Type 1 diabetes
management in education
and children’s services
Learning objectives
> Understands how type 1 diabetes
managed?
> Can identify and manage low blood
glucose as per care plan.
> Can identify and manage high blood
glucose as per care plan.
> Is aware of the health support planning
needs and responsibilities of the school,
child and family.
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What happens in type 1 diabetes?
> trigger is unknown; however a
genetic predisposition may exist
> autoimmune response
> insulin producing (islet) cells in
the pancreas are destroyed and
no longer produce insulin
> insulin is needed to move
glucose out of the blood stream
and into the cells for energy
> insulin is needed 24 hours a day,
7 days a week, 365 days a year
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Psychosocial considerations
> managing type 1 diabetes is extremely
demanding for students and their families
> it is normal for families to feel overwhelmed
> students may often feel ‘burnt-out’,
unmotivated or isolated
> always be encouraging and supportive
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Daily care routines
> insulin via injections (2-4) or a pump
> balancing the insulin dose with
carbohydrate intake and exercise
> testing blood glucose levels (BGL’s)
> managing low & high BGL’s
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Nutrition principles
> General eating principles for
children with type 1 diabetes
are the same as for all children
(Australian Guide to Healthy
Eating).
.
> There are 3 major
food group.
Carbohydrates, fat and protein.
> Foods containing
carbohydrates directly affect
blood glucose. Insulin doses
are matched to carbohydrate
exchanges or serves.
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Lunch box example
Can you identify the
carbohydrate foods
in this lunch box?
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Blood glucose monitoring
BGL’s can change according to:
> carbohydrate intake
> exercise pattern
> emotional state
> infection.
Refer to individual care plan re blood glucose
level targets and testing times.
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Low blood glucose
(hypoglycaemia)
> hypoglycaemia occurs
when the BGL is less
than 4mmol/L or if there
are symptoms of hypo
> symptoms vary
> if a hypo is left untreated
the child can become
very drowsy, may have
a seizure or become
unconscious.
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Causes of low blood glucose
(hypoglycaemia)
> delayed or missed meals
> not eating enough carbohydrate
> too much insulin
> unplanned physical activity
> vomiting and nausea
> refer to care plan/flowchart instructions
on how to treat
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High blood glucose levels
(hyperglycaemia)
> Hyperglycaemia is when the
blood glucose is higher than
the target range.
> Start the child’s high blood
glucose care plan once the
BGL has reached 15mmol/L.
> Symptoms include excessive
thirst, frequency of urination,
blurred vision, tired and
lethargic, irritability, hunger.
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Causes of hyperglycaemia
(high BGL’s)
>
>
>
>
>
>
not enough insulin
too much carbohydrate
illness/infection
stress
pump failure
refer to care plan/flowchart for
instructions on how to treat
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High BGL’s at school
If the student’s blood glucose level is above
15mmol/L:
> allow free water intake
> allow extra toilet breaks
> if child is vomiting, feels unwell or has
abdominal pain, contact parents
> exercise is not encouraged.
Remember: high blood glucose levels
cause tiredness, reduce concentration
and mood changes
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Health support planning
When preparing the care plan and flow charts
consideration needs to be given to:
> food at school
> blood glucose monitoring
> insulin administration
> storage of meters
> changes to routine
> camps
> exams eg special provisions in SACE.
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Responsibilities
Parent/guardian
> primary responsiblity for child/student health and
wellbeing
> changes/updates to care plan
> provides equipment including BGL kit, food (hypo kits)
> discusses changes in care needs with staff
> participates in assessment, planning and review
> provides current emergency contact details.
Student/child (depending on level of development)
> engaged in their care
> participates and takes responsibility for aspects of self
management appropriate for their age.
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Responsibilities
Principal, Director, Manager
> has duty of care for child/student health and wellbeing
> communicates care plan changes/updates to relevant staff
> ensures systems are documented and in place for
implementation of care plan
> enables staff access to relevant training and information.
Staff
> participate in assessment, planning and review
> provide health support to student according to care and
support plans.
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Community resources
SA Health
> Your specialist diabetes service
Country Health SA
> Your local diabetes education service
Country Health SA - Diabetes
> (08) 8226 7168
> www.diabetesoutreach.org.au
Diabetes SA
> (08) 8234 1977
> www.diabetessa.com.au
Diabetes Kids and Teens
> www.diabeteskidsandteens.com
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