The Babysitter’s Guide to Type 1 Diabetes


Editor’s Note: This content is a part of Beyond Type 1’s guidebook, which includes guides for everyone who has a type 1 in their life. Check out the rest of our customized guides for the different people in your life here

Whether you’re a full-time nanny, part-time babysitter, relative, or close friend of a family affected by type 1 diabetes, the idea of caring for a child with type 1 diabetes (T1D) might seem daunting if you’ve never done it before. Perhaps your son or daughter wants to invite a classmate with T1D to your house for a sleepover or maybe you’re a long time au pair for a newly-diagnosed child with T1D (OR MAYBE you’re just an AMAZING neighbor who wants to give an overworked T1D mama/papa a long overdue date night!) Whatever the circumstances, it’s important to know that children with T1D can do anything non-T1D children can do. Just like children with allergies or asthma, all it takes is some basic knowledge and simple preparation to keep a child with T1D safe and healthy.

The facts about Type 1 diabetes

What is type 1 diabetes?

T1D is an autoimmune disease. It occurs when the pancreas stops producing insulin.

What is insulin?

Insulin is a hormone that everybody needs to stay alive. Insulin helps turn food into energy and keep blood sugar levels in a healthy range. Because they can’t produce any of their own, people with T1D must inject or infuse insulin via injection or insulin pump.

What is a healthy blood sugar level?

While every child is a little different, a good blood sugar range to aim for is between 4.4 mmol/L80 mg/dL and 6.7 mmol/L120 mg/dL. It is NORMAL and COMMON for a T1D child to fall outside this range, especially following meals or after physical activity. Unlike blood pressure, blood sugar levels can change frequently and rapidly throughout the day.

Why might a T1D child fall outside the 4.4-6.7 mmol/L80-120 mg/dL range?

Two simple reasons: either too much FOOD and not enough INSULIN; OR too much INSULIN and not enough FOOD. Insulin LOWERS blood sugar levels; in comparison, eating food (especially those with carbohydrates and sugar) will INCREASE blood sugar levels. Balancing food intake with insulin replacement therapy is how you keep a T1D child’s blood sugar in range.

What are the signs that a T1D kid’s blood sugars are out of wack?

High symptoms: nausea, deep sighing breaths, confusion, flushed and warm skin, drowsiness
Low symptoms: shaky, pale and sweaty skin, headache, hunger, weakness, trembling

How do I test blood sugar?

Blood glucose(BG) or blood sugar checks tell us how the insulin is working.

  • You should test the child’s blood sugar at least four times a day (before meals and after meals and right before bedtime).
  • Never hesitate to test a blood sugar, especially if the child doesn’t appear to be feeling well. This information is very important for keeping the child in range and safe.
  • The amount of insulin needed may change in growing children. Monitoring is key.

How do I inject insulin?

Insulin can be delivered in two different ways: either through a needle injected under the skin or via an insulin pump.

What can’t I do with a kid with T1D?

It is important to remember that children with T1D can participate in all of the same activities as other kids, such as play sports and join activities. They can also eat sweets and any other type of food/drink, if their parents permit,  as long as they are giving themselves the appropriate amount of insulin to cover the meal. Some foods affect blood sugar levels differently than others.

Know the supplies

When going out, make sure to extra pack supplies. Your daily supplies kit could look like this:

For Testing Blood Sugar:

  • Lancing Device with Lancet – Device that contains lancet (small, sharp object) to prick skin for blood sample
  • Test Strips – Item that collects your blood sample and then is inserted into your blood glucose meter for reading blood glucose levels.
  • Blood Glucose Meter – The go-to device for testing your blood sugar levels.

For Combating/Preventing High Blood Sugar:

  • Insulin – If the child uses an insulin pump, they have their insulin supply all ready to go. If packing a pen or syringes and insulin vials, pack enough for the outing plus a bit extra.
  • Syringes or Pen Needles – Both deliver insulin; it depends on what’s your instrument of choice. If you are on a pump you should carry emergency needles and insulin vials, or an emergency pen in case of failure.

For Combating Low Blood Sugar:

  • Something sugary – For treating hypoglycemia pack hard candy, fruit juice, regular soda, glucose tablets, or gels.
  • Nasal glucagon BAQSIMI – spray formulation of glucagon (available by prescription) and used to treat severe hypoglycemia.
  • Glucagon Emergency Kit – Injectable form of glucagon (available by prescription) and used to treat severe hypoglycemia. (opposite of insulin.)

Communication is key!

The first step is to have a conversation with the child’s parents about their expectations and the unique T1D management style of their child. Every child with T1D is different! Some children may be fully capable of checking their own blood sugar, but need some help counting carbohydrates or figuring out how much insulin to give, while others may be completely independent in these areas.

You might need to be trained on how to use specific T1D management equipment. For example, there are multiple kinds of glucose monitors and insulin pumps. In the same way every cell phone or remote control is a little different, you may need a tutorial to understand exactly how these devices work. If operating an insulin pump, dosing insulin, or overseeing blood sugar testing makes you nervous, speak up! Depending on the circumstances, some parents may be open to doing the more complicated tasks for you (i.e.; “Hey, could you tell Sarah to give herself 3 units of insulin? Thx!”) Also keep in mind, nearly all insulin pumps are pre-programmed to do insulin dosing calculations, so all you really need to do is press a few simple buttons!

Ask for any and all contact information from the caregivers of the child. You want to be sure that you have cell phone number, as well as the number of neighbors or nearby friends.  Also, include the specific T1D instructions for your child, such as what specific numbers are considered to be “low” or “high,” how to treat, and what to do in case of emergency. The child has a daily routine of glucose monitoring, carbohydrate counting and insulin injections (or delivery through a pump), and don’t hesitant to bring up questions to the caregivers of the child. They will appreciate that you are taking the time and effort to learn about T1D!

If you find yourself in an unfamiliar situation and you do not know what to do, don’t wait or try and make a guess. Call the caregiver and get their instructions before making any decisions on your own.

You can manage this.

Babysitting is a demanding responsibility and requires you to be on top of your game, and T1D is another piece to add to the puzzle. One of the most important things that you can do is to stay levelheaded and calm during your time with the child. Dealing with T1D is frustrating and challenging for a child to deal with, and they will lean on you for support and motivation! The keys to success are asking questions, getting educated and being prepared for anything that can come your way. You can do this!

See the rest of our customized guides here.

WRITTEN BY BT1 Editorial Team, POSTED 06/15/18, UPDATED 12/31/22

This piece was authored collaboratively by the Beyond Type 1 Editorial Team.