Diabetes Care Tasks at School:

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Diabetes Care Tasks at School What Key
Personnel Need to Know
DIABETES BASICS
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Overall Goal Optimal Student Health and Learning
Hypoglycemia Hyperglycemia
Monitoring Blood Glucose
Ketones
Health Learning
Legal Rights
Glucagon Administration
Exercise
Insulin Regimen
Nutrition
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Learning Objectives

• Participants will learn
• What is diabetes?
• Why care at school is required
• Basic components of diabetes care at school
• Short and long term consequences of diabetes

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What is Diabetes?

• Body does not make or properly use insulin
• no insulin production
• insufficient insulin production
• resistance to insulins effects
• No insulin to move glucose from blood into cells
  
• high blood glucose means
• 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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Type 1 Diabetes
ONSET
relatively quick
increased thirst hunger blurred vision

• increased urination
• tiredness
• weight loss

• SYMPTOMS

uncertain, likely both genetic and environmental
factors
CAUSE
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Type 2 Diabetes

• Insulin resistance first step
• Age at onset

• Most common in adults
• Increasingly common in children

• overweight
• inactivity

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Type 2 Diabetes
in children variable timeframe
ONSET
tired, thirsty, hunger, increased urination
SYMPTOMS

• some children show no symptoms at diagnosis

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Diabetes is Managed,But it Does Not Go Away.

• GOAL

To maintain target blood glucose
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Diabetes Management 24/7

• Constant Juggling
• Insulin/medication
• with
• Exercise
• Food intake

BG
BG

BG
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Diabetes Management

• Proactive

• keep juggling the balls

Reactive

• a response is indicated
• corrective actions for highs or low
• emergency intervention

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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.

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Care in the Schools School Nurses and Others

• Nurse most appropriate to
• Supervise diabetes care
• Provide direct care (when available)
• However, a nurse is not always available.
• Non-medical school staff can be trained to assist
  students
• For both routine and emergency care
• Including insulin and glucagon injections

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Diabetes Medical Management Plan

• A Diabetes Medical Management Plan (DMMP) should
  be implemented for every student with diabetes.
• DMMP is
• developed by the students personal health care
  team and family and signed by a member of
  students personal health care team
• implemented collaboratively by the school
  diabetes team, including
• school nurse
• the student
• parents/guardians
• other school personnel

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Elements of a DMMP

• Date of diagnosis
• Emergency contact information
• Students ability to perform self-management
  tasks at school
• List of diabetes equipment and supplies
• Specific medical orders for blood glucose
  monitoring, insulin, glucagon, and other
  medications to be given at school
• Meal and snack plan
• Exercise requirements
• Actions to be taken in response to hypoglycemia
  and
  hyperglycemia

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Quick Reference Plan

• Development based on information from students
  DMMP
• Summarizes how to recognize and treat
  hypoglycemia and hyperglycemia
• Distribute to all personnel who have
  responsibility for students with diabetes

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How to Tell if You Have Pre-Diabetes or Diabetes

• While diabetes and pre-diabetes occur in people
  of all ages and races, some groups have a higher
  risk for developing the disease than others.

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There are two different tests your doctor can use
to determine whether you have diabetes 

• the fasting plasma glucose test (FPG) or
• the oral glucose tolerance test (OGTT). 
• The blood glucose levels measured after these
  tests determine whether you have a normal
  metabolism, or whether you have pre-diabetes or
  diabetes.  If your blood glucose level is
  abnormal following the FPG, you have impaired
  fasting glucose (IFG) if your blood glucose
  level is abnormal following the OGTT, you have
  impaired glucose tolerance (IGT).

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How to Tell if You Have Pre-Diabetes or Diabetes

FPG
OGTT
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Where to Get More Information

• American Diabetes Association
• 1-800- DIABETES
• www.diabetes.org
• National Diabetes Education Program/NIH
• www.ndep.nih.gov