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Intro to BG Management

A number of factors impact your child’s blood glucose reading at any given moment in time. Effective glycemic control (that is, reducing highs and lows, and maximizing the time your child spends in the target blood glucose range) requires attention to these factors, and may involve proactive changes in how you or your child manage his diabetes, as well as changes in how you react to certain factors. Some of these factors decrease blood glucose, while other factors lead to an increase, as follows:

Factors which Raise BGfactors that raise blood sugar in type 1 diabetes

  • Food and Drink Consumed
 When your child eats foods containing carbohydrates (or protein, to some degree), her blood glucose will rise.

The goal of effective blood glucose management is to match the food bolus (insulin dose to cover food) as closely as possible to the food consumed, so that blood glucose rises as little as is reasonably possible, and returns to the target range after meals and snacks.

(See the articles in the Nutrition section of this website, WaltzingTheDragon.ca)
  • Hormones (released due to growth, stress, menstruation, etc.)
If your child is in a growth spurt, has entered puberty, is menstruating, is in a period of elevated stress or excitement (such as exam time, travel, or exciting visits with grandparents or to an amusement park), you may need to make adjustments to the insulin she receives, possibly giving more insulin than her body would require in non-growth, non-stress, non-hormonal times.
tips from the trenches of type 1 diabetes

When we travel, we find that we need to increase our son’s basal insulin significantly, or else we are constantly battling high blood glucose. ~Michelle

Factors which Lower BGfactors that lower blood sugar in type 1 diabetes

  • Recent Insulin Doses
Your child’s blood glucose will be affected by the amount of insulin that is currently acting, including:

You may find that changes need to be made periodically to these rates and ratios to meet the changing needs of your child’s body for insulin. Also, If your child is on a Conventional Insulin Program and there have been or will be changes in his eating habits/planned meals, insulin doses may need to be adjusted.
  • Exercise
If your child will be participating in planned exercise, you may need to adjust insulin doses or provide extra carbs to accommodate for the blood-glucose-lowering effect of physical activity.
(See Exercise Affects BG for more information.)

Factors which may Raise OR Lower BGfactors that raise and lower blood sugar in type 1 diabetes

If your child is sick, his insulin doses will likely need to be adjusted (either up or down) throughout the course of the illness.
tips from the trenches of type 1 diabetesWe have found that our son has several unexplainable lows for about 3 days before he shows symptoms of a cold or flu-like illness. Just when we’re wondering “what the heck is going on here?!” he starts to cough or get congested, and then highs often become the norm for the next few days. ~Michelle

  • Stress
Although stress generally leads to high blood glucose, we have heard from more than a few kids that lows are more common just before or during school exams.
  • Exercise
Although exercise most commonly lowers blood glucose, there are circumstances in which exercise actually raises it. (See Exercise/Next Steps for Exercise.)

When your child experiences any of the above factors, or you notice that her blood glucose is often below or above the target range, you may want to explore some of these factors in more detail. For more information, click on any of the underlined topics above for more information. Many parents choose to consult with their child’s diabetes health care team for assistance with changes to the blood glucose management regime.

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The above information was reviewed for content accuracy by clinical staff of the Alberta Children’s Hospital Diabetes Clinic.

This material has been developed from sources that we believe are accurate, however, as the field of medicine (in particular as it applies to diabetes) is rapidly evolving, the information should not be relied upon, as it is designed for informational purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate health care professional.

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