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Sample Child Care Checklist

You can download
a printer-friendly
version of this
checklist here

Use this checklist when providing instructions to people who will be caring for your child.

Child Care Checklist for __________________________

My child has type 1 diabetes. They are generally normal and healthy. In a child who has type 1 diabetes, sugar (carbohydrates) cannot be used by the body because the pancreas no longer makes the hormone insulin. Because of this, daily insulin injections are needed. Caring for a child with diabetes is not very difficult, but it does require a small amount of extra knowledge.

The only emergency that could come on quickly is Low Blood Sugar. This can occur if my child gets more exercise than usual or does not eat as much as usual.

The warning signs for low blood sugar vary but may include any one or combination of the following:

  • Hunger
  • Paleness, sweating (often cold), shakiness or trembling
  • Glassy eyes, dilated pupils
  • Pale or flushed face
  • Personality changes such as crying, stubbornness, or anger
  • Headaches
  • Inattention, drowsiness, or sleepiness at an unusual time
  • Weakness, irritability, confusion
  • Speech and/or coordination changes
  • If not treated, loss of consciousness and/or seizure

The signs in our child usually are _____________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Blood Sugar: If possible check the blood sugar whenever any of these symptoms are present. It takes about 10 minutes for the blood sugar to increase after taking liquids with sugar so you can check the blood sugar right after you have given them if needed. If you can't check the blood sugar, go ahead with the treatment anyway.

Treatment: Give sugar (preferably in liquid form or Glucose Tablets) to help the blood sugar come back up. Give any of the following:

  • Soda or soft drink that contains sugar 1/2 cup - Do Not Give Diet
  • Two or three glucose tablets, sugar packets, or cubes, or a teaspoon of honey
  • Fruit juice 1/2 cup
  • Five or six Lifesavers (only to children over three years old)
  • If unable to eat or drink, 1/2 tube of oral glucose gel or cake decorating gel (see below)

We usually treat low blood sugar reactions with ____________________________

_________________________________________________________________

_________________________________________________________________

If my child is having a low blood sugar reaction and refuses to eat give oral glucose gel or cake decorating gel. Put the gel, a little bit at a time between the cheeks and gums and tell them to swallow. If they can't swallow, lay my child down and turn their head to the side so they don't choke when you give the gel.

My child may resist the gel. Make them take it! You can speed the sugar absorption by massaging their cheek.


If a low blood sugar or other problems occur, please call (in order):

Parent ________________________________ at: _________________________

Dr. ___________________________________ at: _________________________

Other: ________________________________ at: _________________________

Meals and Snacks

My child must have meals and snacks on time. The schedule is as follows:

Time Food to Give

Breakfast ________________ ____________________________

Snack ________________ _____________________________

Lunch _________________ _____________________________

Snack _________________ _____________________________

Dinner _________________ _____________________________

Snack _________________ _____________________________

Sometimes my child may not eat meals and snacks at exactly the suggested time. If this happens do not panic. Set the food within my child's reach. If after 10 minutes they haven't eaten, remind them.

Blood Sugars

It may be necessary to check my child's blood sugar or urine ketones.

The test supplies are: ______________________________________________

We keep them: ___________________________________________________

Please record the results of any blood or urine tests.

Time: ________________________ Result: ____________________________

Side Trips

Please be sure if my child is away from home with you, you take all supplies, extra snacks, and a source of sugar.

Other

Other concerns we have are: _______________________________

_______________________________________________________

_______________________________________________________

_______________________________________________________

If you have any questions, or if my child vomits or does not feel well, please call me or the other people at the above numbers.

Thank you

You can download a printer-friendly version of this checklist here