As any parent can attest, not knowing how to help your hurting child is a horrible feeling. When your very young child has diabetes, he can't tell you if he's “feeling low” or needs to check his blood glucose. But just as parents develop a sense of a “hungry cry” versus a “wet cry,” you will become attuned to the signs your child gives about how he's feeling.

Recognizing Signs and Symptoms

The same symptoms that occur in older kids and adults signaling the possibility of type 1 diabetes apply to infants and toddlers; the difference is that because their verbal communication skills are limited, you probably won't recognize them as quickly. In addition, symptoms like fatigue are hard to discern in a baby who sleeps a good deal of the day anyway.

The positive news is that most parents, particularly new ones, will have a “better safe than sorry” attitude and take an inconsolable infant or toddler to the doctor to figure out what's wrong quickly rather than waiting around for things to worsen. You can be on the lookout for the following symptoms:

• Excessive wet diapers

• Diaper rash that doesn't resolve quickly or keeps recurring

• Constant hunger and/or thirst

• Irritability or fussiness that doesn't seem related to colic

• Unexplained weight loss

• Sleeping more than usual

Detecting Highs and Lows

Recognizing blood sugar highs and lows may be hard when a diabetes diagnosis is new in your very young child. Fortunately, you have the best tool for making sure things are in balance right at your fingertips — a glucose monitor. If your child is acting the least bit out of sorts, always check glucose levels first. It may not be his diabetes, but if it is, you want to find out quickly and treat it fast.

Talk to your child's doctor about an appropriate amount of carbohydrates to treat his lows. As a general rule, kids under age six require 5 to 10 grams of a fast-acting carb for each 50 mg/dl blood glucose is low.

Glucose Monitoring

Glucose checks are a tough job for parents, especially in very young children who don't have the capacity to understand why they must get poked and prodded. You can make the job a little easier by buying an alternative site meter, which allows you to test on less-sensitive areas like the forearm. You may also be able to stick the heel instead of the fingers.

Talk to your child's doctor for his specific recommendations, and try out different meters until you find one that works well for you. Both you and your child will eventually get used to checks.

On Eating and Insulin

Small children have notoriously unpredictable appetites. They can go for days eating very little, and then suddenly down a whole plate of mac and cheese in the blink of an eye. Of course, if you don't know what your child is going to wolf down or push away at the next meal, it makes giving insulin a tad difficult. For this reason, your doctor may recommend short-acting insulin to be administered immediately following a meal to correctly cover the carbs and avoid highs or lows.

Insulin injections can be traumatic for young children, but there are several injection aids available to make the job easier on both of you. Your doctor can prescribe a topical anesthetic cream to numb the injection site, and a device called an Inject-Ease can be used with a standard syringe to both hide the needle and minimize pain by facilitating a rapid injection. There are also multiuse injection ports — including the i-Port (Patton Medical Devices) and the Insuflon (Unomedical) — now available.