If the insulin or the diet was not properly adjusted, the child would probably feel sick or not grow properly. We do not want this to happen. We want to know if the diabetes is getting out of control before he feels the bad effects of this. We can do this by measuring the level of glucose in the blood.
The body needs a certain amount of glucose circulating in the blood at all times: not too much and not too little.
If there is too much (as when diabetes is not well controlled) it may lead to ill-health, but if there is too little the body – particularly the brain – may suffer from inadequate glucose energy. So by measuring the level of glucose in the blood we can check whether treatment for diabetes is just right or whether it needs adjustment.
The level of glucose in the blood of young people with diabetes on insulin treatment can vary a lot during the day, so we may need to check this at various times of day.
If levels of glucose in the blood rise too high, we may need to increase the insulin dose or perhaps check that the diet was correct. If the level of glucose in the blood is too low we may need to reduce the dose of insulin or have more food. Thus these tests help to adjust insulin and diet to keep good control of diabetes.
When a child develops an infection or other illness (such as a cold or flu) the level of glucose in the blood may rise, and we may need to increase the insulin dose for a few days while he is sick. This helps the child get over the illness quickly.
If there is too much glucose in the blood it spills out into the urine, we can test for this also. Some children prefer to test their urine rather than their blood. Urine tests are not as reliable or informative as blood tests, but they can provide a useful guide.
If we find glucose in the urine it suggests there was too much in the blood. As glucose levels in blood do rise at times, particularly after meals, it may be hard to avoid small amounts of sugar appearing in the urine from time to time.
If the urine contains no glucose (no glucose has spilled out into the urine, so the blood glucose levels were not too high) this may be a sign of really good control, but we need to be on the lookout for hypos.
The child with diabetes is asked to do things in controlling his diabetes that may seem boring or irritating. He should remember however that the treatment of diet and insulin and the tests and regular check-ups are designed, not only to keep him feeling well from day to day, but to help him grow normally, and to help protect his health when he grows up.
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