DATA Program Diabetes Awareness, Training, and Action

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DATA ProgramDiabetes Awareness, Training, and
Action

• Online Training for School Staff
• Public Schools of Robeson County
• Care of School Children with Diabetes

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Introduction

• When a student with diabetes is part of the
  school system, the school staff automatically
  becomes a part of the students health care team.
• A student with diabetes can have special
  challenges for which teachers and staff must be
  prepared.
• This program is designed to train school
  personnel in general diabetes care to allow the
  student to have a successful day at school.
• Students health information is confidential and
  should only be discussed on a need to know
  basis.

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Part 1 Overview of Senate Bill 911 Care of
School Children With Diabetes
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Overview of SB 911 Care of School Children
with Diabetes

• September 5, 2002-became law
• Provides a standardized diabetic care plan (DCP)
  for children with diabetes (parents
  responsibility to complete)
• Parents must request in writing that a diabetic
  care plan be developed
• PSRC must ensure that the DCP and/or emergency
  action plan (EAP) are implemented
• The completed DCP clearly describes the
  responsibilities of the student, parent, and
  school staff
• If no DCP is completed by the parent/guardian,
  the student will follow EAP for self-care,
  parent-care, and 911 care procedure
• In an emergency with a diabetic student, 911 must
  be called
• All PSRC employees must receive basic diabetes
  awareness training
• Each school with a diabetic student must have at
  least 2 individuals trained as a diabetic care
  manager (DCM) to assist students with diabetes
  and handle emergencies
• Students with diabetes are allowed to carry
  necessary supplies at all times and are allowed
  access to water and the bathroom

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Guidelines for PE Teacher and Coach

• Encourage exercise and participation in sports
  and physical activities for students with
  diabetes.
• Treat the student with diabetes the same as other
  students, except to meet medical needs.
• Encourage the student to have blood glucose
  equipment and treatment for low blood sugar
  available.
• Understand and be aware that hypoglycemia can
  occur during and after physical activity.
• Recognize any changes in students behaviors
  which could be a symptom of low blood sugar.

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Guidelines for Bus Drivers

• At the beginning of the school year, identify any
  students on the bus who have diabetes. Be
  familiar with their DCP (Diabetic Care Plan) or
  EAP (Emergency Action Plan).
• Be prepared to recognize respond to
  signs/symptoms of low blood sugar
• Student may carry BS monitor, Insulin, Glucagon,
  snacks on bus.
• Student, teacher, and parent should communicate
  with bus driver.
• Bus driver may consider carrying extra snacks in
  case of bus breakdown, traffic jam, etc.

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Liability Concerns and Issues

• So what about sharps, blood, carrying medication
  around the school?
• Self-monitoring of blood sugar should be
  supported.
• Students should discard used needles in an
  approved sharps container.
• Students injecting insulin with pens or syringes
  should be provided a safe place for injecting.

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Part 2 Diabetes Overview

• Diabetes Defined
• Diabetes is a chronic disease that affects the
  bodys ability to use sugar. Sugar is what fuels
  our body. Insulin is made in the pancreas and is
  needed to get the sugar from the blood stream
  into the cell so it can be used for energy. With
  diabetes, either the body doesnt make insulin or
  the body cant use it properly. Without insulin,
  glucose (sugar)-the bodys main energy
  source-builds up in the blood. There are 2 types
  of diabetes.

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Diabetes Overview continued

• Type 1
• Has been called Juvenile-Onset or Insulin
  Dependent Diabetes in the past.
• Results from the destruction of the part of the
  pancreas that makes insulin.
• The body does not make insulin or does not make
  enough insulin.
• Sugar builds up in the blood and the student
  will become very sick.
• The student with Type I diabetes must take
  insulin by injection for the remainder of his/her
  life.

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Diabetes Overview continued

• Type 2
• Has been called Adult-Onset or
  Non-Insulin-Dependent Diabetes.
• The body makes insulin. The body either doesnt
  use the insulin it makes or doesnt make enough.
  
• Central abdominal obesity is directly related
  to insulin resistance.
• Type 2 diabetes is a fast-growing epidemic in
  our young population.
• Type 2 diabetes is related to family history of
  diabetes, weight gain, and sedentary lifestyle.
• Usually improves with weight loss, exercise, and
  diet
• May require oral medication if diet and exercise
  dont improve blood sugars, and eventually
  insulin may be needed.

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Necessary Tools for Diabetes Management

• Blood sugar monitor (glucometer) for
  self-monitoring of blood sugar
• Carbohydrate counting and the meal plan
• Type I Insulin is needed to control blood sugar
  levels
• Type II - important to promote weight loss

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Part 3Acute Complications of Diabetes

• Hyperglycemia (High Blood
• Sugar)
• Hypoglycemia (Low Blood Sugar)

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High Blood Sugar Hyperglycemia
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Hyperglycemia

• High blood glucose (hyperglycemia) occurs when
  the body gets too little insulin, too much food,
  or too little exercise.
• Definition-blood sugar greater than 240
• Signs/symptoms frequent urination, extreme
  hunger, extreme fatigue, unusual thirst,
  irritability, blurred vision

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• In all cases of high blood sugar, if the student
  is able, he should drink calorie-free,
  caffeine-free liquids such as water.
• If the student is unable to drink liquids because
  of nausea or vomiting, you should seek medical
  attention immediately according to the students
  DCP(Diabetic Care Plan) or EAP (Emergency Action
  Plan).
• Insulin is given according to the students
  Diabetic Care Plan.
• The urine may be tested for ketones, if ordered.
• Do not have the student exercise in order to
  bring the blood sugar level down.

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Low Blood Sugar

• Hypoglycemia

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What Is Hypoglycemia or Low Blood Sugar?

• Sometimes called an insulin reaction
• Occurs when blood sugar is below the target range
  (under 70-80)
• Can be caused by too much insulin, unplanned
  increased activity, eating too few carbohydrates,
  missing/delayed meals, changes in school schedule

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• Low blood glucose levels, which can be
  life-threatening, present the greatest immediate
  danger to people with diabetes.

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Signs and Symptoms of Low Blood Sugar

• Hunger
• Shakiness
• Dizziness
• Sweatiness
• Fast heartbeat
• Drowsiness
• Feeling irritable, sad or angry
• Nervousness
• Pallor

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More Signs and Symptoms of Low Blood Sugars

• Feeling sleepy
• Being stubborn
• Lack of coordination
• Tingling or numbness of the tongue
• Personality change
• Passing out
• Seizure

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Recognizing Low Blood Sugar

• It is important to recognize a low blood sugar as
  soon as possible so that it does not progress to
  a severe reaction.
• Early signs are caused by the release of the
  hormone epinephrine.
• Our bodies make this hormone when we are
  excited or stressed.

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What To Do When Hypoglycemia Occurs

• If meter is unavailable and the child feels sick,
  treat as if sugar is low.
• Student should immediately eat or drink about 15
  grams of fast-acting carbohydrate.
• Notify DCM (Diabetic Care Manager) or school
  nurse

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Treatment of HypoglycemiaFast Acting Sugar
Sources (15 gram carbohydrates)

• 3-4 teaspoons of sugar or syrup
• 1 cup of low fat milk
• 1 tube of cake gel
• 1 carton chocolate milk

• 2-4 glucose tablets
• 4 ounces of apple or orange juice
• 4-6 ounces of regular soda
• 2 tablespoons of raisins

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Treating Severe Hypoglycemia

• When severe hypoglycemia occurs, not enough sugar
  is in the brain.
• The student may lose consciousness and/or have
  convulsions.
• At this time the student will need the assistance
  of someone else.

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What Happens when the Child is Unconscious?

• Drinking soda or eating glucose tablets is not
  possible and would be dangerous when the child is
  unconscious .
• Glucagon injection may then be necessary.
  Glucagon is a substance (hormone) that makes the
  liver release sugar into the blood stream.
• Turn student to their side, administer Glucagon
  if ordered, call 911 and parent.
• Remain with student until help arrives.

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Only designated, trained school staff will
administer Glucagon. Orders for its use must be
included on the childs Diabetes Care Plan.

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Contact the school nurse with any
questions/concerns relating to students with
diabetes. Diabetes Awareness Post-test