Care at diagnosis

At hospital or at home

These days with newly diagnosed diabetes, children may receive their initial care and treatment either at hospital, at home or a combination of both, depending on your child’s health and the facilities available in your area.

If your child is going to be cared for in hospital and is under 16, s/he should be admitted to a paediatric ward staffed by healthcare professionals experienced in childhood diabetes. There should be facilities for you to stay with your child at the hospital, and the amount of time your child spends away from home should be kept to a minimum.

In some cases, your child may be treated at home by a children’s diabetes care team if s/he does not have ketoacidosis (a complication of diabetes that needs to be treated in hospital). Your child may be able to spend the day at home and sleep at the hospital at night. Such ‘home-based’ diabetes services for children, though not widespread, are being developed in some areas.

What care to expect

Whether your child is to be at hospital or at home in the first few days after diagnosis, there are certain things that should happen:

·        You should be given an explanation of diabetes from a senior member of the medical team, and appropriately written information on diabetes to back this up.

·        You should be given time to absorb the fact that your child has diabetes, and a chance to talk over the emotional impact of diabetes on your child and the rest of the family.

·        You should be able to talk over your concerns with senior staff while your child is in hospital or being looked after at home.

·        One of the diabetes care team should inform your GP about your child’s diabetes, and offer to get in contact with the school or nursery.

·        You should have several sessions with a paediatric dietitian who can give you dietary advice and help you make any changes that are needed to your family’s eating habits.

·        You should be seen by a paediatric diabetes specialist nurse.

·        You should be given information about Diabetes UK, family support groups in your area, and how to claim Disability Living Allowance to help cover the home supervision of your child now that s/he has diabetes.

Continuing care

At diagnosis and in the weeks and months following your child’s diagnosis, members of the diabetes care team, will give you and your child more detailed information on how to manage their diabetes. This should include:

·        Information and advice on how and where to inject, injecting devices, and how to dispose of needles and finger pricking lancets.

·        How and when to test for glucose and ketones, what the results of these tests mean, and when to seek advice.

·        Information about how insulin, food, exercise, stress and excitement interact, and how they affect blood glucose levels.

·        A discussion about hypoglycaemia (hypos) with clear information about its causes, symptoms and treatment. This should include the use of Glucagon and/or Hypostop. You should be given information on convulsions (fits) which can occasionally be caused by hypos, and how to deal with them.

·        An explanation of what is called the ‘honeymoon’ phase – the time shortly after diagnosis when your child may need less insulin.

·        An explanation that your child may find it hard to adjust to early day to day life with diabetes.

·        You should be given a telephone number to call for 24-hour advice from members of the diabetes care team or the paediatric ward.

Once your child’s diabetes is reasonably controlled

After a time, you will become more confident in managing your child’s diabetes. However, the diabetes care team should always be available when and if you need them. They will maintain contact to continue their education programme and to support you. Don’t hesitate to ask for more help or information.

You can now expect the following:

·        You and your child should see a paediatric diabetes specialist nurse, consultant and dietitian frequently in the weeks and months after diagnosis. Once you feel more confident in managing your child’s diabetes, you will need to visit the clinic at least three or four times a year as part of your child’s regular diabetes care.

·        At these visits, your child’s general health will be checked and their blood glucose levels will be reviewed by looking at your home records, and by some extra tests of long-term blood glucose control.

·        You should have a chance to get further education about diabetes, and discuss any other concerns you may have about diet, insulin, hypos or any other aspect of living with diabetes.

·        As your child gets older there will be opportunities to discuss how s/he is coping with diabetes and life in general.