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For Parents: Diabetes Care (3 to 5 years)

Diabetes care in young children is not always easy. It might seem like there is a lot for you to remember. But you don’t have to do it alone! You’ll work with your child’s health care team to develop a diabetes management plan. Use the tips on this sheet to help you adjust to managing your child’s diabetes. NOTE: This sheet does not give all the information you need to care for your child with diabetes. Ask your child’s health care provider for more information. 

You should have a diabetes management plan that instructs you on the overall treatment plan for your child's diabetes. It should include: 

  • A detailed list of medications, instructions, and when to use each

  • Monitoring blood sugars

  • Symptoms of and treating low blood sugar levels

  • Symptoms of and treating high blood sugar levels

  • Carb counting if your child needs coverage for what they are going to eat.

  • Instructions on dealing with physical activity and sports

  • What to do in an emergency

Also make sure you discuss dealing with day care and school with your health care provider. 

Outline of child's hand with shaded areas on sides of tips of fingers, pad of thumb, and side of palm. Outline of child with shaded areas on forearms.

Checking Your Child’s Blood Sugar

At first, young children may be frightened of finger sticks for blood sugar checks. You can help your child feel more in control. Let him or her pick the finger or site to be used for the check. If needed, offer nonfood rewards, such as stickers or time playing favorite games. This can help your child feel better about checking blood sugar. At this age, children often need checks in the middle of the night. You can do blood sugar checks while your child is sleeping.

Managing Low Blood Sugar

It’s very important for young children’s blood sugar never to get too low. Very low blood sugar (hypoglycemia) can affect a child’s developing brain. So, manage your child’s blood sugar as much as possible without letting it get too low. Very young children can’t tell you when they have low blood sugar. Over time, you will learn what is normal for your child. This will help you recognize symptoms of low blood sugar. Pay close attention to how your child is acting. Your child may have low blood sugar if he or she is:

  • Pale

  • Fussy

  • Very irritable

  • Sweaty

  • Lethargic (sleepy or drowsy)

  • Staring into space or glassy-eyed

  • Shaky

  • Confused or having difficulty concentrating

  • Complaining of visual problems, headaches, or nightmares

  • Uncoordinated

  • Dizzy

If you suspect your child has low blood sugar, check it right away. If the result is less than 70, take action. Treat your child right away with a fast-acting sugar as you were told by the health care provider. If your child is confused, unresponsive, unconscious, or having convulsions (seizures), he or she may have severely low blood sugar. Treat your child right away with glucagon. This is a substance that will raise your child’s blood sugar very quickly. Always have an emergency kit with a shot of glucagon with you. (Your child’s health care team will teach you how to give a glucagon shot.)

Low Blood Sugar: When to Call the Doctor

Call your child’s health care provider right away or seek emergency care if your child has any of the following symptoms:

  • Hard to wake or unresponsive

  • Passes out (faints)

  • Blood sugar below the “danger number” given to you by the health care provider

  • Any time glucagon is given

  • Seizure

Managing ShotsOutline of child from front with shaded areas on sides of upper arms, on either side of lower abdomen, and on tops of thighs. Outline of child from back with shaded areas on side of buttocks.

The amount of insulin your child needs and how often it’s needed may vary. It depends on when and how often your child is eating. Give insulin shots after your child has eaten, not before. This way, you’ll be giving the correct amount of mealtime insulin based on what your child eats. Your child’s health care team will teach you how to give your child shots. In young children, the best places to give shots are:

  • Buttocks

  • Abdomen (avoid injecting within 2 inches of the navel)  

  • Sides of thighs

  • Back of upper arms

Coping with Shots

At first, you may have some concerns about giving shots. If you are nervous, you may want to practice on yourself first. Ask your child’s health care provider about giving yourself an injection of sterile saline to learn how a shot feels. (If you are afraid of needles, using an injection device may help ease your fear.) How quickly your child adjusts may depend on how comfortable you are giving shots. Treat shots as a normal routine.

Helping Your Child Deal with Shots

It’s not unusual for children to cry and be upset when they get shots. But most children adjust very quickly to diabetes care. Shots and blood sugar checks may not be easy for your child to deal with at first. Your child should never feel that blood sugar checks and insulin shots are “punishment.” Here are some tips to help make getting shots easier for your child:

  • Always give your child love and attention before and after shots.

  • Use toys or other types of play to focus your child on something fun.

  • Help your child adjust by demonstrating shots on stuffed animals. Your child may even be able to practice giving shots to stuffed animals using a needle-less syringe.

  • Talk to your child’s health care team about other ways to help your child deal with insulin shots.

Food Issues with Young Children

Even young children can start learning about foods that affect blood sugar the most. Keep these things in mind:

  • Your child’s health care team will teach you about carbohydrates. Carbohydrates are foods that give your child the energy he or she needs to grow. But they also raise blood sugar higher and faster than other kinds of foods. Your child’s health care team will teach you “carb counting.” This is a technique to help you figure out how many carbohydrates your child eats each day. Carb counting helps you decide how much insulin your child needs.

  • Remember that kids will be kids! While it may be necessary to limit eating to meal times and scheduled snacks and to restrict certain foods in terms of quantity and frequency in order to obtain the best glucose control, no foods should be "off limits." Children will sneak treats if they feel deprived. So work the foods your child likes to eat into his or her meal plan. Adjust insulin dosages as needed. The health care team will teach you how to adjust your child’s insulin based on what your child eats.Boy giving pretend injection to stuffed animal while healthcare provider and woman look on.

Physical Activity Issues with Young Children

Like food and insulin, physical activity plays a big role in managing your child’s blood sugar. Being active helps reduce the amount of glucose in your child’s blood. But too much activity can cause your child’s blood sugar to get too low. That’s why it’s important to check your child’s blood sugar often when he or she is active. Talk to your child’s health care provider to learn how to balance your child’s activity with food and insulin.

School Issues with Young Children

If your child attends preschool or kindergarten, you will need to meet with school officials and teachers. You will need to work out a diabetes care plan for your child. This is sometimes called a “504 plan.” You may even wish to find a preschool or day care provider with diabetes care experience. Keep in mind that you will need to be reachable at all times in case of an emergency.

Diabetes Affects the Whole Family

Caring for a young child with diabetes is a full-time job. You may sometimes feel worn out or overwhelmed. This can lead to burnout. Feeling burned out means that you might have a harder time managing your child’s blood sugar. These tips can help you:

  • All the adults in the household should be involved with diabetes management. Anyone else who takes care of your child, such as a babysitter, must also be prepared to manage your child’s diabetes. A diabetes class can help. So can joining a diabetes support group or talking with a social worker.

  • Keep in mind that it may take some time for your family to adjust to diabetes care. At first, it might seem like your child with diabetes needs more attention than siblings without diabetes. Try to give siblings equal attention.

Making Adjustments

Despite your best efforts, your child’s blood sugar numbers will sometimes be too high or too low. When this happens, you may take these readings personally. After all, you’re working hard every day to keep your child’s blood sugar in target range. But try to remember: The numbers are tools to help you make decisions about your child’s management plan. As your child grows, his or her body changes quickly. This means that perfect blood sugar control is impossible. Adjustments to your child’s management plan are not a sign of failure. They are a normal part of your growing child’s diabetes care. Still, within these limits, most families manage to have very good blood sugar control. 


For more information about diabetes, visit these websites:

  • American Diabetes Association

  • Children with Diabetes

  • Juvenile Diabetes Research Foundation

  • American Association of Diabetes Educators

  • American Association of Clinical Endocrinologists

  • National Diabetes Information Clearinghouse


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