DIABETES CARE TASKS AT SCHOOL: What Key Personnel Need to Know
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1 DIABETES CARE TASKS AT SCHOOL: What Key Personnel Need to Know HYPOGLYCEMIA
2 Goal: Optimal Student Health and Learning Managing hypoglycemia is a vital piece of a comprehensive plan. 2
3 Learning Objectives Participants will be able to understand: Symptoms of low blood glucose Treatment of low blood glucose Prevention of low blood glucose Short- and long-term risks and complications 3
4 Vocabulary Glucose - simple sugar found in the blood; fuel that all body cells need to function HYPOglycemia - a LOW level of glucose in the blood Quick-acting glucose - sources of simple sugar that raises blood glucose levels, like juice, regular soda, glucose tabs or gel, hard candy Glucose tablets or gel - special products that deliver a pre-measured amount of pure glucose. They are a fast-acting form of glucose used to counteract hypoglycemia Carbohydrate - source of energy for the body which raises blood glucose level Glucagon - hormone given by injection that raises level of glucose in the blood 4
5 HYPOglycemia = LOW Glucose (sugar) Onset: sudden, must be treated immediately may progress to unconsciousness if not treated can result in brain damage or death DMMP should specify signs and action steps at each level of severity: mild moderate severe 5
6 Hypoglycemia: Risks & Complications Early recognition and intervention can prevent an emergency Greatest immediate danger Not always preventable Impairs cognitive and motor functioning 6
7 Hypoglycemia: Possible Causes Too much insulin Too little food or delayed meal or snack Extra/unanticipated physical activity Illness Medications Stress 7
8 Hypoglycemia: Possible Signs & Symptoms Mild Symptoms Hunger Sleepiness Shakiness Changed behavior Weakness Sweating Paleness Anxiety Blurry vision Dilated pupils Increase heart rate or palpitations Moderate to Severe Symptoms Yawning Irritability/frustration Extreme tiredness/fatigue Inability to swallow Sudden crying Confusion Restlessness Dazed appearance Unconsciousness/coma Seizures 8
9 Mild/Moderate Hypoglycemia: What to do Intervene promptly; follow DMMP: Check blood glucose if meter is available. If no meter is available, treat immediately, on the spot. NEVER send a student with suspected low blood glucose anywhere alone When in doubt, always treat. If untreated may progress to more serious events. Consider Rule of 15 9
10 Rule of 15 General guidelines, follow DMMP for each student: Have student eat or drink fast acting carbs (15g) Check blood glucose minutes after treatment Repeat treatment if blood glucose level remains low or if symptoms persist If symptoms continue, call parent/guardian per DMMP 10
11 Quick Acting Glucose for Mild/Moderate Hypoglycemia Treatment for Lows: 15 g Carbohydrate 4 oz. fruit juice 15 g. glucose tablets (3-4 tablets) 1 tube of glucose gel 4-6 small hard candies 1-2 tablespoons of honey 6 oz. regular (not diet) soda (about half a can) 3 tsp. table sugar One-half tube of cake mate 11
12 Severe Hypoglycemia Symptoms Convulsions (seizures) Loss of consciousness Inability to swallow 12
13 Severe Hypoglycemia: What To Do Rare, but life threatening, if not treated promptly: Place student on his or her side Lift chin to keep airway open Inject glucagon, per student s DMMP Never give food or put anything in student s mouth Call 911, then parent/guardian Student should respond in 10 to 20 minutes Remain with the student until help arrives 13
14 Hypoglycemia: Prevention Physical activity, insulin, eating, checking BG, per schedule. Keep a quick-acting sugar source with the student. ALWAYS. Treat at onset of symptoms Ensure reliable insulin dosing, per DMMP. Ensure insulin dosing matches food eaten. Watch picky eaters Provide nutritional information to parent/guardian DMMP may specify after-meal dosing 14
15 Hypoglycemia: Prevention Consult with parent/guardian or school nurse when snack, meal or physical activity times must be changed. Monitor blood glucose variations on gym days. An extra snack may be required ½ hour before gym or during prolonged vigorous physical activity per DMMP. A student should never be unattended when a low blood glucose is suspected. Maintain adult supervision. 15
16 Information for Teachers Students with hyperglycemia or hypoglycemia often do not concentrate well. Students should have adequate time for taking medication, checking blood glucose, and eating. During academic testing, provide accommodations as per 504 plan or IEP Check blood glucose before and during testing, per plan Access to food/drink and restroom If a serious high or low blood glucose episode occurs, students should be excused with an opportunity for retake 16
17 Make the Right Choice the Easy Choice Eliminate barriers to diabetes management: Become familiar with and follow students written plans Eliminate barriers to: Snacking Blood glucose checks Access to water and bathrooms Insulin administration Avoid judgments based on individual blood glucose readings Communicate with parent/guardian and school nurse 17
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