COVID-19 (Coronavirus) Updates
Tips for Quarantine:
The COVID-19 crisis has introduced many new challenges for all of us, including children with T1D and their families. Below, we have compiled resources to assist with the mental health struggles of the crisis and tips on keeping your children healthy and educated during the stay-at-home order. You can use the links above to navigate to a particular subject.
Please check back on this page as the COVID-19 situation develops to be informed on the most up-to-date recommendations and advice.
We appreciate your patience and resilience in this historic moment and we would like to reassure all of our patient families: you are not alone. The U-M Pediatric Diabetes Clinic remains committed to caring for your children and teenagers with T1D during this time.
Health & Safety Tips
The best defense against any contagious illness is frequent and effective handwashing and seeking immediate medical assistance if experiencing symptoms.
Below are our recommendations for patients and families:
Wear a cloth or disposable face mask whenever you go out in public. Research has shown that face masks can help prevent the spread of the disease.
If you are socializing with people outside of your household:
Be sure to wear a mask
Practice "social distancing" by staying at least 6 feet apart
Try to socialize outdoors where there is more airflow and less chance to spread germs
Wash your hands with soap and water. Young children may enjoy singing one of their favorite songs to help achieve the recommended 20 second pace. If you're a fan of University of Michigan Athletics, try following along with these handwashing instructions set to the U-M fight song!
Avoid touching your eyes, nose or mouth with unwashed hands.
Cover your mouth and nose with a tissue or use your elbow when coughing or sneezing.
Avoid contact with people who are sick.
Disinfect "high-touch" areas in your household frequently, including sinks, counters, appliance handles, doorknobs, and bathroom areas.
Stay home if you are sick and contact your healthcare provider right away if you are experiencing coughing, fever, or shortness of breath.
Please refer to the links below for the most current information on taking precautions, symptoms, and situation updates:
JDRF recorded this conversation with Dr. Mary Pat Gallagher, director of pediatric diabetes at the Pediatric Diabetes Center at Hassenfeld Children’s Hospital at NYU Langone concerning T1D and coronavirus.
Mental Health Tips
The COVID-19 situation, "social distancing", and the state of Michigan's stay at home order have introduced new challenges for all of us, including children and teenagers with T1D. If your family is experiencing "diabetes burnout", we encourage you to read our tips on Overcoming Stress with T1D in addition to the tips below. If you or someone you love is experiencing depression or extreme diabetes burnout, please talk to our psychosocial team at the U-M Pediatric Diabetes Clinic by calling the clinic. We encourage parents of young children to visit Zero to Thrive's website for helpful information on explaining the coronavirus situation to them.
Increasing social distancing without increasing the blues
Children and teenagers need social interaction and activity for typical development. Social distancing encourages limiting interactions with large groups and contact with potentially ill individuals, or those that potentially carry the virus without symptoms. While many of the activities we enjoy are limited at this time, we can think creatively about activities that can promote a positive mood. Here are a few ideas:
Good ol’ technology: Consider adjusting screen time limits to allow children to interact with their peers via technology. Also – consider using video chatting to connect with elderly family and friends who may be socially isolated themselves. Grandparents might enjoy spending craft time with young ones or reading books together. That’s a win-win! You should continue to monitor the content of your child’s technology including video games, streaming websites like Twitch and YouTube, and social media apps like TikTok, Instagram, and Snapchat to set age-appropriate limits.
Get outside! We know that being in nature is good for our mood. Plan to get out of the house for a while each day. This may include a family walk around the neighborhood, walking your family pets, raking leaves (or other spring yard work), a picnic lunch, or just sitting on the grass while reading.
Move it, Move it! You may have heard it many times, but physical activity does wonders for mood. Even 5 minutes of moderate activity can boost your mood. It doesn’t have to be push-up and sit-ups - try dancing to your favorite songs or kicking a soccer ball around outside. Consider setting a goal as a family to do at least 30 minutes of activity in the morning and 30 minutes in the afternoon/evening. Doing it together will help the whole family! You can read up on Exercise & Activities with T1D to make sure your blood sugar is steady during any intense activity.
Take a grateful approach. Spend time each day as a family identifying things from the day each person is grateful for. It doesn’t have to be extraordinary, just meaningful. For example, a parent making a favorite food or a sibling sharing a toy.
Limit popular media about the COVID-19 situation. It is good to stay informed, but focusing too much on the crisis can put you in a funk and children may pick up on the stress.
T1D Care Tips
School and after-school activities provide kids with diabetes additional structure and supports daily diabetes management behaviors. When students are out of school, it can be at higher risk of struggling to complete their diabetes care, even when they typically do really well! Being cooped up at home can also lead to less physical activity and exertion which may affect blood sugars.
Here are our tips on maintaining a healthy T1D routine at home:
A daily routine is key! Help your child as much as possible to maintain a fairly consistent routine when it comes to to sleep and eating schedules. This helps anchor care to typical activities. Remember, you should be checking blood sugar when you wake up, before you go to bed, before every meal and snack, and any time you are feeling the symptoms of a high or low blood sugar.
Educate any additional caregivers. This situation has prompted many families to rely on new or less T1D-experienced caregivers. Be sure to share our education resources including the New Onset Guide or JDRF's resources to provide quick and accurate education.
If you’re not together during the day, send pictures of devices when possible. It’s better to lay eyes on the meter or pump than rely on verbal report - not because your child is dishonest, but because it helps keep them accountable in the moment.
Set up a family “diabetes care review” conversation each day. Use this time to review meters, pumps, or CGM together. Focus your attention on what went well during the day and problem-solving how to improve care for tomorrow. Avoid focusing on missed opportunities for care, as this is unlikely to help your child do better tomorrow.
Check out Diatribe's resources on COVID-19 for people with T1D for more information.
With schools closed, many children and teenagers are lacking the structure of their ordinary schedule. Below are some tips and resources for children and teenagers to maintain their academic skills during this time away from school.
Stay connected with school. If your child's school is offering virtual classes, be sure to help them connect and complete assignments as required. Review assignments from the school, and help your child establish a reasonable pace for completing the work. You may need to assist them with turning on devices, reading instructions, and typing answers. Stay in touch with teachers and school staff if your child is having trouble with the assigned materials or if you have difficulty connecting to lessons.
Create consistency. Create a schedule and routine for learning at home, but try to remain flexible. Start with a consistent bedtime and wake up time during the week. Break up the day with time for learning, time for play, time for meals and snacks, and time for physical activity. Most importantly, allow yourself flexibility in the schedule - it's okay to adapt from day-to-day as things come up.
Practice makes perfect! One of the best things you can do for your children is practice what they have learned in school. Review vocabulary words from science and language arts, practice math problems and create your own word problems, and give presentations on history or books they have read. You can search for instructional games or grade-appropriate activities online to help you.
Make learning fun. Children love hands-on activities like puzzles, painting, drawing, and making things. YouTube and Facebook can be great places to check for tips on these kinds of activities. Playtime can also be used in place of structured learning when appropriate - encourage your children to build a fort from sheets or practice counting by stacking blocks. Practice handwriting and grammar by writing letters to family members or starting a journal. Listen to audiobooks or see if your local library is hosting virtual or live-streamed reading events. JDRF has assembled this fun list of "quarantine activities" that can spark creativity or interest in learning.
Give freedom to explore. If your child is happily engaging in art, reading, science, or history, let them explore! Self-directed learning is one of the most effective ways to absorb educational material. Don't feel the need to move children from topic to topic if they are enjoying a particular subject and are staying productive.
Promoting Academic Skills at Home
Clinic Virtual Visits
For more information on how to sign up for virtual visits, check our Virtual Visits page.
Returning to Clinic Visits
For more information on what to expect as in-person clinic visits resume, check our Returning to Clinic Visits page.
Returning to School
With the rising number of coronavirus/COVID-19 cases across the country, we understand that patients with diabetes and their families will have special concerns about how this may impact their health. Based on current scientific evidence, children and teens with type 1 diabetes do not appear to be at higher risk of becoming infected with coronavirus compared to their peers without diabetes. However, if they do contract COVID-19, it is possible that the child or teen’s course of illness may be more severe and impacted by potential challenges in controlling blood glucose levels and risk of developing DKA. Please keep in mind that we are learning new information about this virus on a daily basis and our advice may change to reflect new knowledge.
For more information on making back to school decisions for families with underlying health conditions, please check this Michigan Medicine blog post.
How can I prevent my child from getting COVID-19? Should I do anything differently?
We advise children with diabetes and their families to be vigilant to well-known preventative measures to help prevent infection. You can read more about our health and safety tips above.
If your child has concerning symptoms, please contact your primary care doctor or pediatrician to arrange for testing and seek medical advice. Please follow your blood glucose and ketones closely and follow your diabetes sick day plan.
My child has tested positive for COVID-19, what do we do?
It is important to monitor your blood glucose and ketones closely and follow your sick day plan. If your child is having high fever, trouble breathing or other concerning symptoms, you should call their primary care provider or seek urgent medical care. Visit our Sick Days page for more information on how to manage T1D during an illness.
Should I keep my child out of school in the fall if it is in-person?
This will be a decision that each family has to make based on their situation. The benefits of learning, socializing with peers and being involved in school activities must be considered with the risk of the virus. The decision to have school in-person will be based on the community transmission in your area. We recommend having a conversation with your child's primary care physician who may be able to advise you based on local community infection rates.
We would like to stress the importance of making sure your child is safe at all times and remind patient families that our primary focus is on treating diabetes concerns. If your child will be attending school remotely or learning at home, it is still very important that they have a dependable support system in place in case of a diabetes emergency. If they will be left alone, their health is still the parent or guardian's responsibility. Child Protective Services in the state of Michigan recommends children under 10 years old should not be left home alone.
Whether schools meet in-person or with distance learning, your child has rights. The American Diabetes Association has helpful resources on this topic. We recommend speaking with your child's teacher to establish a communication system for your child to excuse themselves to take care of diabetes concerns. This can be as simple as a colorful index card or a hand gesture. We can also assist you in drafting a Diabetes Medical Management Plan (DMMP) to ensure your child's diabetes needs are taken care of at school. Visit our Back to School page for more information and contact us for help.
Thank you for your dedication to your child’s diabetes management. As always, if you have specific concerns that come up, do not hesitate to contact our clinic.