How to Manage the Student with Diabetes At School

A training module for school staff

What is Diabetes?A disease that causes the body to have trouble making and/or

using insulin. Insulin, a hormone made by the body, helps control blood glucose/sugar levels.

There are 2 main types of diabetes.

Type 1 and Type 2

Type IType 1 Diabetics

Body does not make insulin.

Dependent upon multiple insulin injections/day for survival. (This used to be called insulin dependent diabetes.)

Usually develops at a younger age.

Most students with diabetes have type 1.

Type 2 DiabetesType 2 Diabetes

Body makes some insulin but usually do not start out on daily insulin injections.

Blood sugars controlled with a combination of oral medications, healthy diet, exercise, and stress management.

Ususally develop type 2 diabetes later in life.

With the growing obesity epidemic, more and more children are now being diagnosed with type 2.

Diabetes Mananagment in SchoolYou don’t have to be a diabetes expert. You just

need to feel comfortable with the following 3 things:

1. Know which students have diabetes and be familiar with their 504, health care plans, and accommodations.

2. Know how to recognize and treat a high blood sugar

3. Know how to recognize and treat a low blood sugar

Diabetic AccommodationsCan carry monitor at all timesAllowed to eat in class when necessary,

snacks provided by parent and easily accessed.

If mood or attitude change, student to check blood sugar.

Blood sugar checks completed before any major test and indicate results at the top of the page

If student becomes symptomatic while taking a test of major assignment, they will be allowed to check sugar and deal accordingly with possible retest.

Diabetic Accommodations cont. Allow access to water and restroom as soon as

feasible to reduce episodes of hyperglycemia and support diabetic wellness.

Allow student to participate fully in extra-curricular activities.

Receive necessary assistance with blood glucose monitoring and/or insulin injections.

Should send to clinic with someone else if signs of high or low blood sugar.

Keep a prescription of glucagon supplied by parent. with two trained staff available for an emergency at all times.

Treat student in a respectful, , sensitive, and supportive

manner.

Mild/Moderate Low Blood SugarsDefinition: Blood sugar reading <80

Causes: Not enough food, too much insulin, extra physical activity

Symptoms of Mild/Moderate Low Blood Sugar:Mood changes, shakiness, sweaty skin, increased hunger, sleepiness, headache,

“I don’t feel so well”, consult child’s health care plan for typical low blood sugar symptoms

*When in doubt, check blood sugar

Treatment of Mild/Moderate Low Blood Sugar

Follow student’s Diabetes Medical Management Plan.

*If low blood sugar is suspected, have child escorted to the clinic.

Check blood sugar. If <80, treat with a “fast

acting” sugar source, such as 4 oz juice or soda OR 3-4 glucose tabs

Wait 15 minutes and then recheck blood sugar

If it is >80, provide snack. If it is <80, provide more of the fast acting sugar source and recheck in 15 minutes.

Notify parent/school nurse.

Severe Low Blood Sugar

Symptoms: Confusion, extreme sleepiness, loss of consciousness, combativeness, seizure

Treat with Glucagon Injection (At least 2 school staff in each school trained by school nurse to provide glucagon)

Glucagon1. Have someone call 911.2. Prepare Glucagon- Open glucagon kit. Flip cap off vial.

Take cap off syringe. Inject contents of syringe into vial. Roll vial until contents turn clear. Draw up contents of vial into syringe.

3. Turn student on side.4. Inject glucagon into buttocks, thigh, or arm. (Try to

remove clothing from site before injection.)5. Stay with student until EMS arrives. It is not

uncommon for student to wake up and vomit. If he wakes up before EMS arrives and is able to drink, provide him with regular soda, juice, or milk to help keep blood sugar up.

High Blood SugarsCauses and SymptomsCauses: Too much food, not enough insulin, illness, stressSymptoms of Mild/Moderate High Blood Sugar: Increased

thirst, more frequent urination or asking to go to the bathroom a lot, increased hunger, headache, change in mood, “I don’t feel well”

Symptoms of Severe High Blood Sugar: Difficulty breathing, nausea/vomiting, extreme sleepiness, confusion

High Blood SugarTreatmentAllow student to drink water and use the restroom

as needed, send student to nurse/clinic aide for blood sugar check with a buddy. Clinic Aide/nurse will test urine ketones, provide extra medication as ordered, and determine whether or not child needs to be sent home.

If student exhibits symptoms of illness or severe high blood sugar, have them escorted to the clinic.

Insulin Pumps• Some students with diabetes will wear an insulin pump. A pump

is a pager-sized device with tubing that attaches to a catheter placed into the student’s skin. The pump provides them with a small, continuous amount of insulin and replaces insulin injections given by syringe. A student who has a pump still has to check his blood sugar and program the pump to deliver the correct amount of insulin.

• The pump also allows the student/clinic aide to provide extra insulin for high blood sugars and before eating without having to give the student an injection each time.

*Be familiar with how to turn off/suspend the pump. You may be asked to do this if your student has a low blood sugar.

Insulin InjectionsInsulin Pen Insulin Injection

Things to Remember:The school health staff will notify and provide staff

with names of diabetic students with their plan of careBe familiar with the signs/symptoms and treatment for

high and low blood sugars.Know which staff in your school are trained to give

glucagon and insulin.Ensure you have gotten the necessary diabetes

supplies for your student from the school nurse when traveling with the student off school grounds.

If you find your diabetic student unconscious or seizing and you cannot quickly check his blood sugar, assume the blood sugar is LOW. Call 911 and treat with GLUCAGON.

Go to site below to take quiz and submit completion

Diabetes Training Confirmation