Caring for the child with diabetes

Summary  CARE of the child with diabetes presents a continuously changing challenge as the physiological and psychological factors influencing diabetic control interact with the period of growth. Attempts to achieve diabetic control must be based on thorough patient education and on a knowledge of how the blood glucose fluctuates within a day, from day to day and from week to week. Twenty-four hour metabolic profiles give an insight into the blood glucose swings on particular insulin regimes which allow a rationalisation of diabetic management. The main adjustable variables in management are the insulin: type, timing, frequency and dose; the diet: carbohydrate quantity, distribution, presentation and source; exercise and psychological and environmental stresses.