Diabetes Type I In Schools Erin Pein RNBSN

Diabetes- Type I In Schools Erin Pein, RN-BSN Float School Nurse Stafford Township School District

TYPE I Diabetes. There are several different types of diabetes. Among children and youth, type 1 is the most common. About 1 in 300 children have type 1 diabetes. Type 1 diabetes is a condition where the pancreas stops producing insulin. Insulin is a hormone that helps your body control the level of glucose—or sugar—in your blood. Your body produces glucose, and also gets glucose from foods that contain carbohydrates—such as bread, potatoes, rice, pasta, milk and fruit. Without insulin, glucose builds up in your blood instead of being used by your cells for energy. Symptoms of undiagnosed type 1 diabetes include: Increased thirst Increased urination A lack of energy Weight loss A person with type 1 diabetes must take insulin either by injections or through an insulin pump.

What causes type 1 diabetes? The cause of type 1 diabetes is not known. What we do know is that type 1 diabetes is not caused by eating too much sugar. It cannot be prevented. Type 1 diabetes is currently understood as an autoimmune disease, meaning the body’s immune system destroys the cells that produce insulin. REMEMBER: Type 1 diabetes is not caused by eating too much sugar. It cannot be prevented.

What is it like to manage type 1 diabetes every day? A healthy pancreas automatically releases just the right amount of insulin to keep blood sugar in a healthy range. It is constantly adjusting, minute to minute, responding to how much food we eat, activity, stress levels, and other factors. The pancreas is a very complex organ. Doing the job of the pancreas is very difficult. It is impossible to have that perfect minute-to-minute adjustment. No matter how closely they manage their disease, people with type 1 diabetes can still experience swings in their blood sugar levels. People with diabetes must check their blood sugar several times a day: If blood sugar levels go too low, they must eat or drink a fast-acting sugar (like juice or candy) to raise their blood sugar. Low blood sugar (hypoglycemia) can be dangerous if it is not treated. If levels go too high, they will be thirsty and need to urinate more. If high blood sugar (hyperglycemia) isn’t treated, it can become dangerously high. Type 1 diabetes is a chronic disease, meaning it lasts a lifetime. Children will not “outgrow” it, and there is no cure yet. Children under the age of 5 years are the fastest growing group of newly-diagnosed cases of type 1 diabetes.

Preventing and preparing for emergencies When it comes to emergencies related to type 1 diabetes, the first step is prevention. That’s why a student’s Individualized Healthcare Plan is so important: It describes all of the daily tasks for good diabetes management at school. Among the many ways to prevent an emergency: Frequent blood checks, Eating meals and snacks on time (or as planned), and Reacting quickly to signs of low blood sugar. It’s also important to be prepared. That means being aware of what emergencies could arise, having the proper plans in place, and knowing what to do.

Potential emergency situations There are 3 potential emergency situations to be alert for at school: 1. Low blood sugar (hypoglycemia): All students with type 1 diabetes will have low blood sugar (less than 70) at school, usually at least once or twice a week. Signs of mild low blood sugar include hunger, confusion, shakiness, and weakness/fatigue. It is important to catch low blood sugar early, and to treat it appropriately and immediately. Ensure that a student always has access to a source of fast-acting sugar (such as juice, glucose tablets, candy). See below, Emergency kits. ALL Emergecy kits must have these items: Equipment to check blood sugar: Glucose meter, test strips, lancets Fast-acting sugar (juice, glucose tabs, candy) for low blood sugar Carbohydrate snack(s) Parents’ names and contact numbers SOME kits will also have one or more of these items: Insulin pen, pen needles, insulin (in case of pump failure) Extra batteries for meter Glucagon (if there agreement to administer it at school, and someone has been trained) Ketone urine strips and/or a meter for measuring ketones in blood

HYPOGLYCEMIA SYMPTOMS – LOW BLOOD SUGAR Shakiness Irritability/grouchiness Dizziness Sweating Blurry Vision Headache Hunger Weakness/Fatigue Pale Skin Confusion Low Blood Sugar is also called Hypoglycemia, It can be caused by too much insulin, not enough food, delaying or missing a snack, not enough food before an activity, unplanned activity without adjusting food or insulin. Low blood sugar must be treated immediately. Treat the low blood sugar WHERE IT OCCURS, do not bring to another location. Walking may cause the blood sugar to go even lower. DO NOT LEAVE A STUDENT ALONE IF YOU THINK BLOOD SUGAR IS LOW. Even students who are independent may need help when their blood sugar is low.

Potential emergency situations There are 3 potential emergency situations to be alert for at school: 2. Very low blood sugar: If mild low blood sugar is not treated, it can become severe. Very low blood sugar is an emergency. You must act immediately. Do not leave the student alone. If a student is not responding, unconscious, having a seizure, or uncooperative (unable/unwilling to take food or drink), call 911. If someone at your school has been trained to give glucagon, it can be given according to the protocol, which will be in the student’s Individualized Healthcare Plan.

Potential emergency situations There are 3 potential emergency situations to be alert for at school: 3. Very high blood sugar: All students with type 1 diabetes will have high blood sugar from time to time, and usually it is not a cause for concern at school. A student’s Individual Care Plan will have more details. However, very high blood sugar with ketones needs action. Symptoms of very high blood sugar include: rapid, shallow breathing; vomiting; or fruity -smelling breath. Parents should be called to pick up a student immediately if the student has symptoms of very high blood sugar. NOTE: Very high blood sugar with ketones needs action. Symptoms of severe high blood sugar include: rapid, shallow breathing; vomiting; or fruitysmelling breath.

HYPERGLYCEMIA SYMPTOMS- High Blood Sugar High blood sugar or hyperglycemia occurs when a student’s blood sugar is higher than the target range. It is usually caused by: SYMPTOMS OF HIGH BLOOD SUGAR Extra food, without extra insulin Extreme Thirst Not enough Insulin Frequent Urination Headache Hunger Decreased activity Illness, stress or excitement. Warm, flushed skin Students are not usually in immediate danger from high blood sugar unless they are vomiting, breathing heavily or lethargic. They may have difficulty concentrating in class. Irritability WHAT TO DO? Abdominal Pain Blurry vision SYMPTOMS OF VERY HIGH BLOOD SUGAR Check blood sugar. Rapid, shallow breathing Allow unlimited trips to the bathroom. Vomitting Encourage plenty of water. Fruity Breath Nurse to give insulin.

10 things SCHOOL STAFF should know about Type I Diabetes 1. Children will not outgrow Type I Diabetes 2. Insulin is not a cure, but it is the only treatment. Without insulin, people with Type 1 would die. 3. It takes a lot of work to manage diabetes. 4. Technology is helpful, but it doesn’t work on its own 5. Blood sugar levels can change quickly 6. Low Blood sugar needs immediate attention 7. High Blood Sugar means extra trips to the bathroom, encouraging water and decreased attention span. 8. Kids with diabetes can still eat sweets. 9. Even students who are independent may still need help managing diabetes. 10. Kids with Diabetes want to be like everyone else.

How Teachers can support students with Type 1 Diabetes 1. Learn about type 1 Diabetes. 2. Be familiar with signs and symptoms of low blood sugar and high blood sugar. 3. Become familiar with the students Individualized Healthcare Plan. 4. Ensure the student has easy access to supplies for blood glucose monitoring and treating low blood sugar. 5. Ensure the student eats meals and snacks on time. 6. Provide parents with as much notice as possible about filed trips, special events and changes to the school routine, especially where food or activity is involved. 7. If a student experiences low blood sugar before or during an exam, allow a reasonable amount of time to treat and recover from the low sugar. 8. Support the students self care by allowing blood sugar monitoring at anytime or anywhere and respecting the students wish for privacy. 9. Know that the student may need to eat outside a planned meal or snack time. 10. Ensure that the student has unrestricted bathroom access, as well as access to water at all times.

Resources https: //www. diabetesatschool. ca/awareness