Fostering a Child With Diabetes

A referral comes through, you get to the words “type 1 diabetes”, and the thought that follows is usually about needles. Could I give an injection? What if I got it wrong? It is a normal place to start, and it turns out to be the least of it. Here is what caring for a child with diabetes involves, and where the real work sits.

Please note: this is general information for people thinking about fostering, not medical or personal advice about any individual child. Figures and guidance are correct at October 2026. Every child with diabetes has their own care plan written by their diabetes team, and that plan always comes first. For the NHS overview, see nhs.uk/conditions/diabetes.

What it actually means in a fostering household

Diabetes is not an illness a child is unwell with. It is a set of jobs folded into the ordinary day: a glance at a phone before breakfast, a snack in a coat pocket on the way out. Once the rhythm is in, most carers find it takes less daily effort than getting a reluctant nine-year-old to do their reading. The hard parts are the first fortnight, while you learn a child’s own patterns, and the nights when a reading goes somewhere you did not expect. Both get easier.

Type 1 and type 2 are different conditions

People use “diabetes” as one word, which is unhelpful: the two types behave differently, and most children who have it have type 1. In 2023/24 the National Paediatric Diabetes Audit counted 35,122 children and young people under paediatric diabetes care in England and Wales:

• type 1: 32,809 children, 93.4 per cent
• type 2: 1,359 children, 3.9 per cent
• rarer forms such as MODY and cystic fibrosis-related diabetes: 954 children, 2.7 per cent

In type 1 the pancreas stops making insulin, so insulin has to be replaced for life. Nothing anyone ate or did caused it. Type 2 is about how the body responds to the insulin it makes, and in children it is bound up with family history and deprivation rather than willpower: Diabetes UK’s 2024 position statement found more than 85 per cent of young people with type 2 had a relative with the condition. If you are caring for a child with type 2, do not let anyone frame it as the child’s fault. It is not.

If a child arrives undiagnosed, know the 4 Ts

Children sometimes come into care with no diagnosis and no health history, and type 1 can arrive fast. Diabetes UK teaches the 4 Ts, worth having in your head from the day a child moves in:

• Toilet: going a lot, or wetting the bed again after being dry
• Thirsty: drinking far more than usual and still thirsty
• Tired: flat, heavy, sleeping in the afternoon
• Thinner: losing weight without trying

Any of those, phone the GP the same day and say you are worried about type 1 diabetes. Bedwetting is the one that gets missed in fostering, because there are so many other reasons a child who has just come into care might start wetting the bed. Mention diabetes anyway.

The kit has changed, and it changes your job

If your picture of diabetes care is a finger-prick kit and a chart on the fridge, it is about a decade out of date. NICE now says real-time continuous glucose monitoring should be offered to every child and young person with type 1, and by 2023/24 the audit found 79 per cent were using one. A sensor on the arm sends a reading to a phone every few minutes. Fifty-five per cent were on an insulin pump. Thirty-six per cent had a hybrid closed loop system, which NICE recommended for all children with type 1 in December 2023: the sensor talks to the pump and adjusts background insulin by itself. In practice this means far fewer finger pricks and an alarm that wakes you before a low gets serious, on a phone you can check from the kitchen while a child sleeps upstairs.

A low blood sugar, step by step

Hypoglycaemia, a “hypo”, is the thing carers worry about and the thing you get good at. A child may go shaky, sweaty, pale, irritable or oddly quiet, with tingling lips. Below 4 mmol/L needs treating. The amount of fast-acting sugar depends on the child’s size, which is where general advice often gets it wrong by quoting adult doses. Sheffield Children’s Hospital works to roughly 0.3g of glucose per kilogram of body weight:

• around 5g for a child of about 10kg
• around 10g for a child of about 30kg
• around 15g for a child of about 50kg
• retest after 10 minutes, and repeat the same amount if it is still low

Once they are back above 4 mmol/L, give the next meal or snack if one is due. Paediatric teams no longer routinely add a biscuit on top, because it tips the child high instead. If a child is unconscious or fitting, put nothing in their mouth, put them in the recovery position, give glucagon if you have been trained and it is there, and call 999 if you cannot give it, if they have not come round ten minutes after the injection, or if alcohol is involved. Tell the diabetes team the same day, every time.

High readings, ketones, and the line that makes it an emergency

Highs are less dramatic and need more thought. A child who is very thirsty, weeing a lot at night and tired may just be running high, and sugar-free fluids plus a correction dose per their plan will sort it. What decides whether this is a nuisance or an ambulance is ketones, and every child with type 1 should have a ketone meter and strips, required by NICE since 2015. Blood ketones under 0.6 mmol/L are normal. Between 0.6 and 1.5, retest in two hours. From 1.6 to 3, ring the diabetes team. Above 3, or urine ketones at 2+, that is 999 or A&E now, because it points to diabetic ketoacidosis. DKA usually builds over about 24 hours and can move faster, and the giveaway is breath that smells sweet or fruity, stomach pain, vomiting and deep fast breathing. A child who is vomiting with diabetes is never a wait-and-see.

School, trips, and who is allowed to do what

This is the part people do not expect to be hard, and it often is. Under the Equality Act 2010 a child with diabetes counts as disabled, so a school has to make reasonable adjustments in advance rather than improvising on the day, and schools in England have a duty under the Children and Families Act 2014 to support pupils with medical conditions. In practice you want an individual healthcare plan agreed in writing before the first residential trip, not during the phone call about it. Fostering adds a second layer: delegated authority. Who can consent to a dose change, sign a trip form, or agree to a new pump? That gets settled with the local authority at the placement planning meeting, and it is worth pushing for specifics early. Our piece on how foster carers work with schools covers the wider ground, and because diabetes is a disability in law our guide to fostering a child with a disability or additional needs is worth a read.

Handing it over as they get older

A seven-year-old needs you to do almost everything. A fifteen-year-old needs you to stop doing most of it, slowly, while staying close enough to catch the gap. Sensors and pumps stay under your eye even when a young person manages them well, and from age 12 there is annual diabetic eye screening for the diary. Teenagers in care often arrive having had to look after themselves far too early, and diabetes can become one more thing adults nag about. Keep the food side ordinary: the same pudding as everyone else, carbs counted without commentary. Our article on food, mealtimes and fussy eating is a good companion, and fostering a teenager covers the handing-over years.

You won’t have to do this alone

No one expects you to arrive knowing any of this. A child who moves in with us comes with an NHS paediatric diabetes team already in place, and your supervising social worker sorts the training and the delegated authority paperwork with you. You have someone on the phone out of hours, and you will not be the first GLF carer to ring at 2am about a reading. Ofsted inspected us from 21 to 25 July 2025 and rated us Outstanding in all three judgements. GLF pay is one fixed weekly fee of 479.50 pounds for a child under 11 and 507.50 pounds for a child aged 11 or over, with an enhanced fee of roughly 100 to 200 pounds a week more where a child’s needs are higher. Diabetes UK’s helpline is also there for carers, on 0345 123 2399, Monday to Friday, 9am to 6pm. You can read more about the support our carers get.

Frequently asked questions

Do I need medical training to foster a child with diabetes?

No. You need willingness and a phone. The child’s NHS diabetes team trains the adults who care for them, and your supervising social worker arranges it before or just after a child moves in. Most carers say the first fortnight feels like a lot and the second feels normal.

Will I have to give insulin injections?

You may, and many children now use a pump instead, so it is less often a needle than people assume. Either way you are shown how, in person, by the nurses who do it daily.

Does the school have to look after a child with diabetes?

Schools in England have a duty under the Children and Families Act 2014 to support pupils with medical conditions, and under the Equality Act 2010 a child with diabetes is treated as disabled, so reasonable adjustments have to be in place in advance. Get an individual healthcare plan written down early. The Department for Education consulted on updated statutory guidance in spring 2026 and has said it will publish a revised version.

Does GLF pay more for a child with diabetes?

Possibly. Our standard weekly fee is 479.50 pounds for a child under 11 and 507.50 pounds for a child aged 11 or over, and where a child’s needs are higher there can be an enhanced fee of roughly 100 to 200 pounds a week more. Whether a particular child’s needs qualify is decided case by case, so ask us about the referral.