Testing for Children with Diabetes

Daily testing: the American Diabetes Association has specific daily testing recommendations for adults with type 1 diabetes and insulin-dependent type 2 diabetes. However, managing diabetes in children does not lend itself to specific recommendations.

Pediatric endocrinologists need to tailor the testing to each child, based on the following considerations:

  • In children, insulin doses based on body size alone are likely to be incorrect.
  • Children respond differently to hypoglycemia (low blood glucose) than adults do.
  • Puberty impacts a child’s risks for diabetic complications.

Once daily testing recommendations have been worked out, parents need to keep a logbook or use a sensor to track testing results over time. Some common testing situations include:

  • Before each meal
  • One or two hours after a meal
  • Before a snack
  • In the middle of the night
  • Before exercising, to determine whether the child should eat something first
  • During and after physical activity
  • If you think your child’s blood sugar may be high, low, or dropping
  • When the child is sick or under stress

A1C Testing

Once a child has been diagnosed, their doctor will periodically prescribe an A1C test to determine the level of blood sugar control. This blood test provides information about a child’s average blood sugar levels over the three months preceding the test. An A1C test result is reported as a percentage.

Ketone Testing

Ketones are a chemical the body produces when there isn’t enough insulin in the blood and the body starts using fat for energy instead of glucose. This is more likely to occur in type 1 diabetes than in type 2. Ketones upset the chemical balance of the blood and are toxic to the body. Combined with high blood glucose, ketones in the blood are a sign of poorly managed diabetes. Ketones can be detected through a simple urine test you can buy at the pharmacy. Talk to your child’s doctor at once if their urine results show moderate to large amounts of ketones.

Signs of Elevated Ketone Levels

  • Blood glucose of more than 300 mg/dl
  • Nausea, vomiting and/or abdominal pain
  • Feeling tired all the time
  • Thirst and dry mouth
  • Flushed skin
  • Breathing difficulties
  • A strange, fruity breath odor
  • Feeling confused or "in a fog"

SOURCES

  1. ADA: http://www.diabetes.org/diabetes-basics/type-1/