DIABETES

Body does not make or properly use insulin:– no insulin production– insufficient insulin production– resistance to insulin’s effects

Insulin is the key that opens the door of each

cell to allow glucose (sugar) inside

No insulin to move glucose from bloodstream into cells causes high blood glucose

fuel loss. cells starve short and long-term complications

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TYPE 1 DIABETES

auto immune disorder

insulin-producing cells destroyed

daily insulin replacement necessary

age of onset: usually childhood-young adulthood

most prevalent type of Diabetes in children and adolescents

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Diabetes Management 24/7

Constant Juggling:

Insulin/medication

with:

Exercise

Food intake

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BGBG

BGBG

BGBG&

Blood Glucose Monitors

INSULINvarious ways to administer

Diabetes is Managed, But it Does Not Go Away.

GOAL:

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To maintain target blood

glucose

Assistance in Diabetes Management

Routine Care:– Many students will be able to handle all or almost all

routine diabetes care by themselves – Some students, because of age, developmental level, or

inexperience, will need help from school staff.

Urgent Care:– Any student with diabetes may need help with emergency

medical care.

The student’s Individualized Health Care Plan will provide student specific instructions 7

HYPOGLYCEMIA low blood sugar

Caused by:

Too much insulin

Missed or delayed food

Exercise

Onset: sudden may progress to unconsciousness if not treated can result in brain damage or death

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Hypoglycemia(low blood sugar)Possible signs and symptomsMild Moderate Severe

Hunger, Paleness,Dizziness, Crying, Weakness, IrritabilitySweating, Anxiety Poor concentrationDrowsiness Shakiness Personality changes

Blurry visionConfusionWeaknessHeadacheBehavior changesSlurred speechPoor concentration

Inability to swallow

Loss of consciousness

Seizures

Treatment for Mild to Moderate

HypoglycemiaQuick acting source of glucose, 15 gm Carbohydrate• 4 oz. fruit juice • 15 gm glucose tablets (2-3 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) Repeat in 15 minutes if symptoms persist

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Basic Rule for Unclear Symptoms

• If in doubt, give quick acting sugar (juice/snack)

• If symptoms are hypoglycemia - it will treat symptoms

• If symptoms are hyperglycemia - it will not hurt or cause a diabetic coma

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Treatment for severe Hypoglycemia

If included in the Individualized HealthCare Plan, use when student exhibits:Unconsciousness, unresponsivenessConvulsions or seizuresInability to safely eat or drink

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Glucagon

What is Glucagon?

• Naturally occurring hormone made in the pancreas• A life-saving, injectable hormone that raises blood glucose level, tells liver to immediately dump it’s emergency reserve of sugar • Treatment for severe hypoglycemia• Can save a life• Cannot harm a student

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1 mg of freeze-dried glucagon (Vial) 1 ml of water for reconstitution (Syringe)

Emergency Kit Contents:

Combine immediately before use

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Administration of Glucagon 1 2

3 4

Act Immediately

• Position student safely on side for comfort and protection from injury

• Call 911

• Call parents as per DMMP (Health Care Plan) 16

After Injection• May take 15-20 minutes for student to regain

consciousness. EMS will likely arrive before student regains consciousness

• Side effects - vomiting,

• If conscious, check blood sugar

• Give sips of fruit juice or regular soda, once student is awake and able to drink

• Document. Contact nurse.

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HYPERGLYCEMIA High Blood Sugar

Too much sugar in the blood-but cells are starvingOnset: Severe hyperglycemia is usually slow to develop

Caused by: Too much food Too little insulin Decreased physical activity Illness or infection Injury Stress Hormones Any combination of the above 18

HyperglycemiaPossible signs and symptoms

Mild Moderate SevereThirstFrequent urinationFatigueHungerLack of concentration Weight lossStomach painFlushed skinBlurred visionSweet fruity breath

Mild symptoms plus: Stomach crampsDry mouthNauseaVomiting

Mild and Moderate symptoms plus:Labored breathingConfusionVery weakUnconscious

Hyperglycemia What to do

Goal: Lower the blood glucose to target range.

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Student tests blood glucose, takes insulin as orderedEncourage student to drink water or sugar free drinksCall parents per care plan.Call 911 for severe symptoms

• Extreme weakness (collapsing)• Very confused• Unconsciousness