diabetes resource center

Type 1 diabetes support group

The constant work it takes to manage diabetes well can be very overwhelming. Connecting with others in a safe environment can help you feel less alone, decrease stress and develop friendships. Yelena Nicholson, DO will be leading regular support groups by age group. Details are below. Currently there are no support groups planned, but keep checking back.

• For toddlers to teens
• Topics include developing independence, sports, preparing for school and general discussion
• RSVP at least 3 business days in advance by messaging the diabetes team in MyKidsChart, letting us know at your next appointment, or by calling us at 937-641-3487.

After your child receives a diabetes diagnosis, an appointment will need to be scheduled for follow-up one to two weeks after they are discharged and then in one month. After initial follow-up, routine appointments will be scheduled every two to three months. If your cell phone number is your primary number with us, we'll send a text reminder before your child's appointment.

In order for the diabetes clinic appointments to go as smoothly as possible, please follow the guidelines below: 

• When coming to clinic, please allow up to two to four hours to meet with team members. You will be seen by your physician. You may also be seen by the nurse, dietitian, social worker and/or psychologist. Video visits usually last about 45 minutes.
• Please come prepared with:
  • Your records for the last two weeks - Download any pump or meter data the day before your appointment.
  • All home meters
  • Insulin pump
  • List of prescriptions
  • Any questions or concerns you have
• Fasting lab work: Fasting labs are done on a yearly basis. You must arrive in the lab one hour before your appointment. This will allow enough time for blood work to be drawn, insulin given, and breakfast eaten. When finished, go immediately to the diabetes clinic and sign in.
• Routine clinic: At routine visits, a hemoblobin A1C lab is drawn. This can be drawn in the clinic. If you choose to go to lab to have this drawn, then you must arrive in the lab 30-60 minutes before your scheduled appointment. After blood is drawn, go immediately to the diabetes clinic and sign in.
• If the meter and blood sugars are not brought, your appointment may need to be rescheduled. This information is needed to accurately determine what changes need to be made in your treatment plan.
• Remember your child’s snack or meal if the visit is scheduled close to meal or snack time.

During the visit you will meet with a few members of your child’s care team:

• Nurse – The nurse will start the visit and obtain some information from you and your child.
• Endocrinologist – Next you will meet with your child’s endocrinologist. They will go over your child’s pump/meter data and discuss any changes that need to be made in your child’s care.
• Dietitian – Your child will meet with a dietitian at least once a year. The dietitian will help your child meet their nutritional needs.
• Social worker – Your child will also meet with a social worker at least once a year. The social worker will talk with you and your child and help your family deal with the challenges of having a sick child. 
• Care coordinator- Your child will meet with their care coordinator to review information and educate your family, as needed.

At the end of the appointment, we’ll schedule your child’s next appointment. This could be a video visit or in-person appointment.

While you can always call the diabetes team or contact us through MyKidsChart, please follow these steps to contact us about:

Illness:

If your child is ill, has moderate or large ketones, or has an emergency, please call 937-641-3487 for assistance. If this is after hours, please call the hospital operator at 937-641-3000. Ask to speak to the endocrinologist on-call.

When you call, please have the following information ready:

1. Blood sugars and ketone results
2. Insulin doses

Blood sugars:

You can submit blood sugar records for review through:

• Our online form – Preferred method
• MyKidsChart
• Call our blood sugar line 937-641-3474. Please do not leave a message requesting the nurse to call you back for blood sugars. This will only delay the physician reviewing the blood sugars and adjusting doses.
• Fax to 937-641-5878

You will need to include the following information:

1. Your child’s name and date of birth. Please spell your child’s name if calling.
2. Your child’s current doses.
3. The date, time, and actual blood sugar numbers.

Please do not leave a message asking the nurse to call you back for blood sugars. This will delay the process. The dosing changes will be returned to you by phone or MyKidsChart.

Prescriptions:

Please leave the following information on the prescription line by calling 937-641-3474.

1. Your child’s name and date of birth. Please spell your child’s name.
2. The refill needed.
   • Ex: Test strips – be sure to leave the type of strips so the correct refill will be provided (ex. Aviva Plus, Contour, Freestyle Lite, Smart View, True-Test, Ultra, Verio, etc.)
3. 30-day or 90-day supply (this is dependent upon your insurance)
4. The pharmacy name and phone number
   • Requests are faxed to the pharmacy you specify unless you request the prescription to be mailed or picked up.
   • If you are requesting a 90-day supply, please also provide the pharmacy city and state.

Non-emergency requests:

These include forms for school, work, or driving, general questions, etc.

• For any form to be completed and sent by the diabetes team, a release of medical information form must be signed by the parent or child if 18 years of age or older.
• A release of information is good for one year.
• Please allow up to two weeks for these forms to be completed.

Physicals:

All school, work, and sports physicals need to be done by your pediatrician or primary care doctor.

Tips for using MyKidsChart
For tips on using MyKidsChart to communicate with us, view this tips sheet.

Tidepool is software that provides us access to all your diabetes data. Our hope is that this data will make our visits more efficient and effective — using our time for collaboration, discussion and questions. 

Signing up for Tidepool is quick and easy! Visit tidepool.org/signup and follow the instructions below to sign up.

(backside) follow these instructions before your next appointment:

1. Ensure you have Google Chrome installed as a browser on your computer. If you don’t, please visit google.com/chrome to download it.
2. Please visit tidepool.org/signup to create your personal account.
3. Install Tidepool Uploader on your computer by visiting tidepool.org/download
4. Find your device on the Tidepool Uploader Compatible Devices List and follow the instructions to upload data from your device. You may need a USB cable or cord to do this. Some companies will send them to you, others you may need to order online.
5. Use Tidepool Web to view your diabetes device data at app.tidepool.org/login. Guides and walkthroughs relating to data visualization in Tidepool Web as well as how to share your data can be found in this section of our support documentation.
6. Confirm you are sharing your data with our clinic. Our Clinic Share Code is XHJA-HS5M-UZA4.
7. Please add us to your care team by logging into Tidepool Web, then click “Share” at the top of the screen, and our Share Code where prompted. This Tidepool support article will walk you through the process of sharing your data.

If you have any questions at all, or run into trouble, please email support@tidepool.org right away so they can help you.

Blood sugar testing:

You can check your child's blood sugar (also called blood glucose) by using a glucose meter. Here are a few tips for using a glucose meter:

• Use a meter that has date, time and memory. Make sure that you program the correct date and time in the meter.
• Use the proper strip for your glucose meter.
• If you have questions for using your meter, you can ask your diabetes team, or call the 1-800 number on the back of your meter.
• Check blood sugar at least four times a day (before breakfast, lunch, dinner and bedtime snack). You'll check more frequently if your child is going to be more active, and when insulin changes are made.

Keep track of your child's glucose by handwriting it on this glucose record template, or you can use the software that comes with your glucose meter. 

View more information on blood sugar testing.

Ketone testing:

Ketone testing is done by testing urine using a ketone testing strip. You'll compare the color of the strip to the color block on the color chart. It needs to be checked:

• If blood sugar is above 300 mg/dl.
• If your child feels sick or nauseated
• For the first week after diagnosis, every morning.

Notify the diabetes nurse or physician if ketones are moderate or large. Have your child rest or play quitely, and encourage fluid intake, especially water. Give insulin as directed. View more information on ketone testing.

Insulin and injections:

Insulin allows sugar to go from the bloodstream into the body's cells to be used as energy. People with type 1 diabetes make little or no insulin, so they need multiple insulin injections every day. People with type 2 diabetes may still produce insulin, but are unable to use it well. Some may need insulin to help control blood sugar levels. Here are some tips and things to know about insulin:

• Insulin should be refrigerated, but make sure it does not freeze!
• New vials need to be opened every 28-30 days. Write the date on the vial, or change the vials on the same day each month.
• Know the name of your child's insulin, the type of insulin and the doses (measured in units).
• Always have an extra supply of insulin on hand.
• Some insulins are rapid acting, and some are long acting. Basal or "background" insulins control blood sugar in a fasting or non-eating state. Rapid acting insulins are used at mealtimes and when the blood sugar is too high.
• In general, you will check your child's blood sugar, count the number of carbs they've eaten (or will eat) and then determine the total insulin dose.

For more tips on calculating insulin doses and how to give insulin injections, view our resource guide.

Today’s technology makes it possible for children to manage their diabetes better than ever before. Our team is up-to-date on the most advanced blood glucose meters, continuous blood glucose monitors, insulin pumps and phone apps. The endocrinology team offers online education for choosing your insulin pump.

View instructions for uploading your pump/meter/glucose monitor data here.

High and low blood sugars have different causes, symptoms and treatments. See below for a breakdown of each. For more information and steps to treat high and low blood sugar, view this section of the diabetes manual.

Being prepared can help you and your child feel more comfortable at school, when traveling, or during special occassions like birthday parties or sleepovers! See below for quick tips, our view more recommendations in the school and other information section of the diabetes manual.

School

• Meet with your child's school nurse to talk about your child's diabetes and put together a plan.
• The diabetes team will provide your child's with forms specific to your child's diabetes care. For us to send these forms to your school, you need to fill out this release of information form.
• Sports physical forms need to be completed by your child's pediatrician or primary care doctor. If you need a statement regarding diabetes care for coaches or trainers, we can provide one.
• View the parents' checklist for a full list of questions to ask related to your child's school.

Travel tips

• Discuss any travel plans with your child's diabetes doctor in advance.
• Always carry food for meals and snacks with you, including a quick sugar source.
• Have your child carry identification and wear their medic-alert jewelry at all times.
• Carry your child's insulin with you, and be prepared with extra supplies.
• Continue doing blood and ketone testing like you do at home.

Parties

• For school parties, as the teacher to let you know when there will be a party and find out what foods or treats are planned. If you need help with the carb content, let your dietitian or us know.
• For slumber parties, talk about what foods will be served and about when they'll be available. Plan for your child to be up later and more active than usual. Blood sugar may need to be checked more often on these nights.

Maintaining good health habits and keeping your child's diabetes in good control can help them avoid long-term complications. For more tips and recommendations, view the general health, long-term complications and foot care section of the diabetes manual. 

Health care tips:

• Watch cuts closely.
• Don't get sunburned.
• Dress warmly for cold weather. In particular, make sure your feet are warm!
• Get plenty of sleep.
• See your diabetes doctor, pediatrician, dentist and opthmalmologist (eye doctor) regularly.
• Wash your feet in warm, soapy water and look over them carefully every day. If you notice any cracks, blisters, sores or signs of infection, call your pediatrician.
• Wear shoes or slippers everywhere, even around the house or at the pool or beach.

Medic alerts

Wearing a medic alert bracelet, necklace or anklet can be lifesaving! Make sure your child wears one all the time. You can buy them from The Medic Alert Foundation, Lauren's Hope for a Cure Bracelets, Fifty 50 Pharmacy, or most pharmacies and jewelry stores.

Exercise, blood sugar and insulin

Remember that exercise can make your blood sugar go down. Follow these tips to help control your insulin levels:

• Test your blood sugar before exercising, and treat if it's low before starting. Pre-treat for exercise too. 
• Carry quick energy foods with you when you exercise (like fruit juice or fruit snacks)
• Drink plenty of water.
• Contact us if you have any questions about exercise.

Illness includes colds, flu, diarrhea, ear infections, fever, poison ivy, viruses or even sunburns. Basically, any condition in which the body is physically stressed. Here are some quick tips for what to do when your child is ill. View the complete sick days section of the diabetes manual for more details.

1. Check blood sugar and ketones and call the diabetes team (937-641-3487) Monday-Friday 8:00 am to 5:00 pm, or the endocrinologist on-call if after office hours (937-641-3000). Check ketones, even if blood sugar is less than 300, or even low.
2. Contact the diabetes team/endocrinologist for sick day care instruction and insulin dosing instruction.
3. You can still use over-the-counter medications such as Tylenol or cough medicine.
4. Your child will still need to take in some carbohydrates during illness:
   • If your child refuses to eat regular foods, liquids with carbs like 7Up, Sprite or Gatorade can be given.
   • Fluids are also important to prevent dehydration. Offer at least 2 tablespoons of fluids every 20-30 minutes to help prevent dehydratation.
   • Avoid foods with meat, protein and fat if your child has an upset stomach. Saltines, toast and ginger ale are all good options if your child has an upset stomach.

View these additional sick day guidelines and instructions for if your child has a pump, or if they receive insulin injections. 

Diabetes organizations and support

There are many organizations who focus on treatment and support of children and adults with diabetes. These are a few that we recommend to our patients and families:

• American Diabetes Association
• JDRF - local chapter and national group
• Diabetes Dayton
• College Diabetes Network
• Beyond Type 1
• Beyond Type 2
• Children With Diabetes
• Diatribe

User guides for meters

• Accu-Chek guide
• One Touch Verio
• Freestyle Lite or Freestyle Freedom Lite

User guides for continuous glucose monitors (CGM)

• Freestyle Libre
• Dexcom G6
• Medtronic Guardian

Family Support Resource Directory:

Families of children with type 1 or type 2 diabetes can find resources such as camps for children with diabetes or support groups in our Family Support Resource Directory.

Nutrition/food resources

• Dayton Children's diabetes manual tips and resources
• MyPlate - learn how to build a healthy plate
• Vegetables and fruits - fun tips to eat more fruits and veggies!
• Academy of Nutrition and Dietetics 
• Calorie King Online - track calories at common restaurants
• MyPlate Calorie Tracker
• Carb Counter
• Calorie Count
• Busting myths about diabetes and food

Pinterest boards

Dayton Children’s also provides various Pinterest boards to help patients with prediabetes and diabetes. Some examples are recipes for meals and snacks, grocery shopping tips, meal replacement shakes and carb-counting tips. 

Diabetes care apps

There are a number of phone apps that can help you manage your diabetes care. Below are some recommended by our experts. Some are free, some cost up to $5.00.

$ indicates a charge for the app

• Carb counting with Lenny the Lion (free app from Medtronic) shows children how many carbs are in various foods by showing serving sizes & pictures. It also offers games on carbs.
• Glucose Buddy is a simple free log book app that can be emailed to yourself, your family members, or the diabetes doctor.
• Wave Sense Diabetes Manager is another free log book option. It is similar to Glucose Buddy, but has a flashier format.
• Diabetes Companion ($) – made by dLife (dLife also offers a website), allows you to track blood sugars and food.
• Sensei: My Diabetes Guide ($) – you can track your blood sugars, weight and blood pressure, and learn about diabetes.
• Go Meals, Carb Master ($), and Fast Food Calories ($) help you to count carbs in meals.
• Food Scanner ($) allows you to scan foods using bar codes to see how many carbs are in that item. However, the food label should also tell you this information.

Insulin to carb count dose

• Insulin Carb Count Dose 0.5 unit of insulin for every 7 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 8 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 10 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 12 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 15 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 20 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 25 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 30 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 35 g of carbs
• Insulin Carb Count Dose 0.5 unit of insulin for every 40 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 3 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 4 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 5 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 6 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 7 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 8 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 10 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 12 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 15 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 18 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 20 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 25 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 30 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 35 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 40 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 45 g of carbs
• Insulin Carb Count Dose 1 unit of insulin for every 60 g of carbs

Insulin correction dose

• Insulin Correction Dose 0.5 unit per 30 mg/dL over 150 mg/dL
• Insulin Correction Dose 0.5 unit per 50 mg/dL over 150 mg/dL
• Insulin Correction Dose 0.5 unit per 50 mg/dL over 200 mg/dL
• Insulin Correction Dose 0.5 unit per 75 mg/dL over 150 mg/dL
• Insulin Correction Dose 0.5 unit per 100 mg/dL over 150 mg/dL
• Insulin Correction Dose 0.5 unit per 100 mg/dL over 200 mg/dL
• Insulin Correction Dose 1 unit per 5 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 5 mg/dL over 125 mg/dL
• Insulin Correction Dose 1 unit per 5 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 10 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 10 mg/dL over 125 mg/dL
• Insulin Correction Dose 1 unit per 10 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 12 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 12 mg/dL over 125 mg/dL
• Insulin Correction Dose 1 unit per 12 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 15 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 15 mg/dL over 125 mg/dL
• Insulin Correction Dose 1 unit per 15 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 20 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 20 mg/dL over 120 mg/dL
• Insulin Correction Dose 1 unit per 20 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 25 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 25 mg/dL over 125 mg/dL
• Insulin Correction Dose 1 unit per 25 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 30 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 30 mg/dL over 125 mg/dL
• Insulin Correction Dose 1 unit per 30 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 40 mg/dL over 100 mg/dL
• Insulin Correction Dose 1 unit per 40 mg/dL over 120 mg/dL
• Insulin Correction Dose 1 unit per 40 mg/dL over 160 mg/dL
• Insulin Correction Dose 1 unit per 50 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 50 mg/dL over 200 mg/dL
• Insulin Correction Dose 1 unit per 75 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 100 mg/dL over 150 mg/dL
• Insulin Correction Dose 1 unit per 100 mg/dL over 200 mg/dL

A1C conversion table
Blood glucose log sheet - Basalgar, Lantus, Levemir
Blood glucose log sheet - Pump
Blood sugar log for school
Diabetic foot care
Diabetes school plan
Guide to setting up MyKidsChart and for video visits
Halloween candy carb counts
Insulin timing and rotation
Intro to continuous glucose monitor
Limited Release of Information form - Fill this out so that your care team can communicate verbally and written with school staff about your diabetes care. The highlighted boxes need to be filled out. Click here for instructions on completing and sending us the form.
Mini-dose Glucagon
Self-assessment of diabetes management
Uploading data from CGM, pump, meter: Glooko, Dexcom, Freestyle Libre, Medronic, Omnipod, Tandem, One Touch

View more patient forms here.

MyKidsChart tips sheets

• All tips
• Scheduling an appointment
• Viewing, printing or saving letters as a PDF
• Sending messages and uploading/sending attachments