The daily lives of children with diabetes

A diagnosis of diabetes for a child can transform a family's routine. From the moment the condition is detected, a journey starts where essential foundations such as medical treatment, ongoing learning and emotional support are established. Contrary to what one might think, the daily management of childhood diabetes does not consist solely of insulin treatment. It involves detailed monitoring, education of the child and their surroundings, a balanced diet, safety in sports activities and above all building a full and healthy life for the child.

1. Treatment: where it all starts

Treatment, for the vast majority of children with diabetes, consists of daily administration of insulin¹. This can be done with multiple injections throughout the day, or via an insulin pump, which provides a continuous and adjustable supply. The method chosen will depend on the child's age, their lifestyle and healthcare professional's recommendations.

The treatment must be flexible and can be adapted to changes in the child's body: growth, appetite, school times and physical activity. Constant and fluid communication with the paediatric endocrinologist and regular controls are therefore very important. A well-adjusted treatment process not only improves glucose management but also helps to prevent long-term complications¹.

2. Glucose monitoring: information is power

Measuring glucose levels in the blood several times a day is one of the most important tasks in daily management. Glucose levels can be monitored either by fingerstick tests, which measure blood glucose, or by continuous glucose monitors (CGM) devices, which estimate glucose concentration in the interstitial fluid.

Thanks to technological advances, many children nowadays use CGM devices that provide near-real-time readings and trend alerts that help anticipate potential hypo- or hyperglycaemia (excessively low or high glucose)². This technology enables swift action to be taken and helps in making more precise decisions about nutrition and insulin administration.

In cases where a CGM is not available, controls with a glucometer are still highly effective. The ideal times for measuring glucose are before and after every meal, before physical exercise and at bedtime. This information not only helps to keep glucose within safe ranges, it also empowers the child to interpret the messages sent by their own bodies².

A key factor is drawing up a diabetes medical management plan (or DMMP) in collaboration with a team of healthcare professionals, in which the glucose targets, measurement guidelines, diet, insulin administration and emergency protocols are defined. It's a good idea to share the plan with the school, carers and close family members to ensure a safe environment at all times².

3. Diet: a balanced routine, not a restriction

One very common myth is that a child with diabetes has to follow a strict and monotonous diet, when, in fact, with some degree of planning, a child can enjoy a wide range of delicious meals. The most important thing is to control carbohydrate intake, as it has a direct effect on glucose levels.

The key lies in learning to read labels, identify adequate portions, choose foods with a low glycaemic index and accurately count carbohydrates, which supports proper insulin dosing and helps maintain stable glucose levels. Whole-grain cereals, whole fruit, legumes, vegetables and healthy fats are allies in glucose control.

On the other hand, it's best to avoid simple sugars, ultra-processed foods and sugary drinks. 
Regular meal times also help to prevent imbalances. The ideal thing is to have five meal times a day: three main ones and two healthy snacks. These habits not only benefit the child, they can be adopted by all the family to create a healthier and more united environment.

4. Physical activity: moving your body, watching your sugar

Regular exercise is another essential element in treatment. It improves insulin sensitivity, strengthens the cardiovascular system, facilitates weight control and has a positive impact on emotional wellbeing³.

However, physical activity for children with diabetes needs to be carefully planned.
It's important to measure the child's glucose levels before they do exercise. In general, though this threshold may vary based on individual treatment plans, if it's below 5.6 mmol/L,, it's recommended that they have a drink with carbohydrates. It's also necessary to check glucose at the end of the activity, as hypoglycaemia can appear even hours after any physical effort³.

Depending on the type, duration and intensity of the activity, it may be necessary to adjust the insulin dosage or food intake before and after the exercise. Having some carbohydrates to hand, such as fruit juices, glucose tablets or biscuits, is a very necessary precaution. It's also highly recommended to inform physical education teachers and trainers about the child's diabetes and how to act in the event of hypoglycaemia³.

5. Education and emotional support: the foundations for autonomy

One of the most important aspects of managing childhood diabetes is progressive education of the child and their environment. Learning about diabetes enables the child to participate in caring for their own health, making informed decisions and gradually acquiring autonomy⁴.

A child can be taught from an early age to recognise symptoms of hypoglycaemia, identify foods that raise or lower glucose levels, and understand why they have to inject themselves with insulin. As they grow older, they can learn to measure their glucose, adjust doses under supervision and eventually manage their own treatment with almost complete independence⁴.

Attention also needs to be paid to the emotional dimension. Diabetes can cause frustration, anxiety and isolation, especially during adolescence. That's why help from psychologists, support groups and social networks specifically for young people with diabetes can make all the difference. Family members, friends and teaching staff can also help by showing understanding and empathy⁴.

The daily management of childhood diabetes goes way beyond medical controls. It requires commitment, constant learning and a solid support network. When the adequate tools are provided — personalised treatment, effective monitoring, nutritional education, planned physical activity and emotional support — a child with diabetes can have a full, safe and happy life.

The challenge lies not just in keeping glucose levels under control, but also in building trust, encouraging independence and offering security so that any child can grow without being limited by their diabetes.