Tips to Help Teachers Keep Kids with Diabetes Safe at School
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1 Tips to Help Teachers Keep Kids with Diabetes Safe at School Pamela Kontos, DNP, MS, ACNP-BC ADVOCATE SOUTH SUBURBAN HOSPITAL HAZEL CREST, IL
2 Diabetes is NOT about blood sugar..
3 Diabetes is about INSULIN level.
4 Blood glucose is simply a * SIGN * of the person s insulin level!
5 About Diabetes Type 1 diabetes Occurs when the pancreas does not produce insulin Requires multiple doses of insulin every day via injections or an insulin pump Most prevalent type of diabetes among children and adolescents Type 1 diabetes cannot be prevented.
6 About Diabetes Type 2 diabetes Occurs when the pancreas does not produce enough insulin or use insulin properly African Americans and Hispanic/Latino Americans are at higher risk Managed with insulin injections, oral or injected medication, diet and other healthy living choices Type 2 diabetes may be prevented.
7 Symptoms of Diabetes Type 1 diabetes Frequent urination Excessive thirst Extreme hunger Dramatic weight loss Irritability Weakness and fatigue Nausea and vomiting These symptoms usually occur suddenly and can be deadly if left untreated. Type 2 diabetes Increased thirst Frequent or night time urination Blurry vision Unusual fatigue Dark skin around the neck or armpits (Acanthosis Nigricans) These symptoms usually occur gradually and may go unnoticed.
8
9 Diabetes management is 24/7 Every student with diabetes will be different Diabetes requires constant juggling of insulin/medication with physical activity and food
10 It s important to recognize the behaviors and signs of high and low blood sugar levels A student with a diabetes emergency will need help from school staff (ex. low blood sugar) Students with diabetes can do the same every day activities as students without diabetes
11 Diabetes Management at School Most immediate concerns in managing type 1 diabetes Hypoglycemia = low blood glucose Hyperglycemia = high blood glucose Ketoacidosis (key-toe-ass-i-doe-sis) = ketone (acid) build up in the blood because there is not enough insulin in the body
12 Diabetes Management at School Causes of Hypoglycemia (low blood sugar): Administering too much insulin Skipping or delaying meals/snacks Too much insulin for the amount of food eaten Exercising longer or harder than planned More likely to occur before lunch, at end of school day or during/after PE Combination of the above factors Never leave a student alone or send them away when experiencing hypoglycemia. Treat on the spot.
13 Diabetes Management at School Symptoms of mild hypoglycemia: Sudden change in behavior (lethargic, confused, uncoordinated, irritable, nervous) Sudden change in appearance (shaky, sweaty, pale or sleepy) Complaints of headache or weakness Response: 1. Give the student a quickacting sugar equivalent to 15 grams of carbohydrate: Examples: 4 oz. of juice, ½ a can of regular soda, or 3-4 glucose tablets Ask parents to provide you with what works best for their child 2. Check blood glucose (BG) level 10 to 15 minutes later 3. Repeat treatment if BG is below student s target range
14 Diabetes Management at School MILD HYPOGLYCEMIA (low blood sugar) Shaky, weak, tired, pale Quick-acting sugar snack like juice, regular soda, glucose tabs
15 Diabetes Management at School Symptoms of severe hypoglycemia: Inability to swallow Seizure or convulsion Unconsciousness This is the most immediate danger to kids with diabetes. Response: Position student on side Contact school nurse or trained diabetes staff Administer prescribed glucagon Call 911 Call student s parents GLUCAGON IS A HORMONE THAT RAISES BLOOD GLUCOSE LEVELS. It is only administered when hypoglycemic symptoms are SEVERE. Glucagon may cause nausea or vomiting, but... GLUCAGON IS A LIFE-SAVING TREATMENT THAT CANNOT HARM A STUDENT!
16 Hypoglycemia dh9y_rby-jq
17 Diabetes Management at School Diabetes Management at School Causes of Hyperglycemia (high blood sugar): Too little insulin Illness, infection or injury Stress or emotional upset Decreased exercise or activity Combination of the above factors
18 Signs of hyperglycemia: Thirst, drowsiness, frequent urination.
19 Diabetes Management at School Symptoms of hyperglycemia: Increased thirst Frequent urination Nausea Blurry vision Fatigue Response: Allow free and unrestricted access to liquids and restrooms Allow student to administer insulin or seek a trained staff person to administer Encourage student to test blood glucose levels more frequently In the short term, hyperglycemia can impair cognitive abilities and adversely affect academic performance. In the long-term, high blood glucose levels can be very dangerous.
20 Diabetes Management at School Bathroom breaks, water, insulin Increased urination, thirst, blurry vision, nausea HYPERGLYCEMIA (high blood sugar)
21 Hyperglycemia i26p860r1au
22 Diabetes Management at School As a teacher, you can help by: Supporting self-care by capable students Providing easy-access to diabetes supplies Ensuring students eat snacks at a scheduled time - make sure snacks are available to treat low blood sugar Allowing students reasonable time to make up missed homework or tests
23 Diabetes Management at School Other Classroom Tips: Keep a contact sheet of trained diabetes staff at your desk for emergencies Learn signs and responses to low/high blood sugar levels Allow blood glucose monitoring and free access to bathrooms/water during class Teach your class about diabetes Let parents know, in advance, changes to the class schedule (field trips, special events, etc.)
24 Diabetes Information For More Information: Visit /schools Visit /safeatschool Download the following free tools: NDEP s Helping the Student with Diabetes Succeed: A Guide for School Personnel ADA s Diabetes Care Tasks at School: What Key Personnel Need to Know Visit /schoolwalk for free lesson plans about diabetes
25 For hypoglycemic persons who are NOT alert, administer Glucagon in a muscle.
26 What Is Glucagon? Natural hormone made in the pancreas A life-saving, injectable hormone, Glucagon that raises blood glucose level by stimulating the liver to release stored glucose Treatment for severe hypoglycemia Life-saving, cannot harm a student cannot overdose 26
27 Considerations The time to complete recovery from a severe hypoglycemic episode varies according to how low the blood glucose level was and for how long prior to treatment Some symptoms, such as headache, may persist for several hours, although the blood glucose level is satisfactory Continued monitoring is important 27
28 Procedure: Act Immediately If possible check blood glucose, don t delay If in doubt, always treat School nurse or trained personnel notified to give glucagon in accordance with DMMP or emergency care plan Call 911, parent/guardian, school nurse as per DMMP or emergency care plan
29 Mixing Solution 4. Inject entire fluid in syringe into the bottle containing powder 5. Shake gently or roll to mix until all powder is dissolved and solution is clear. 29
30 Dosing and Drawing Out 6. Inspect. Solution should be clear and colorless. 7. Draw prescribed amount of glucagon back into syringe. 30
31 Injecting 8. Clean site if possible. 9. Inject at 90 into the tissue under cleansed area (may administer through clothing as necessary buttocks thigh arm 31
32 After Injecting 10. May take minutes for student to regain consciousness 11. Check blood glucose 12. Give sips of fruit juice or regular soda, once student is awake and able to drink 13. Advance diet as tolerated 32
33 Don't Be Surprised If... Student does not remember being unconscious, incoherent or has a headache Blood glucose becomes very high (over 200) Nausea or vomiting may occur 33
34 Glucagon OC-dcDgmXuI
35 Use correct diabetes vocabulary in your interactions with others.
36 Avoid using the term diabetic Instead: diabetes patient person with diabetes diabetes clinic diabetes education No: Are you a diabetic? Yes: Do you have diabetes?
37
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