What is diabetes

When you swallow food, it goes into your stomach where enzymes break it down to simple sugars.

The sugars that are found in food like potato, bread and pasta are taken out more slowly by the enzymes than the sugars that are in sweet food such as chocolate and toffees.

The sugar is then taken from your stomach to your small intestine where it enters your blood stream to be carried all round your body.

Normally, when sugar starts entering your blood stream, a hormone called insulin is released from a part of your body called the pancreas.

Insulin' s job is to take the sugar out of the blood stream and feed it to all the cells that make up your body.

Each cells is like a tiny oven that uses the sugar as fuel. They need a constant supply of sugar to keep them going.

When you have Type 1 diabetes, your pancreas doesn't produce insulin any more.

Your stomach will continue to take out the sugar from the food you eat but there will be no insulin to take it out from your blood stream and feed it to your body cells.

This means that the amount of sugar in your blood keeps on going up and the cells don't get any fuel.

At this point, your body will start to tell you that something is not right. You'll probably pass a lot of urine, feel thirsty and hungry and lose weight.

Questions or worries you might have   

Why me?

Nobody really knows what causes diabetes.

One thing is for sure: diabetes isn?t your fault and it is certainly not because of something you have eaten or something you have done wrong!

Diabetes may be passed down in families, just like the colour of your eyes. For some people, diabetes may be triggered after a viral infection.

Will I always need insulin?

In your case, you have what is called Type I diabetes. This means that your body completely stops making the insulin it needs to work properly and injecting insulin is the only way to replace what your body no longer makes.

You may have heard about a person having diabetes and taking pills but it's not the same diabetes. That's what we call Type 2 diabetes.

Will my diabetes ever go away?

Unfortunately, you won't grow out of diabetes and it will always be there. However, you can treat your diabetes by injecting the insulin that you body is not able to make anymore.

Can my friends catch my diabetes?

 Unlike chicken pox or flu, you can?t catch diabetes or give it to anyone else. So, none of your friends will become diabetic if they play with you.

What's going to happen when I go back to school?

As soon as you feel better, you will be able to go back to school as usual and do all the things you used to do: playing with your mates, doing exercise, going for a picnic or a day trip with your class... Nothing will really change actually!

Can I still go to parties?

Of course you can! An occasional treat is all right and with a little bit of planning everything will be fine. Try to stick to sandwiches, pizza, popcorn or crisps... a piece of birthday cake is fine too! If there aren?t sugar free or light fizzy drinks, try to drink squash/fruit juices or bring your own sugar free drink

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What will make you feel better?    

Because your body completely stops making insulin, the only way to treat your diabetes is to give yourself the insulin that your body can?t produce anymore. However, if you swallow insulin, it will be destroyed in your stomach and will not be able to do its job.

That?s the reason why you have to give yourself injections of insulin through the skin.

But don't worry, today's insulin needles are so thin and tiny that you will hardly feel a thing!

To inject your insulin, you will have the choice between an insulin syringe and an insulin pen.

Your diabetes nurse will help you to choose the one that is best for you.

There are also different types of insulin to be used with your syringe or you pen.

The most common ones are clear insulins (they are fast acting insulins) and cloudy insulins (they are slower acting insulins).

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Injecting with an insulin pen   

 Before you inject, make sure there is enough insulin in the cartridge for your injection and check that the expiry date on the cartridge has not passed.

If you insulin is cloudy, gently rock the pen up and down or roll it between your hands 20 times to make sure that the insulin is mixed.

Screw on the needle.

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How to inject your insulin?   

If your nurse has asked you to inject using a skin fold, do so by taking a clean fold of skin between your thumb and index finger making sure that you only lift the skin and not the muscle beneath.

Quickly push the needle straight into the skin fold as far as it will go and with your thumb on top of the plunger, smoothly inject all the insulin.

You must continue to hold the skin fold throughout all the injection of the insulin.

When finished, remove the needle slowly and only then, release the skin fold.

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Where do you inject insulin?   

The best areas where to inject are:

     Insulin is absorbed at different speeds depending on where you inject. So in order for your insulin to work the same way from one day to the next, always inject in the same area at the same time.

Ask your diabetes specialist nurse which injection areas are best for you and write down the time of the day for each of them.

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How and why do you rotate your injection sites?   

It is important that you don't keep injecting your insulin in the same place.

Change sides using, for instance, your right thigh one day and your left thigh the following day and vice versa.

Each time you inject in a site, make sure that you don't inject in the exact same place as the last time. Move the place of the injection by about a finger's width from the place you used the previous time.

There are site rotation guides available to help you rotate your injections.

Ask your nurse if you want to use them.

If you always inject in the same place and/or reuse your needles more than once, your sites may become red, sore and lumpy. This is what we call lipodystrophy or "lipo".

Lipos can develop anywhere on your body where you inject.

Insulin injected into a lipo may not work properly and it may affect your blood sugar level. This is why it's very important to always rotate your injection sites and change your needle after each injection.

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What makes your blood level rise and fall?   

Looking after your diabetes isn?t just about insulin injections. You should eat regular meals and avoid too many sugary foods and sweet drinks. Doing regular exercise several times a week will also help you to balance your blood sugar level.

Controlling your diabetes is all about getting the balance right between insulin, food and exercise!

 Imagine a submarine is your blood sugar level:

When you eat or drink, your blood sugar level rises.

When you inject insulin, your blood sugar level falls. If you exercise, your blood sugar level falls even faster.

This is why balancing the amount of insulin, food and exercise is so important.

Your blood sugar level should not be allowed to go too high or too low.

By doing regular blood sugar level tests, your insulin dose can be adjusted to keep your blood sugar level as normal as possible.

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How to test your blood sugar level?   

The only way to actually find out if your sugar level is too high, too low or well balanced is to test your blood sugar level regularly by pricking your finger with a lancer and a lancet.

Choose the finger you want to prick avoiding your thumb and index finger (your first finger).

Massage your finger carefully. This helps bring blood into your finger.

Using a lancer and a lancet, prick the side of your finger. Do not prick the very end because it would be more likely to hurt.

Once you have pricked your finger, put a drop of blood onto a test strip and read the result.

Write your results in your diary.

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 What is a hypo?   

If your blood sugar level drops too low, there won't be enough sugar in your blood stream for the insulin to feed the cells of your body. That is what we call hypoglycaemia or "hypo".

     Try to remember how you feel when you have a hypo and make sure that your friends and teachers know what to look for if it ever happens.

Here are some of the symptoms that you may feel:

Hunger.

Shaking/wobbly legs.

Butterflies in tummy.

Pale and sweating.

Headache and faintness.

Sleepy or irritable.

Blurred vision.

There are different reasons why you can have a hypo but it?s mainly when you?ve had:

Too much insulin

Not enough food

An unusual amount of exercise

A delayed meal

Stress or hot weather

What to do if you have a hypo?

Take sugar or food containing sugar straight away followed by a sandwich or digestive biscuits.

If you are unable to swallow, HypostopTM can be used. This is a sugary gel that can be rubbed onto your lips and gums.

If it doesn't work, you may be given an injection of glucagon and possibly go to hospital to see a doctor.

It is very important that you always have sweet foods or sugar with you.

Other people may not know that you have diabetes. You should carry an ID card or ID tag saying that you have diabetes and explaining what to do if you're not feeling well

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Things to remember   

There are lots of things you'll have to think about now that you have diabetes. Here are a few things you should always remember.  

 Insulin vials or cartridges that are not open should be stored in the refrigerator but you can keep your opened insulin bottle or cartridge at room temperature for up to a month.

However be careful not to expose your insulin to extreme temperatures (very cold or very hot temperatures) and never use insulin after the expiry date.

Injecting through clothes

Even though it may sound handy, it is important not to inject through your clothes especially if you wear jeans! Why?... because:

It is difficult to make a skin fold through clothes.

You can bend or blunt the needle, which would make the injection hurt.

You won?t be able to see if you have bled or if some insulin has leaked out.

Reuse

It is important not to reuse your syringe or your pen needle. Syringes and pen needles should indeed only be used once.

Reuse may bend or blunt the needle tip making injections become more painful and possibly causing lumpy sites called lipos to develop.

To dispose of your needles safely you can clip off the needle with a BD Safe Clip and/or put your used syringe or pen needle in a container such as an empty hard plastic bottle. When it is full, give it to your parents who will know what to do with it.

 Where can I find more information about diabetes?

There are loads of education leaflets you can read to learn more about diabetes: at your hospital, at your GP or by contacting Diabetes UK.

You can also participate in group meetings, at your hospital for example. You may also attend summer camps with other children with diabetes or even log on to the Internet!

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