• If 75-80% of your daily blood sugar readings are between 100-200mg/dl – then you are doing good !!
  • Ideally BG should be checked 5 times/day –
    • Morning- before breakfast (fasting)
    • Afternoon- before lunch
    • Evening- before dinner
    • 2.5-3 hrs post dinner
    • Late night- 3 am
  • It is essential to check BG and give Insulin injection before giving 3 major meals - Breakfast/ Lunch/ Dinner – DO NOT MISS INSULIN DOSE
  • It is important to coordinate child’s food (meal + snack) with peak time of insulin –
    • Rapid insulin (Humalog/ Novorapid) – food to be given within 2-2.5 hrs of giving insulin
    • Regular insulin (Actrapid/ Huminsulin R)  – food to be given within 3-3.5 hrs of giving insulin
  • If peak time of insulin is over and child is hungry, FREE FOODS (carbohydrate < 5 grams) can be given to the child before next meal –
    • Lemonade (salted)
    • Buttermilk
    • Paneer/tofu
    • Soya
    • White portion of egg
    • Salad (no salad dressing)
    • Soups (veg/ chicken)- avoid adding cream/butter/corn/corn starch
    • Popcorn (prepared at home)
    • Roasted chana- murmura
    • Nuts- almonds and walnuts (4-5)
    • Roasted Makhana
  • Long acting insulin (Lantus/ Tresiba) – to be given at a fixed time every evening/morning – no need to check BG before giving this insulin.
    • PLEASE REMEMBER - This insulin will not cover any food eaten after taking this injection
    • Do not change timing/dose of this insulin without your doctor’s consultation
  • If child has low BG (<80 mg/dl) –
    • Give ½ - 1 teaspoon of sugar to the child (depending on child’s age)– Repeat BG check after 20 mins
      • If still <80- repeat the same – can be repeated 3 times
      • If > 80 – give insulin injection followed by child’s meal/give a snack
    • Other options – honey/glucose water/2-3 sips coke/ juice
      • DO NOT give chocolates/biscuits/toffees- as these contain fat, so they do not increase blood sugar immediately.
    • Injection GLUCAGON – to be used only in case of hypoglycaemic emergency- if child becomes unconscious/ has a fit (unable to take sugar from mouth)- to be given like an insulin injection.
  • If child has high BG (>300 for consecutive 2 days) -
    • Increase insulin dosage
    • Change your insulin vial
    • Check for KETONES in urine (ketodiastix)
    • Make your child drink more water
    • Contact your doctor
  • If any time you feel your child is not behaving normally- angry/ irritated/ overly sleepy/ very lethargic- check his/her BG.
  • If the child is unwell (stomach ache, vomiting, high grade fever, fit, etc.)- immediately consult with your paediatrician.
    • Frequent BG monitoring should be done when the child is unwell
    • Check for urinary ketones
    • DO NOT MISS INSULIN DOSAGE EVEN IF THE CHILD IS EATING LESS!! – as body requires more insulin at the time of illness.
  • Always keep insulins in door of fridge – Insulins should NOT freeze – do not use frozen insulin, discard them.
  • Keep changing insulin injection site – repeated injections at same site can cause swelling/atrophy – leading to poor insulin absorption.
  • Maintain daily BG monitoring diary and carry it with you for every doctor’s appointment –
  •  NUTRITION –
    • Avoid simple sugars like- table sugar, honey, candy, sweets, fruit juices etc.
    • Avoid fruits like- mango, grapes, litchi, jackfruit (high sugar content)
    • As a thumb rule – sweeter the fruit, giver lesser the quantity
    • Eat balanced meals with inclusion of variety of vegetables, whole grains and pulses.
    • Exercise should be a part of daily routine
  • Whenever you travel, you should carry following things with you -
    • Insulin pens (with ice packs)
    • Extra cartridges
    • Glucometer with strips
    • Something sweet – sugar sachet/candy/juice
    • A snack
    • If travelling for more than a day – ketone sticks and Inj. Glucagon