Managing type 1 diabetes: What can children do?

Type 1 diabetes is a lifelong disease that involves a great deal of day-to-day effort. When children with type 1 diabetes are young, their parents will do most of the work for them. As children get older, they can become more involved in their own care.

How quickly children start doing some of the day-to-day tasks of managing type 1 diabetes depends on many factors, including:

  • How old they are
  • What they are able do
  • How independent they are
  • How long since they were diagnosed
  • How willing they are to take on diabetes-related tasks

When it comes to diabetes care, it is up to parents and children to decide “who does what”.

Especially in the early years, a child’s willingness to be involved in their care may vary from day to day, and depending on circumstances.


Schools should be prepared to provide support and supervision that matches each child’s needs and abilities.

All children and youth with type 1 diabetes—even those who manage a lot of their own care—may:

  • Need help when their blood sugar is too high or too low.
  • Need someone else to share diabetes tasks from time to time.

It’s helpful if the student’s individual care plan is clear about who does each task, and exactly how much support a child needs.

Here are some general guidelines. But remember, every child is unique.

Age/stageHow they think and feelSome typical diabetes tasks


4 to 5 years old

  • Concrete thinkers
  • Can understand 3-part directions
  • Ask lots of questions
  • Cooperate with adult requests
  • Wear medical ID bracelet
  • Choose finger for blood checks
  • Turn on glucose meter / insert strip
  • Know which adults are there to help
  • May start to recognize and tell an adult when signs of low blood sugar
  • Children this age need supervision to ensure meals and snacks are eaten

Early school-aged

6 to 7 years old

  • Concrete thinkers
  • Can count and do simple math
  • Learning about time
  • May struggle for control
  • Forgetful or easily distracted: Need reminders and supervision
  • Prick finger for blood check
  • Start learning about carbohydrate content of foods
  • May recognize low blood sugar
  • May begin to help with injections
  • May give pump bolus with supervision
  • Children this age need supervision to ensure meals and snacks are eaten

Middle school-aged

8 to 12 years old

  • Forming social bonds
  • Want to fit in
  • More logical and responsible
  • Curious: Can understand cause and effect
  • Need reminders and supervision
  • Can check blood sugar with supervision
  • Recognize and treat low blood sugar
  • More involved with injections or pump boluses
  • Make food choices according to plan

High school/adolescence

13 to 18 years old

  • Abstract thinkers
  • More independent
  • May rebel or take risks
  • Self-image is important
  • Can be self-conscious
  • Take part in annual diabetes team meetings
  • Plan meals and snacks, and eat them on time
  • Recognize and treat low blood sugar
  • Ensure emergency kit is on hand
  • Usually able to do injections or pump boluses, but still need some supervision and review

*While there are many more aspects to development, the ones listed here are especially relevant to the day-to-day tasks involved in managing type 1 diabetes

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