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&
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
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