Woods Charter School

Diabetic Training

What you’ll learn from this presentation

• What Senate Bill 911 requires

• Diabetes--- Type 1 and Type 2

• How to recognize and treat:– High blood sugar (Hyperglycemia)– Low blood sugar (Hypoglycemia)

LAW

SENATE BILL 911

Diabetes is considered a disability; therefore…

• Diabetes is covered under many federal and state mandates and laws

• It is important to understand what diabetes is in order to: Comply with legal mandates and laws Facilitate care for students with diabetes

NC Bill 911 We all need to work together

Parents are required by law to

• Provide pertinent information needed to develop a diabetes care plan for the student

• Communicate with the school staff, including the bus drivers, about any changes or developments concerning the

student’s diabetes care regimen

The School is required by law to:

• Provide diabetes training and education to school staff

• Train two or more Diabetes Care Mangers (DCM’s)

Responsibilities of the Diabetes Care Manager

• Plan and participate in conferences with the student, parents, and school staff to develop an individualized diabetes care plan

• Assist student with diabetes care and maintenance

• Be accessible in case of an emergency• Be up-to-date on diabetes information about

individual student and diabetes in general• Have open lines of communication with those

involved with student, including:– Teachers– Substitute teaches– Parents– School nurse– Bus drivers– Other members of school staff that may

be involved with care of student

Basic Facts about Diabetes Mellitus

• Diabetes is a major contributor to the development and risk of: – Cardiovascular disease– Heart Attacks– Stroke– Blindness– Kidney failure– Amputations

• Normal growth and development in children may be delayed or stunted• There are two types of Diabetes, and both types have a problem with the

balance between glucose (sugar) and insulin (anti-sugar)

Insulin Versus Glucose

• Insulin is a hormone produced by the pancreas

• Insulin interacts with glucose to maintain the right balance of glucose in the body

• Carbohydrates are metabolized into glucose

• Glucose is required by the body’s cells for energy

• Insulin and glucose have an inverse relationship– If one is up the other is down

• The Goal is to find the right BALANCE between Glucose and Insulin

Type 1 Diabetes• Commonly known as juvenile or childhood

diabetes• The pancreas does not produce insulin• Type 1 Diabetics are INSULIN-

DEPENDANT• They must have daily injections of insulin• Type 1 accounts for 10% of all cases of

diabetes cases in the US– 1 in 400 children have Type 1 diabetes

• Usually discovered during childhood or before the age of 30

Type 2 Diabetes

• The pancreas does not produce enough insulin or does not use the insulin properly, they are INSULIN RESISTANT

• More common in adults, but there is a rising epidemic of children developing Type 2 diabetes

• Those most at risk:– Hispanics– African-Americans– Native Americans– A family history of diabetes– Obesity– Apple shaped bodies are more prone to diabetes

than pear shaped bodies

Managing DiabetesWhen diabetes is kept in control complications can be prevented

and controlled

Type 1 Diabetes• Require daily insulin

injections• Maintain a balance between

– Amount of insulin taken, – Food intake (especially

carbohydrates), and– Exercise

• The balance in measured by self monitoring blood sugar readings

Type 2 Diabetes• If caught early, Type 2 can

usually be managed by lifestyle modifications including:

– Weight loss– Healthier eating habits– Oral medications– Regular exercise

Treatment of Diabetes• Self monitoring of glucose levels

– Place a drop of blood on a test strip that is read by a blood glucose monitor

– Important assessment for anyone with diabetes– Usually done during the school day

• Insulin – Type 1 diabetes requires insulin by injection using

one or a combination of• Insulin pump,• Syringe, or• Pen device

– Type 2 (insulin only in later stages)

• Exercise and diet control by carbohydrate counting are important for both types of diabetes

Insulin• Most students require at least two

injections a day unless they are using an insulin pump

• There are many combinations of insulin used depending on activity level, time of day, etc.– Some work faster while some last longer

• Insulin pumps are battery operated devices that automatically deliver insulin– Insulin pumps are the size of a pager

Carbohydrate Counting

• Type 1 diabetics need to “Carb Count” to balance insulin with food and activity

• Type 2 diabetics need to “Carb Count” to record what they eat in an effort to eat a balanced diet and promote weight loss– The goal for Type 2 diabetics is to ward off the need for insulin

injections with lifestyle modifications

Regular Exercise

• It is recommended for 30 minutes of cardiovascular exercise daily

• Promotes weight loss• Helps increase self

esteem

Signs and Symptomsof Diabetes

HyperglycemiaToo much glucose (sugar)

Not enough insulin

(The feeling one gets when one eats too much)

HypoglycemiaNot enough glucose (sugar)

Too much insulin

(The feeling one gets when they are very hungry)

HyperglycemiaToo Much Glucose

Too much sugar in the blood

Happens when Eat too much food Don’t exercise enough Body trying to

compensate for Illness or Physical and/or mental

stress

Signs and Symptoms of Hyperglycemia

Usually these are the first signs of developing diabetes Frequent urination Extreme hunger or thirst Extreme fatigue Dry itchy skin Blurred vision Frequent infections Slow healing wounds

Teachers and school staff are key in identifying students with these symptoms

Treating Hyperglycemia

• Drink water or other calorie free/ caffeine free liquid to dilute the blood and sugar– This will also help hydrate the body

• Seek immediate medical assistance if person unable to eat or drink

If high blood sugar goes untreated for a long period of time Diabetic Ketoacidosis can result

Diabetic Ketoacidosis (DKA)• High blood sugar that goes untreated

for a long period of time

• Signs and symptoms include:

– Nausea

– Vomiting

– High levels of ketones in urine and blood

• Life threatening, so if you suspect DKA get immediate medical attention

CAUTION: Students with insulin pumps use rapid acting insulin, so they may develop DKA very rapidly if pump is not working properly

HypoglycemiaNot enough sugar

• Also called “low” or “insulin reaction”• Usually symptoms occur when blood sugar

below 70-80 on blood glucose reading• Usual causes:

– Too much insulin– Increased activity– Eating too few carbohydrates– Too much time between snacks and meals

Signs and Symptoms of Hypoglycemia

Early signs Hunger Shakiness Dizziness Sweating Fast heartbeat Drowsiness Irritable, sad, or angry Nervous Pale, clammy skinImportant to recognize thesesymptoms before late signs develop

Late Signs Feeling sleepy Being unusually

stubborn Lack of coordination Tingling or numbness in

tongue Personality change Passing out Seizure

Recognizing Hypoglycemia (low blood sugar)

Frequent causes:• Late or missed meals• Exercise or activity• Change in school schedule (be on

the lookout)– Fire drill– Assemblies– End of grade testing– Anything that may cause stress or

alters normal patterns

Treating HypoglycemiaSometimes it is hard to tell the difference between high and

low blood sugar, but rememberYOU WILL NOT HURT ANYONE BY GIVING THEM FOOD

If you suspect low blood sugar:

1. If possible, test their blood sugar with a glucose monitor

2. Give juice or another source of easily ingested carbohydrates

3. Wait 30 minutes and test blood sugar again, or reassess signs and symptoms

• If blood sugar is still low, give more carbohydrates and start over with testing blood sugar

Hypoglycemia Busters

What to give someone with low blood sugar: 2-4 glucose tablets 4 oz of apple or orange juice 4-6 oz of regular soda 4-8 Life Savers 2 tablespoons of raisins 3-4 teaspoons of sugar or syrup 1 cup of low fat milk 2 teaspoons of cake gel/icing• Resist the urge to give them too much food or drink as this can

cause them to have too much sugar in their blood resulting in hyperglycemia (high blood sugar)

If early signs of hypoglycemia develop into late signs:

• The student may have seizures or become unconscious

• A medication called Glucagon must be given by a trained staff member

• Try not to let this become an emergency, be on the lookout for early signs of low blood sugar (hypoglycemia)

Bus Drivers have Important Responsibilities

• When a student is acting unusual, always assume they have low blood sugar and treat according to diabetes care plan

• Students should be allowed to monitor, treat, and eat snacks while on the school bus.

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