You've probably heard your child's doctor talk a lot about "diabetes control," which usually refers to how close the blood sugar, or glucose, is kept to the desired range. What does this mean and why is it important?

What Can Happen if Diabetes Isn't Under Control?

Too much or not enough sugar in the bloodstream can lead to short-term problems that must be treated right away, like hypoglycemia, hyperglycemia, or diabetic ketoacidosis.

Too much sugar in the bloodstream also can cause long-term damage to body tissues. For example, it can harm blood vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems.

These problems don't usually affect kids or teens with diabetes who have had the disease for only a few years. But they can happen in adults with diabetes, particularly if they haven't managed or controlled their diabetes properly.

Kids with diabetes who don't control their blood sugar levels may also have problems with growth and development. They might even have a delay in when puberty starts. Puberty is when the body changes as kids start growing into adults.

What Can Affect Blood Sugar Levels?

Controlling diabetes means keeping blood sugar levels as close to normal as possible. Your child's diabetes medicines (such as insulin), food, and activity level must be in balance to keep blood sugar levels under control. If any one of these is off, blood sugar levels will be too.

Poorly controlled blood sugar levels can be due to:

• not taking medicines as prescribed
• not following the meal plan (like eating too much or not enough food without adjusting medicines)
• not getting regular exercise or not changing the treatment plan when there's a big change in physical activity level
• illness or stress
• not watching blood sugar levels closely enough so that changes are seen and dealt with quickly

What Are the Benefits of Good Diabetes Control?

The problems that diabetes can cause are serious. But the good news is that keeping blood sugar levels as close to normal as possible can help prevent them.

One large study showed that people with type 1 diabetes who checked blood sugar levels four or more times a day — and adjusted their medicines, diet, and exercise based on their readings — had a lower risk for eye disease, kidney problems, nerve damage, and high cholesterol levels (a major risk factor for heart disease).

How Do I Know if Diabetes Is Under Control?

How do you find out if your child's diabetes is under control? First, the diabetes health care team will tell you what the blood sugar levels should be (the "target" range), which is based on things like your child's age and medical condition.

Day to day, the only way to know if the blood sugar levels are close to the target range is to measure them often with a glucose meter or continuous glucose monitor (CGM). These should be used several times a day.

Your doctor will also check your child's blood sugar with a hemoglobin test (HbA1C test for short). It gives information about blood glucose control in the 2 to 3 months before the test. This lets doctors know if the diabetes care plan needs changes.

How Can I Help My Child?

Helping your child achieve good blood sugar control and manage diabetes can be challenging. Here are some tips:

• Make sure your child takes insulin or other diabetes medicines as prescribed.
• Provide meals and snacks that fit into your child's meal plan.
• Encourage your child to engage in regular physical activity.
• Check blood sugar levels often and make any needed changes to the treatment plan with guidance from the health care team.
• Make sure your child gets regular medical checkups.
• Learn as much as you can about diabetes.

Reviewed by: Steven Dowshen, MD
Date Reviewed: 01-02-2018