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 childhoodyoung adulthood
 most prevalent type of Diabetes in
children and adolescents
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Diabetes Management 24/7
Constant Juggling:
Insulin/medication
with:
Exercise
BG
BG
&
BG
Food intake
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Blood Glucose Monitors
INSULIN
various ways to administer
Diabetes is Managed,
But it Does Not Go Away.
GOAL:
To maintain target
blood glucose
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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
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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 symptoms
Mild
Moderate
Hunger, Paleness,
Dizziness, Crying,
Weakness,
Irritability
Sweating, Anxiety
Poor concentration
Drowsiness
Shakiness
Personality changes
Blurry vision
Confusion
Weakness
Headache
Behavior changes
Slurred speech
Poor
concentration
Severe
Inability to
swallow
Loss of
consciousness
Seizures
Treatment
for Mild to Moderate
Hypoglycemia
Quick 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
Glucagon
If included in the Individualized HealthCare
Plan, use when student exhibits:
Unconsciousness, unresponsiveness
Convulsions or seizures
Inability to safely eat or drink
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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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Emergency Kit Contents:
1 mg of freeze-dried glucagon (Vial)
1 ml of water for reconstitution (Syringe)
Combine immediately before use
Administration
of Glucagon1
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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)
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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 starving
Onset: 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
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Hyperglycemia
Possible signs and symptoms
Mild
Moderate
Severe
Thirst
Frequent urination
Fatigue
Hunger
Lack of concentration
Weight loss
Stomach pain
Flushed skin
Blurred vision
Sweet fruity breath
Mild symptoms plus:
Stomach cramps
Dry mouth
Nausea
Vomiting
Mild and Moderate
symptoms plus:
Labored breathing
Confusion
Very weak
Unconscious
Hyperglycemia
What to do
Goal: Lower the blood glucose to target range.
Student tests blood glucose, takes insulin as ordered
Encourage student to drink water or sugar free drinks
Call parents per care plan.
Call 911 for severe symptoms
• Extreme weakness (collapsing)
• Very confused
• Unconsciousness
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