Diabetes in children and young people: social questions

DIABETES IN CHILDREN AND YOUNG PEOPLE: SOCIAL QUESTIONS

Sometimes friends ask me to stay on for a meal at night after school, but I can't because of my evening insulin dose. It is too far to go home just for an insulin injection.
Don't let your diabetes routine spoil things for you. What are the options?
1. Miss out on your evening dose that night. If it is a small dose and you are careful with what you eat and pretty accurate this might be all right. Check your blood glucose when you get home, and if it is high give a small dose of quick acting insulin before supper.
2. Refuse the invitation and go home for insulin. Not a good idea. Even if you didn't want to stay you shouldn't use diabetes as an excuse.
3. Ring up your parents and ask them to drive over with your insulin and syringe. This would answer your problem but would it be fair to ask? Only you (and they) could answer this.
4. Stay for the meal and plan to have a modified dose of insulin when you get home. About two thirds of the usual dose at supper time would probably cover you satisfactorily, but check your blood glucose. You could need a little more of the quick acting insulin if it is high. I favour the fourth option but discuss it with your parents when the occasion arises.

I am going on a school camp. What should I do about blood tests and insulin?
The best way to enjoy your camp is to make sure you don't have a hypo, or let your diabetes get out of control. Be prepared for activity, perhaps delayed meals and unusually late nights.
Take a good supply of syringes, an extra bottle of each insulin (in case of accidents) blood testing strips, urine-ketone strips and a good supply of carbohydrate exchanges, such as dried food, barley-sugar, other lollies and biscuits. It may be best to take the blood testing strips that don't need a meter (BM Test Glycemie 20-800 or Glucostix).
Make sure a responsible adult knows about your diabetes and what to do if you have a hypo.
Make sure that your friends know that you will need insulin injections and may need extra food or sugar.
Divide your supplies of insulin and syringes into two packs. You carry one and a responsible friend or adult carries the other. A lost pack could otherwise spoil the camp.
Discuss what to do about blood tests and insulin in advance with your doctor. Here is my suggestion: Do a blood test when you get up. If it is low have some sugar at once while waiting for breakfast. If it is high and you don't feel well check for urine-ketones. You could need extra quick acting insulin if ketones are positive but check in advance with your doctor how much you would give.
Otherwise have a slightly reduced dose of insulin because you will probably be pretty active at camp and need less insulin because it works more efficiently this way. Have extra carbohydrate during the day if you are very active, especially hikes or swimming.
If a meal is delayed have one or two exchanges at the usual time while you wait for the meal. Have your evening dose of insulin just before the evening meal, but reduce the dose to prevent a night time hypo.
Do a blood test before you go to bed. If it is low have an extra starch exchange to make sure that you don't become hypoglycemic during the night.
With these precautions you should have no trouble - and your parents won't need to worry about you either.

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