, you could have trouble getting your prescriptions filled.
 
  • Keep insulin cool by packing it in an insulated bag with blue ice.
 
  • Keep your diabetes medications and insulin with you. If you're flying, keep them in your carry-on luggage or your purse. The best place to keep these, along with snacks, is at your seat, not in the overhead bin. If you're driving, don't put your supplies in the trunk, since temperatures there can quickly rise. Don't leave medications in the car.
 
  • Make sure all your medications and supplies are well marked and include prescription information.
 
  • Wear a watch with a beeper so you know when to take medications or insulin, have a meal or check your blood sugars. Ask your travel companion to remind you. Your new schedule may throw you off.
 
 
  • Be sure to regularly stretch your legs, about every hour or so. Dangerous blood clots can develop in your legs and travel to other parts of your body.
 
 
  • Let flight attendants or travel companions know about your condition and what you'll need in an emergency.
 
 
  • If you are leaving the country, get a list of English-speaking doctors. Call the American Consulate or American Express for such a list.
 
 
  • If meals are to be served on your flight, ask for a diabetic meal when you book the flight.
 
 
  • Keep the name of an emergency contact with you.
 
 
  • Be sure to track your sugars often. Changes in activity, diet, time zones and schedule may affect your control.
 
 
  • If going through airport security, tell the screener that you have diabetes and have your supplies with you. If you prefer, you can ask for a visual inspection rather than walking through the metal detector or being hand-wanded.
 
  Managing diabetes during a disaster  
  Managing diabetes during a disaster means packing an emergency kit, protecting your medications, monitoring your health and preventing infection.
Emergencies can strike at any time. A hurricane, tornado, earthquake, blizzard or flu pandemic may disrupt life as you know it for days, weeks or months on end. When Hurricane Katrina struck the Gulf Coast in August 2005, more than 200,000 people with diabetes were affected. Some lost medical services and found themselves in shelters without access to lifesaving insulin injections.		  
  But even minor emergencies — such as a temporary power outage in your neighborhood — can present challenges when it comes to managing diabetes. Your safety depends on planning your responses now. Use the following strategies to guide your actions for any type of emergency.  
  Pack an emergency kit:  
  Begin by gathering enough supplies to last for at least a week. In case of emergency, you'll need:
1. Medical supplies. Pack tissues, alcohol swabs, syringes, cotton balls, testing strips, blood glucose meters and any other items key to managing diabetes. Also include a pencil and pad of paper for recording blood sugar levels. 		 
  2. Medications. Be prepared to store insulin, glucagon and other drugs in a cooler. Keep ice or freezer packs handy in case refrigeration fails. Remember that your needs for medication may change if your weight or stress levels change during the emergency period.  
  3. Non-perishable drinks and snacks. Set aside bottled water, granola bars, peanut butter, crackers, cereal, orange juice, or any other snacks recommended for controlling your blood sugar. Remember that you may need to eat more at times when your activity level increases — for example, when walking long distances or lifting heavy objects.  
  4. Routine emergency items. Include a first-aid kit, whistle, candles, matches, gloves, flashlight and radio with spare batteries.  
  5. Medical records. Pack copies of your insurance card and prescriptions in a waterproof plastic bag. Also keep a list of your health care providers and emergency contacts. If your child has diabetes, include a copy of the health care records you've shared with your child's school.  
  6. Store your emergency kit in a place where you can easily find it. Make sure that relatives, friends and neighbors know where you keep the emergency kit. Inspect the kit at least once a year, updating medical records and replacing expired items as needed.  
  Tell others about your diabetes:  
  If you're evacuated to a shelter or other location, identify yourself as a person who has diabetes. If you have diabetes-related complications, mention those as well. Sharing this information immediately means that you're more likely to get appropriate attention from relief workers. It's also important to wear appropriate medical identification at all times.  
  Protect your medications:  
  Keep insulin as cool as possible without freezing it. Also protect it from direct heat and direct sunlight.
Remember that extremes of temperature and humidity can affect medications, blood glucose monitors and test strips. Keep the package inserts for these items and check for information on how to use them in unusual conditions. Keep your medication containers, too. As long as you have the original containers, you might be able to get medications in case of emergency without a prescription.
Discard any medications that come in contact with flood water or other contaminated water. Make a possible exception for lifesaving drugs. If pills are still dry and clean, use them until you can find replacements.		  
  Avoid dehydration:  
  High blood sugar can lead to dehydration. If you're exposed to high temperatures, you can lose body fluids through sweating — which only compounds the risk.
During a disaster, clean drinking water may be in short supply. Ask relief workers if you can boil water for drinking. If not, turn to the water in your emergency kit. Supplement this with bottled drinks that don't include sugar or other carbohydrates.		  
  Prevent wounds and infections:   
  Diabetes can cause problems with blood circulation and make it harder for you to recover from wounds and infections. During a disaster, do everything you can to avoid injuries. Check your feet daily for sores, cuts and blisters. Also look for signs of infection, such as swelling, redness or discharge from a cut. If you're injured or notice signs of infection, seek treatment right away. Treating open wounds immediately can help prevent potentially life-threatening infections.  
  Wash your hands: Washing your hands is one of the most important ways to prevent illness and infection. This simple strategy is especially important in emergency conditions. Be sure to wash your hands:
Before preparing or eating food
After using the toilet, changing a diaper or helping a child use the toilet
After coughing or blowing your nose
After caring for someone who's sick
After handling uncooked foods, especially meat and fish
After handling animals or animal waste
After handling garbage or storm debris
Soap and clean, fresh water work best. If these aren't available, look for alcohol-based hand wipes or gels. The steps you take to keep your hands clean can go a long way toward promoting good health during an emergency.