The Infants, Toddlers, and Preschoolers with Diabetes online resource sheet provides practical advice about the diagnosis and management of Type 1 Diabetes in infants, toddlers and preschoolers. Once the condition has been diagnosed, “the situation can be corrected quickly and long-term management can begin.” The information sheet was produced by The Hospital for Sick Children and available on the aboutkidshealth website.

Type 1 Diabetes diagnosis is less common in infants, toddlers and preschoolers than in older children and adolescents, and management needs to be tailored to the developmental stage of the child.

In this age group, children generally:

• Determine thoughts by what they see and hear
• Begin to develop a sense of themselves, first by gaining a trust in their environment as infants, and then by testing this environment in the next few years
• Enhance their knowledge of the world around them by constantly exploring, asking questions, and developing language (‘Why this? Why that? Why the other thing?’)
• Begin to become more curious and independent, choosing some activities and rejecting others

Children at this age cannot yet recognize the symptoms of low blood sugar, so their care “involves a balance between what might be considered ideal – close to normal blood sugar readings – and what is safe and practical.” It is normal for children under 5 to have changing appetites. “If blood sugar levels before meals are allowed to go slightly higher than for older children, the infant or toddler is more likely to remain safe even during periods of food refusal or picky eating…. For safety’s sake, young children should eat at regular meal and snack times, having at least 3 meals and snacks a day. But beyond that, imposing a rigid meal plan on an infant or toddler may only increase the stress in the family.”

The sheet provides a list of signs of a healthy infant or toddler with diabetes, and discusses the impact of diabetes for children of this age. The recommendation is that parents should “try to balance your child’s need for support against the risk of overprotection and being excluded from activities they would normally do at this age.”

The information sheet provides tips to manage the condition with as normal a life as possible for the child (e.g. tips on how to make injection time go more smoothly) Included is  a sample story of a family that uses routines that avoid excluding siblings and  work around the energy, appetite and control/independence needs of the child with diabetes.