Tags: A to Z of Special Needs

Diabetes is a metabolic disorder in which a person’s normal hormonal mechanisms do not control their blood sugar levels effectively.

This causes the body to try to use fats as an alternative source of energy, with consequent effects. Diabetes can be caused by a number of factors, including stress.

When diabetes starts in childhood it is usually much more severe than when it begins in middle or old age. Most children with diabetes need two injections of insulin each day, which they usually administer themselves at home. Some will take medication instead and this may need to be taken at school. Treatment is based on a carefully controlled diet, with adequate amounts of carbohydrate, together with the drugs or insulin. Children with diabetes need to ensure that their blood glucose levels remain stable and may monitor their levels using a testing machine at regular intervals.

There are two main types of diabetes.

  • Diabetes insipidus is a rare metabolic disorder which is due to a deficiency of the pituitary hormone which regulates the reabsorption of water in the kidneys.
  • Diabetes mellitus is much more common, especially in children. It is a disorder of the carbohydrate metabolism in which sugars are not effectively converted to energy, causing raised sugar levels in the blood and urine.

If a child with diabetes misses a meal or a snack, takes the wrong amount of insulin or medication, or takes too much strenuous exercise, they may have a hypoglycaemic episode, or ‘hypo’. Alternatively, a child may have an imbalance in the amount of insulin or medication they take due to an infection. This may lead to a diabetic coma. In both cases, it is essential to call the doctor immediately.

Key characteristics

A child with diabetes may

  • lack energy
  • lose weight
  • suffer from dry skin and skin problems
  • be excessively thirsty
  • have a sore tongue
  • have frequent pins and needles
  • have blurred vision
  • need to go to the toilet frequently to pass large quantities of dilute urine.

Indications of a hypo include:

  •  excessive hunger
  • sweating
  • shaking or trembling
  • irritability
  • lack of concentration
  • drowsiness
  • pallor
  • glazed eyes.

Indications of impending coma include:

  • loss of appetite
  • nausea
  • abdominal discomfort
  • furred tongue 
  • drowsiness
  • giddiness
  • slow, deep breathing
  • sweet-smelling breath
  • flushed face.

Support strategies

You may need to:

  • allow the child to eat regularly during the day but particularly before exercise
  • call the doctor or an ambulance immediately when the child is having a hypo or is in a coma
  • give fast acting sugar (eg. glucose tablets, a sugary drink, a small chocolate bar) if they have a hypo
  • give slower-acting starchy food (eg. sandwich, biscuits, milk) when they have recovered from a hypo (about 10–15 minutes later).

Support agencies

Diabetes UK

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