1. Diabetes in school What you need to know in school!

2. What is diabetes? In type 1 diabetes the amount of glucose in the body is too high because of a lack of insulin as the cells producing insulin have or are being destroyed by the body Insulin is a hormone which controls the amount of glucose in our blood and opens the door to the cells so glucose from our food and drink can be used as energy

3. What about type 2 diabetes? Body is able to produce insulin but not working well Usually life style related, onset later on in life, higher prevalence ethnic population Controlled by restrictive diets, tablets, although sometimes need insulin injections

4. Diet No such thing as diabetic diet Type of insulin regime dictates when need to eat/snack May need to eat in lesson/ between lessons/ prior to exercise/ during exams Importance of starchy foods

5. Why injections? Protein New developments For life

6. Twice daily injections

7. Multiple daily injections

8. Low blood sugars ( hypo) What is a hypo 4= the floor Causes Too much insulin Missed/ delayed meal or snack Not enough intake complex carbs Weather D + V Stress/emotions Exercise Alcohol

9. Signs & symptoms Hungry Shaky/wobbly Pale/sweaty Moody Dizzy Sleepy ‘out of character’ Tingling/pins+needles crying Hot Angry Incoherent Uncoordinated ‘weird’ Adolescent behaviour? Confirm with blood test! All individual will usually have good awareness

10. Treatment of simple hypo Confirm with blood test Liquid sugar or something that will turn into liquid sugar e.g one of these Lucozade( 60 mls), full sugar Coke, fresh fruit juice ( 150 mls), dextrose tablets (3 or 4), treat size pkt Haribo, 10 Skittles/ Jellie Bellies or 3 Starburst or Fruit pastilles Hypobox

11. Safety! Treat young person experiencing hypo in situ- do not leave unattended May need encouragement, simple commands Check blood sugar level after 10 mins.- repeat above if still under 4 Follow on carbs once above 4 mmols

12. Moderate hypo/ use of Glucogel What is Glucogel If unable to follow instructions but responsive use Glucogel May be agitated, symptoms exaggerated Use Glucogel bucally – do not insert fingers Little bit at a time – massage cheek repeat until responding, ok to switch to tastier option once able to follow instructions/ co operate- wash hands if assisting with blood sugar check

13. Glucogel

14. Severe hypo Unconscious/ fitting/ wide pupils/low blood sugar Do not place anything in mouth- maintain safety Call 999 inform diabetic child- inform family Ensure hypo treatments go where ever young person goes ( school trips etc) if unable to confirm with blood test safer to treat!

15. High blood glucose No fixed figure but generally if below 15 mmols and feeling well no immediate action needed Causes: Lack of insulin Too much food Lack of activity Illness Stress/ emotions/ hormones

16. Hyperglycaemia signs and symptoms Headache Irritable/ mood change Needing toilet more frequently Thirsty Tummy pain Nauseous Blurred vision

17. What to do? Check blood glucose level Encourage extra sugar free fluids Allow to use toilet as often as needed Refer to plan May need extra insulin- allow to be administered If feeling unwell call family- needs closer monitoring especially if vomiting

18. Blood testing Why How By who? When Memory function ‘Golden’ tool if not quite right- confirm and know what to do

19. Management of exercise Encourage exercise as for any young person but need simple preparation Before activity, esp. if e.g. swimming check level, may need extra snack Have dextrose tablets or access to sugary drink if levels drop After activity may need extra carbs but depends on intensity and length of exercise

20. Questions? Contact no’s available Educational literature Every young person individual- not everything is diabetes!