type 1 diabetes management in education and children’s services
TRANSCRIPT
Type 1 diabetes management in education and children’s services
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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 monitoringBGL’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 concentrationand mood changes
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Health support planning
When preparing the care plan and flow chartsconsideration 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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ResponsibilitiesParent/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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ResponsibilitiesPrincipal, 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 resourcesSA 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
