March 2015
What is Diabetes? Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel.
Type 1 Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5% of people with diabetes have this form of the disease. In type 1 diabetes, the body does not produce insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives. 2015
Type 1 cont. For a student using insulin, diabetes must be managed 24/7, including the many hours spent at school, on field trips and in extra-curricular activities. Student using insulin at school will do so using a syringe, insulin pen, or insulin pump.
Type 2 Diabetes is a problem with your body that causes blood glucose (sugar) levels to rise higher than normal. This is also called hyperglycemia. Type 2 diabetes is the most common form of diabetes. If you have type 2 diabetes your body does not use insulin properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for it. But, over time it isn't able to keep up and can't make enough insulin to keep your blood glucose at normal levels. 2015
Type 2 cont. Some people with type 2 can control their blood glucose with healthy eating and being active. But, some people may need to also take oral medications or insulin to help you meet their target blood glucose levels. Type 2 usually gets worse over time even if you don t need medications at first, you may need to later on.
Hypoglycemia (Low Blood Sugar) Hypoglycemia is a condition characterized by abnormally low blood glucose (blood sugar) levels, usually less than 70 mg/dl. 2015
Symptoms of Hypoglycemia (Happen Quickly) Shakiness Nervousness or anxiety Sweating, chills and clamminess Irritability or impatience Confusion, including delirium Rapid/fast heartbeat Lightheadedness or dizziness Hunger and nausea Sleepiness Blurred/impaired vision Tingling or numbness in the lips or tongue Headaches Weakness or fatigue Anger, stubbornness, or sadness Lack of coordination Seizures Unconsciousness
Treatment of Hypoglycemia Consume 15-20 grams of glucose or simple carbohydrates Recheck blood glucose after 15 minutes If hypoglycemia continues, repeat. Once blood glucose returns to normal, eat a small snack if next planned meal or snack is more than an hour or two away. 15 grams of simple carbohydrates commonly used: glucose tablets (follow package instructions) gel tube (follow package instructions) 2 tablespoons of raisins 4 ounces (1/2 cup) of juice or regular soda (not diet) 1 tablespoon sugar, honey, or corn syrup 8 ounces of nonfat or 1% milk hard candies, jellybeans, or gumdrops
Hypoglycemia Treatment cont. Glucagon If left untreated, hypoglycemia may lead to a seizure or unconsciousness (passing out, a coma). In this case, someone else must take over. Glucagon is a hormone that stimulates your liver to release stored glucose into your bloodstream when your blood glucose levels are too low. Injectable glucagon kits are used as a medication to treat someone with diabetes that has become unconscious from a severe insulin reaction. 2015
Frequent causes of Hypoglycemia Meals that are late or missed Extra exercise or activity Too much insulin given Unplanned changes in school schedule
Hyperglycemia (High blood sugar) Hyperglycemia is the technical term for high blood glucose (blood sugar). High blood glucose happens when the body has too little insulin or when the body can't use insulin properly. 2015
Symptoms of Hyperglycemia High blood glucose High levels of sugar in the urine Frequent urination Increased thirst Irritability
Treatment of Hyperglycemia Exercise (unless blood sugar is >240) If >240, check urine for ketones. If positive for ketones, do not exercise) Exercising when ketones are present may make blood glucose level go even higher. Diet changes Insulin Insulin dose changes
Causes of Hyperglycemia Not enough insulin given or insulin not as effective. Ate too much Exercise too little Stress from an illness, such as a cold or flu. Family or social stress The dawn phenomenon (a surge of hormones that the body produces daily around 4:00 a.m. to 5:00 a.m)
Who is responsible for care of these students? Ultimately we are ALL responsible for making sure that students with diabetes get the care they need at school. Each school should have at least 3 DIABETIC CARE MANAGERS that are chosen by the principal and trained by the school nurse to help care for students with diabetes at school. These DCM s take an intensive training that is offered by the school nurses in collaboration with Alamance Regional Medical Center. If you are interested in becoming a DCM at your school, please contact your school nurse!
ABSS Diabetes Emergency Care Plan Name: School/Yr: Bus#: Car Rider: Birth date: Grade/Teacher: After-School/Extracurricular: Physician: Phone: Emergency Contact: Phone: DCM(s): Does student require insulin at school? Yes No If yes, what kind? Is glucagon ordered? Yes No Location: Blood sugar checks at school? Yes No Times: Does student bring snacks? Yes No Snack Location: What time of day does student require a snack? Symptoms of Low Blood Sugar: (Check all that apply) Irritability Sweating Pallor Nausea Confusion Poor Concentration Headache Other: Blood Sugar Target Range: Sliding Scale: Recheck blood sugar in 15 minutes. If blood sugar remains low repeat intervention. If within target range, give protein snack. When in doubt, treat as if insulin reaction (low blood sugar) and give emergency sugar. DO NOT LEAVE STUDENT UNATTENDED! Fast Acting Sugar Sources: 3-4 glucose tablets 4 oz. juice 6 oz. regular soda 3 tsp. glucose gel IF STUDENT BECOMES UNCONSCIOUS, CALL 911 AND ADMINISTER GLUCAGON IF ORDERED. Notify Parents for: Additional Instructions: Parent/Guardian Signature: Date: School Nurse Signature: Date: