Transcript diabetes for school teachers

Diabetes Education
Macon County Schools
Senate Bill 911
• Requires schools to provide care to the
student with diabetes upon parent request.
• Requires that all school personnel have a
basic understanding of diabetes
• Requires that all schools have a designated
Diabetes Care Manager with a back up in
case that person is unavailable
• Requires the schools to have a diabetes
care plan that is updated each school year.
Senate Bill 911
• The student with diabetes should
have access to any medical
interventions that are necessary
(insulin, water, juice or source
of sugar)
• The student should have access to
the bathroom and water as needed.
Type I & Type II
• Type I: used to be known as Juvenile onset or
Insulin dependent Diabetes Mellitus IDDM
– No insulin is being produced by the pancreas.
An external source of insulin must be
administered.
• Type II: used to be known as Adult onset or non
insulin dependent diabetes mellitus NIDDM
– Insulin resistance, “not enough”, or body is not
responsive to the insulin that it is producing.
Often can be controlled by medication that
makes the body more responsive to insulin.
After several years may become IDDM.
Insulin
• Insulin is a hormone.
• Insulin is necessary to move the
glucose (sugar) that we get from
our foods or drink from the blood
stream to the cells where it can be
used by the body as energy.
• Insulin is the mechanism through
which glucose enters the cells.
• Hyperglycemia
– hyper – too much
– Glycemia – glucose or sugar
• Hypoglycemia
– Hypo – too little
– Glycemia – glucose or sugar
High Blood Sugar
(>240 mg/dl)
• Hyperglycemia (hyper - more)
– Too little insulin, too much food, or too
little exercise
– May occur at times of illness even if
there are appropriate levels of insulin,
food or exercise. (infection, viruses)
– Stress from school, home, or peers can
elevate blood sugar levels.
– Adolescence is a time of unpredictable
periods of hyperglycemia.
Signs and symptoms of
Hyperglycemia
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Frequent Urination*
Extreme Hunger
Extreme Fatigue
Unusual Thirst*
Irritability
Blurred Vision
Exercise
• A Normal blood sugar range varies from
person to person. An average range is 80120.
• If blood sugar is elevated > 300 mg/dl
exercise should be delayed.
• When blood sugars are elevated the body
uses muscle rather than carbohydrates as
it’s energy source. Exercising when blood
sugar levels are elevated can further
damage muscle
Hypoglycemia
• Low Blood Sugar
Hypoglycemia
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Sometimes called “insulin reaction”
Below target range (usually <70-80)
Can come on quickly
Caused by too much insulin, eating
too few calories, or too much activity
• Not enough sugar in the blood
• Can become an immediate medical
emergency if not treated quickly.
Hypoglycemia
signs and symptoms
Hunger
Feeling irritable,
Shakiness
sad or angry
Dizziness
Sweatiness
Nervousness
Fast heart beat
Pallor
Drowsiness
( <7yo pale glassy eyed)
More symptoms of
hypoglycemia
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Feeling sleepy
Being stubborn
Lack of coordination
Tingling or numbness of the
tongue
• Personality changes
• Passing out
• Seizure
What to do?
• If possible check blood sugar
• If Blood sugar is 70 or below target (See
the diabetes care plan for specifics for
each student), have the student eat or
drink a source of quick acting sugar (15
gms. Carbs)
• If meter is not handy go ahead and have
the student eat or drink a source of
fasting acting sugar, then obtain the
meter and check their blood sugar.
Fast-acting Carb’s
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2-4 glucose tablets
4 oz apple or orange juice
4-6 oz soda
4-8 life savers
2 tablespoons raisins
3-4 teaspoons sugar or syrup
1 cup low fat milk
• 1 tube of cake gel
Catch low blood sugar
EARLY
• Be alert to when lows may occur
• Test if there is any doubt
• Fast acting carb sources should
always be available
• Treat low blood sugar promptly or it
can turn into severe hypoglycemia- a
medical emergency!!
Treating SEVERE
hypoglycemia
• Not enough sugar is getting to the
brain
• May lose consciousness and/or have
convulsions
• MEDICAL EMERGENCY
• Glucose gel, cake gel, syrup, or honey
may be used only if the student is
still conscious
Unconscious
• Call 911
• Administer Glucagon injection
immediately
• Do not place anything into their
mouth
• Glucagon is a hormone that makes the
liver release sugar into the blood
stream. It is similar to an epi pen.
– Most people with diabetes will have Glucagon
ordered in case of emergency.
Hypoglycemia
• REMEMBER!!
• When in doubt, treat the student as
if he/she is LOW. Provide them a
juice or source of quick acting sugar
(sweet tarts, smarties). Avoid
chocolate or sweets that have a high
fat content as they are absorbed
more slowly and are not considered
“fast acting sugars.”
Field Trips
• Senate bill 911 requires that a diabetes
care manager or parent be present on all
field trips that the student with diabetes
participates in.
• A school can NOT require that the parent
participate but must make accommodations
for the diabetes care manager or
appropriate substitute (school nurse) be
present for the trip.
Field Trips
• If the parent decides to participate it
must be clearly communicated to the
parent that the diabetes care manager or
nurse will not be there and that they are
assuming full responsibility for the medical
care of their child.
Class Parties
• Planning ahead is the best thing.
• Notify parent and diabetes care manager
in advance.
• The parent may decide to be present and
to handle the balancing of food and insulin
• The student should be allowed whatever is
offered to the other students.
Class parties
• The diabetes care manager can decide how to
cover extra foods by administering insulin.
• Students with diabetes can eat foods with sugar.
They just need to adjust for it.
• Sugar Free foods are not carbohydrate free and
will still need to be covered with insulin.
• Sources of foods that do not contain
carbohydrates and will not need to be adjusted
for include: Cheese, meats, diet sodas and most
vegetables.
Thank you!