Did you know that diabetes can impact sleep? Or that poor sleep can affect blood sugar levels in patients with diabetes? Understanding the links between diabetes and sleep is one way you can support your child and help them feel their best!

sleep and unstable blood sugar levels

Children with blood sugar levels that are too high or too low may have a hard time sleeping through the night. Unstable blood sugar levels trigger other changes in the body that can cause your child to wake up.

If blood sugars are low, the body releases adrenaline. This causes an increased heart rate, sweating and possibly panic. These symptoms will usually awake the child from their sleep.

Sometimes, children will wake up because of a nightmare, but are actually hypoglycemic (have low blood sugar). In these cases, treat their low blood sugar. Make sure it climbs above 100mg/dl before your child goes back to bed.

If a child’s blood sugar is too high, they may wake up more often saying they’re thirsty or need to go to the bathroom. For some children, this change in nighttime routine is an early symptom that leads to an initial diabetes diagnosis.

poor sleep, hormones and blood sugar

Poor sleep, like less than six hours, has been linked to higher blood sugar levels the next day in patients with diabetes. This can lead to low energy, less activity and maybe more snacking.

When we don’t sleep well, our hormone levels change. Poor sleep can cause:

• A rise in cortisol, the stress hormone, which can impact insulin and insulin resistance
• Feeling hungrier than normal
• A rise in ghrelin, the “hunger hormone” which makes us hungrier
• Lower levels of leptin, a hormone that makes us feel full

All these changes may cause children to eat more after a bad night of sleep. That can lead to higher blood sugar.

managing blood sugar and sleep

How can you manage blood sugar changes the day after a bad night of sleep? It all comes down to close monitoring and planning.

close monitoring to keep balanced sugars

Keep an eye on blood sugars with frequent finger pokes or with a continuous blood glucose sensor. This close monitoring can help you catch any spikes or lows, and quickly treat them to keep your child’s levels balanced. With balanced blood sugar levels, sleep should be no problem!

stay active

It’s also important to stay active! Exercise can help lower blood sugars and increase energy, even after a bad night of sleep. If your child is feeling tired, suggest they be active rather than take a nap. Napping may affect your child’s sleep schedule and make maintaining their blood sugar levels harder.

eat mindfully

We’ve talked about how poor sleep can impact hunger. So, sticking to a specific diet plan can help manage your child’s blood sugar levels. Encourage your child to eat healthy foods from all food groups. Help them avoid unhealthy snacking or overeating that can cause blood sugar spikes.

If your child still has a hard time sleeping and keeping their blood sugar levels in check, it is time to visit their pediatrician/primary care provider or endocrinologist. These experts can help you learn more ways to manage your child’s diabetes and keep them happy and healthy!

When Aaryn was just six months old, she found herself at Dayton Children’s Hospital, struggling with a severe respiratory illness called RSV. During her stay, the doctors made an important discovery: Aaryn had asthma, a condition that made it difficult for her to breathe freely.

Now Aaryn is 15 years old and although she’s accomplished her dream of making the Thurgood Marshall High School cheerleading squad, she sometimes still struggles with asthma flare-ups especially when the weather changes.  

“I tell her, she can’t be like other kids- even when she wants to. She needs to learn how to manage her asthma,” said Jeanine Belcher, Aaryn’s mom. Jeanine says she recognized that better asthma control was essential for Aaryn’s well-being. 

from research to action: addressing the disparities to treating asthma

Aaryn is far from the only child in the Dayton area struggling with complications from asthma. The Asthma and Allergy Foundation of America 2022 Asthma Capitals report ranked Dayton 24 in the country for most difficult places to live with asthma. Dayton also ranks fourth highest for asthma-related emergency department visits and fifth highest for quick-relief medicine use. For years, Dayton Children’s Hospital’s Community Health Needs Assessment has pointed to asthma as a top pediatric health concern. 

Dayton Children’s has been researching to understand how asthma affects the children in our own community. We’ve discovered that there are some differences across races and socioeconomic status that can impact their struggles with asthma. It’s important for us to recognize these health disparities. 

In a recent article published in the Journal of American Medical Association (JAMA), experts found that Black and Hispanic children have a higher likelihood of developing asthma and experience it at an earlier age compared to White children. Furthermore, they also noticed that kids growing up in areas with more low-income households and higher poverty rates were more prone to asthma diagnoses. These findings highlight the need for us to address these disparities head-on. 

the difference the Dayton Asthma Alliance makes

That’s why we’re proud to have established the Dayton Asthma Alliance here at Dayton Children’s Hospital. Our goal is to tackle the underlying structural and policy issues that often hinder children with asthma from achieving the best possible health outcomes. We work closely with our Medical-Legal Partnership for Children who can support families with asthma who may be living in housing that is a barrier to health. We are also working with housing partners to address housing issues such as mold and pests which can trigger asthma. 

Thanks to the Dayton Asthma Alliance the Community Health Worker program has grown and expanded at Dayton Children’s, which is how Aaryn found a perfect match in a dedicated community health worker who became her trusted guide and superhero. The community health worker not only answers all of Aaryn’s questions about medications and treatments but also provides help with insurance and paperwork when Jeanine needed it.  

“They are so helpful. Any questions I have they answer within 24 hours and they send me useful information to my mailbox,” says Jeanine. “I was so happy to find out that Dayton Children’s had this program because I’ve been waiting for Aaryn to get the help that she needs!”  

By taking a holistic approach that combines medical care, addressing social needs, and advocating for policy changes, we’re striving to create a healthier environment for children with asthma in our community. At Dayton Children’s, we believe that every child deserves the chance to breathe easy and enjoy a happy and active life, regardless of their health condition. 

You may have heard that there has been an increase in autoimmune diseases, including type 1 diabetes and celiac disease. We’ve recently seen an increase in patients having both of these diseases together. We talked with endocrinologist Stacy Meyer, MD and gastroenterologist and division chief of pediatric gastroenterology and nutrition Michael Bates, MD to learn more about the connection between the two, and our clinical nutrition team for tips and resources for families whose children are managing both.

why are we seeing an increase in patients with autoimmune diseases, like type 1 diabetes and celiac disease?

Autoimmune diseases are what we call “two hit” processes. You have to inherit the genes that make it more likely to develop an autoimmune disease, and then something else in the environment must trigger the process. Viruses are often triggers to the start of autoimmune diseases, but we don’t know for sure what the triggers might be for these disorders.  Recently, there has been a rise in type 1 diabetes cases that is thought to be associated with COVID infections. 

how are type 1 diabetes and celiac disease linked?

Celiac disease and type 1 diabetes share a genetic link.  Both celiac disease and type 1 diabetes risks are inherited on HLA genes and share two specific HLA types in their inheritance: DQ8 and DQ2. It appears that a person has to have one of these two HLA types to be at risk for celiac disease or type 1 diabetes.  

why might we be seeing an increase in kids having both type 1 diabetes and celiac disease?

It is not currently known why we are seeing an increase in autoimmune diseases, but there are many theories and studies looking into this.  We have been seeing a rise in autoimmune diseases overall since the 1980s.  We also have better screening tests for celiac disease, which has led to an increase in its diagnosis.

what is the impact on a child if they have both celiac and diabetes? What challenges come with it?

The combination of celiac disease and diabetes can be especially difficult to manage. They both require adjustments to our diet and lifestyle that are independent of each other. Many of the foods safe for kids with celiac disease are higher in carbohydrates. This can make it harder for kids to cover with insulin and to keep their weight in a healthy range. 

how can people with diabetes and celiac get carbohydrates? 

People with diabetes and celiac disease should include healthy carbohydrates in their meals every day. These can include fruits, vegetables, gluten-free whole grains and gluten-free dairy products. Most kids with diabetes and celiac disease eat around 30 to 75 grams of carbohydrates at each meal, and 15 to 30 grams of carbohydrates for each snack.

how do I choose gluten-free whole grains?

Check the ingredient list on a food label to see if a food is a good source of whole grains. The first words on the list should be “whole grain [name of grain].”

• Do not select foods that list the name of the grain as wheat, rye, barley, or oats (unless specified gluten-free oats) – These grains contain gluten.
• Gluten-free grains include: buckwheat, teff, amaranth, rice, corn, quinoa, sorghum, millet, grits and labeled gluten-free oats.  The package should also be labeled as gluten-free.

what are some other resources for patients and families?

• Beyond Celiac
• Beyond Type 1
• Celiac Disease Foundation
• Celiac disease – KidsHealth
• GI Kids
• National Celiac Association gluten-free restaurant directory
• Nutrition for kids with diabetes and celiac disease