Care for School Children With Diabetes Senate Bill 911/G.S. 115C-47

Care for School Children With

DiabetesSenate Bill 911/G.S. 115C-47

OVERVIEW OF SB 911 SECTION 2

Requires local school systems (LEA’s) to ensure that guidelines are implemented to schools in which students are enrolled

LEA will make available necessary information and staff development in order to support the diabetes care plan requirements for students with diabetes

OVERVIEW OF SB 911 SECTION 1

Requires procedures for the development of a diabetes care plan if requested by parents

Procedures must include provisions for a “regular” review

Key components to include: Staff development for all school staff Development of an emergency care plan,

including allowable actions to be taken Extent of the student’s control of

diabetes care

Diabetes Awareness, Training and Action (DATA)

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia (high blood sugar) resulting from defects in insulin secretion, insulin action, or both.

Diabetes Care Supplement, 2003

Diabetes Awareness Insulin is a hormone

produced in the beta or islet cells in the pancreas

It is necessary to move the sugar (glucose) in the bloodstream into the cells for metabolism to occur

Glucose is essential to life and to keeping the cells in the body healthy

Diabetes Awareness

Type 1 Diabetes Used to be known as Juvenile-

Onset or Insulin Dependent Diabetes

Results from the autoimmune destruction of the beta (or islet) cells of the pancreas which produce the hormone insulin

A person cannot live without insulin

Diabetes Awareness

Type 1 Diabetes Occurs in approximately

1:400 children (10% of the diabetic population)

Often presents as an acute illness

Requires insulin injections

Diabetes AwarenessType 2 Diabetes Used to be known as Adult-Onset

or Non-Insulin Dependent Diabetes Characterized by insulin resistance

that develops into insulin deficiency

Is a rising epidemic among young people

Central abdominal obesity is directly related to Type 2 diabetes

Diabetes AwarenessType 2 Diabetes Accounts for 90% of the world’s

population with diabetes Insulin resistance means that

insulin is produced, but the body is not using it correctly

This resistance causes blood sugar levels to rise, resulting in diabetes

Diabetes Overview: Treatment Foundations

The amount of insulin taken has to be balancedwith food intake (specifically, carbohydrates) and levels of activity.

Diabetes Overview: Treatment Foundations Currently, most students are taking

insulin by syringe, pen device or pump. The insulin pump is a type of injection

using a very small catheter under the skin that continuously provides insulin

The food intake is monitored by “counting carb’s” in the nutrition plan

Diabetes Overview: Treatment Foundations

Tools for Diabetes Management Self-monitoring of blood

sugar levels Is important for everyone with

diabetes Is done by a blood glucose

meter reading a drop of blood Is recorded in the person’s log

Diabetes Overview: Treatment Foundations

Tools for Diabetes Management

Carbohydrate Counting and Meal Planning

To balance activity & insulin To calculate the dosage of

insulin to administer To achieve and maintain a

healthy weight level

Diabetes Overview: Treatment Foundations

Tools for Diabetes Management

Insulin Injection Most students take at least

two insulin injections daily Some are on intensive

insulin therapy or wear a pump

Diabetes Overview: Treatment Foundations

Tools for Diabetes Management

Senate Bill 911: Management Tools are to be available to the student at all times, in accordance with the individual diabetes care plan

Diabetes Overview: Acute Complications

HYPERGLYCEMIA – High Blood Sugar Occurs when the body gets:

Too little insulin, OR Too much sugar in the food eaten, OR Too little activity/physical exercise

Hyperglycemia may also occur when the child has an illness, such as a cold

Diabetes Overview: Acute Complications

HYPERGLYCEMIA – Symptoms Frequent Urination Extreme Hunger Extreme Fatigue Unusual Thirst Irritability Blurred Vision

Diabetes Overview: Acute Complications

HYPERGLYCEMIA – High Blood Sugar

In all high cases, if the student is able, s/he should drink lots of calorie-free, caffeine-free liquids, preferably water.

Diabetes Overview: Acute Complications

HYPOGLYCEMIA – Low Blood Sugar Occurs when the body gets:

Too much insulin, OR Too little sugar in the food eaten, OR Too much activity/physical exercise

Hypoglycemia occurs when the body does not have enough sugar in the blood

Diabetes Overview: Acute Complications

HYPOGLYCEMIA – Symptoms Hunger Shakiness Dizziness Sweatiness Fast heartbeat Drowsiness

Diabetes Overview: Acute Complications

HYPOGLYCEMIA – Symptoms

Feeling irritable Nervousness Pallor Stubbornness

Diabetes Overview: Acute Complications

HYPOGLYCEMIA – Symptoms

Lack of coordination Tingling, numbness of

the tongue Personality change Passing out Seizure Death

Diabetes Overview: Acute Complications

RECOGNIZING HYPOGLYCEMIA It is important to recognize a low

blood sugar as soon as possible so that it does not progress to a severe reaction

Early signs are caused by the release of adrenaline (epinephrine), the “fight or flight” hormone

Diabetes Overview: Acute Complications

FREQUENT CAUSES OF HYPOGLYCEMIA

Meals that are late or missed Extra exercise or activity An insulin dose that is too high Unplanned schedule changes

Diabetes Overview: Acute Complications

WHAT TO DO IF HYPOGLYCEMIA OCCURS

Contact DCM If possible, always do a blood sugar

test first Have student eat/drink 15 grams of a

fast-acting carbohydrate Wait 15 minutes and check blood sugar

Diabetes Overview: Acute Complications

HYPOGLYCEMIA BUSTERS 2-4 Glucose Tablets 4 ounces of orange or apple juice 4-6 ounces of regular soda (not diet) 4-8 Lifesaver candies 3-4 teaspoons of sugar or syrup 1 tube of cake icing/gel

Diabetes Overview: Acute Complications

Treating severe hypoglycemia

Immediate action is necessary Glucagon may need to be injected Someone should be calling 911 Turn the person onto their side and

keep comfortable

DATA Summary

SB 911 is intended to eliminate discrimination and provide for student support and safety for those with diabetes.

DATA Summary

Tools for Diabetes Management

Senate Bill 911: Management Tools are to be available to the student at all times, in accordance with the individual diabetes care plan

DATA Summary

All treatment is based on the Diabetes Care Plan provided by the parent in consultation with the student’s health care provider.

DATA Summary

The Diabetes Care Managers (DCM’s) in each school provide support to all the school staff who are directly involved in the daily school life of the student with diabetes.

DATA Summary

In the absence of a Diabetes Care Plan, the parent, the student or EMS/911 will have to assume responsibility for diabetes care for the student.