Woods Charter
School
Diabetic Training
What you’ll learn from this
presentation
• What Senate Bill 911 requires
• Diabetes--- Type 1 and Type 2
• How to recognize and treat:
– High blood sugar (Hyperglycemia)
– Low blood sugar (Hypoglycemia)
LAW
SENATE BILL
911
Diabetes is considered a
disability; therefore…
• Diabetes is covered under many federal and
state mandates and laws
• It is important to understand what diabetes
is in order to:
Comply with legal mandates and laws
Facilitate care for students with diabetes
NC Bill 911
We all need to work together
Parents are required by law to
• Provide pertinent information
needed to develop a diabetes
care plan for the student
• Communicate with the school
staff, including the bus drivers,
about any changes or
developments concerning the
student’s diabetes care regimen
The School is required by law to:
• Provide diabetes training and
education to school staff
• Train two or more Diabetes
Care Mangers (DCM’s)
Responsibilities of the
Diabetes Care Manager
•
•
•
•
•
Plan and participate in conferences with the
student, parents, and school staff to develop
an individualized diabetes care plan
Assist student with diabetes care and
maintenance
Be accessible in case of an emergency
Be up-to-date on diabetes information about
individual student and diabetes in general
Have open lines of communication with those
involved with student, including:
– Teachers
– Substitute teaches
– Parents
– School nurse
– Bus drivers
– Other members of school staff that may
be involved with care of student
Basic Facts about
Diabetes Mellitus
•
•
•
Diabetes is a major contributor to the development and risk of:
– Cardiovascular disease
– Heart Attacks
– Stroke
– Blindness
– Kidney failure
– Amputations
Normal growth and development in children may be delayed or stunted
There are two types of Diabetes, and both types have a problem with the
balance between glucose (sugar) and insulin (anti-sugar)
Insulin Versus Glucose
• Insulin is a hormone produced by the
pancreas
• Insulin interacts with glucose to
maintain the right balance of glucose in
the body
• Carbohydrates are metabolized into
glucose
• Glucose is required by the body’s cells
for energy
• Insulin and glucose have an inverse
relationship
–
If one is up the other is down
• The Goal is to find the right BALANCE
between Glucose and Insulin
Type 1 Diabetes
• Commonly known as juvenile or childhood
diabetes
• The pancreas does not produce insulin
• Type 1 Diabetics are INSULINDEPENDANT
• They must have daily injections of insulin
• Type 1 accounts for 10% of all cases of
diabetes cases in the US
– 1 in 400 children have Type 1 diabetes
• Usually discovered during childhood or
before the age of 30
Type 2 Diabetes
• The pancreas does not produce enough insulin or
does not use the insulin properly, they are INSULIN
RESISTANT
• More common in adults, but there is a rising epidemic
of children developing Type 2 diabetes
• Those most at risk:
– Hispanics
– African-Americans
– Native Americans
– A family history of diabetes
– Obesity
– Apple shaped bodies are more prone to diabetes
than pear shaped bodies
Managing Diabetes
When diabetes is kept in control complications can be prevented
and controlled
Type 1 Diabetes
Type 2 Diabetes
• Require daily insulin
injections
• Maintain a balance between
•
– Amount of insulin taken,
– Food intake (especially
carbohydrates), and
– Exercise
• The balance in measured by
self monitoring blood sugar
readings
If caught early, Type 2 can
usually be managed by lifestyle
modifications including:
–
–
–
–
Weight loss
Healthier eating habits
Oral medications
Regular exercise
Treatment of Diabetes
• Self monitoring of glucose levels
– Place a drop of blood on a test strip that is read by
a blood glucose monitor
– Important assessment for anyone with diabetes
– Usually done during the school day
• Insulin
– Type 1 diabetes requires insulin by injection using
one or a combination of
• Insulin pump,
• Syringe, or
• Pen device
– Type 2 (insulin only in later stages)
• Exercise and diet control by carbohydrate
counting are important for both types of
diabetes
Insulin
• Most students require at least two
injections a day unless they are using an
insulin pump
• There are many combinations of insulin
used depending on activity level, time of
day, etc.
– Some work faster while some last longer
• Insulin pumps are battery operated
devices that automatically deliver insulin
– Insulin pumps are the size of a pager
Carbohydrate Counting
•
•
Type 1 diabetics need to “Carb Count” to balance insulin with food and
activity
Type 2 diabetics need to “Carb Count” to record what they eat in an
effort to eat a balanced diet and promote weight loss
– The goal for Type 2 diabetics is to ward off the need for insulin
injections with lifestyle modifications
Regular Exercise
• It is recommended for
30 minutes of
cardiovascular exercise
daily
• Promotes weight loss
• Helps increase self
esteem
Signs and Symptoms
of Diabetes
Hyperglycemia
Hypoglycemia
Too much glucose (sugar)
Not enough insulin
(The feeling one gets when
one eats too much)
Not enough glucose (sugar)
Too much insulin
(The feeling one gets when
they are very hungry)
Hyperglycemia
Too Much Glucose
 Too much sugar in the
blood
 Happens when
 Eat too much food
 Don’t exercise enough
 Body trying to
compensate for
 Illness or
 Physical and/or mental
stress
Signs and Symptoms of
Hyperglycemia
Usually these are the first signs of
developing diabetes
 Frequent urination
 Extreme hunger or thirst
 Extreme fatigue
 Dry itchy skin
 Blurred vision
 Frequent infections
 Slow healing wounds
Teachers and school staff are key in
identifying students with these
symptoms
Treating Hyperglycemia
• Drink water or other calorie free/
caffeine free liquid to dilute the
blood and sugar
– This will also help hydrate the body
• Seek immediate medical assistance
if person unable to eat or drink
If high blood sugar goes untreated for
a long period of time Diabetic
Ketoacidosis can result
Diabetic Ketoacidosis (DKA)
•
•
•
High blood sugar that goes untreated
for a long period of time
Signs and symptoms include:
– Nausea
– Vomiting
– High levels of ketones in urine and
blood
Life threatening, so if you suspect
DKA get immediate medical attention
 CAUTION: Students with insulin
pumps use rapid acting insulin, so
they may develop DKA very rapidly if
pump is not working properly
Hypoglycemia
Not enough sugar
• Also called “low” or “insulin reaction”
• Usually symptoms occur when blood sugar
below 70-80 on blood glucose reading
• Usual causes:
–
–
–
–
Too much insulin
Increased activity
Eating too few carbohydrates
Too much time between snacks and meals
Signs and Symptoms of
Hypoglycemia
Early signs
 Hunger
 Shakiness
 Dizziness
 Sweating
 Fast heartbeat
 Drowsiness
 Irritable, sad, or angry
 Nervous
 Pale, clammy skin
Important to recognize these
symptoms before late signs develop







Late Signs
Feeling sleepy
Being unusually
stubborn
Lack of coordination
Tingling or numbness in
tongue
Personality change
Passing out
Seizure
Recognizing Hypoglycemia
(low blood sugar)
Frequent causes:
• Late or missed meals
• Exercise or activity
• Change in school schedule (be on the
lookout)
– Fire drill
– Assemblies
– End of grade testing
– Anything that may cause stress or
alters normal patterns
Treating Hypoglycemia
Sometimes it is hard to tell the difference between high and
low blood sugar, but remember
YOU WILL NOT HURT ANYONE BY GIVING THEM FOOD
If you suspect low blood sugar:
1. If possible, test their blood sugar with a glucose monitor
2. Give juice or another source of easily ingested carbohydrates
3. Wait 30 minutes and test blood sugar again, or reassess signs
and symptoms
•
If blood sugar is still low, give more carbohydrates and start over
with testing blood sugar
Hypoglycemia Busters
What to give someone with low blood sugar:
 2-4 glucose tablets
 4 oz of apple or orange juice
 4-6 oz of regular soda
 4-8 Life Savers
 2 tablespoons of raisins
 3-4 teaspoons of sugar or syrup
 1 cup of low fat milk
 2 teaspoons of cake gel/icing
• Resist the urge to give them too much food or drink as this can
cause them to have too much sugar in their blood resulting in
hyperglycemia (high blood sugar)
If early signs of hypoglycemia
develop into late signs:
• The student may have seizures or
become unconscious
• A medication called Glucagon must be
given by a trained staff member
• Try not to let this become an
emergency, be on the lookout for early
signs of low blood sugar (hypoglycemia)
Bus Drivers have Important
Responsibilities
• When a student is acting unusual, always assume they have low blood
sugar and treat according to diabetes care plan
• Students should be allowed to monitor, treat, and eat snacks while on
the school bus.
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