1. Woods Charter School
Diabetic Training

2. What you’ll learn from this presentation
What Senate Bill 911 requires
Diabetes--- Type 1 and Type 2
How to recognize and treat:
High blood sugar (Hyperglycemia)
Low blood sugar (Hypoglycemia)

3. LAW
SENATE BILL 911

4. Diabetes is considered a disability; therefore…
Diabetes is covered under many federal and state mandates and laws
It is important to understand what diabetes is in order to:
Comply with legal mandates and laws
Facilitate care for students with diabetes

5. NC Bill 911 We all need to work together
Parents are required by law to
Provide pertinent information needed to develop a diabetes care plan for the student
Communicate with the school staff, including the bus drivers, about any changes or developments concerning the student’s diabetes care regimen
The School is required by law to:
Provide diabetes training and education to school staff
Train two or more Diabetes Care Mangers (DCM’s)

6. Responsibilities of the Diabetes Care Manager
Plan and participate in conferences with the student, parents, and school staff to develop an individualized diabetes care plan
Assist student with diabetes care and maintenance
Be accessible in case of an emergency
Be up-to-date on diabetes information about individual student and diabetes in general
Have open lines of communication with those involved with student, including:
Teachers
Substitute teaches
Parents
School nurse
Bus drivers
Other members of school staff that may be involved with care of student

7. Basic Facts about Diabetes Mellitus
Diabetes is a major contributor to the development and risk of:
Cardiovascular disease
Heart Attacks
Stroke
Blindness
Kidney failure
Amputations
Normal growth and development in children may be delayed or stunted
There are two types of Diabetes, and both types have a problem with the balance between glucose (sugar) and insulin (anti-sugar)

8. Insulin Versus Glucose
Insulin is a hormone produced by the pancreas
Insulin interacts with glucose to maintain the right balance of glucose in the body
Carbohydrates are metabolized into glucose
Glucose is required by the body’s cells for energy
Insulin and glucose have an inverse relationship
If one is up the other is down
The Goal is to find the right BALANCE between Glucose and Insulin

9. Type 1 Diabetes
Commonly known as juvenile or childhood diabetes
The pancreas does not produce insulin
Type 1 Diabetics are INSULIN-DEPENDANT
They must have daily injections of insulin
Type 1 accounts for 10% of all cases of diabetes cases in the US
1 in 400 children have Type 1 diabetes
Usually discovered during childhood or before the age of 30
INSULIN

10. Type 2 Diabetes
The pancreas does not produce enough insulin or does not use the insulin properly, they are INSULIN RESISTANT
More common in adults, but there is a rising epidemic of children developing Type 2 diabetes
Those most at risk:
Hispanics
African-Americans
Native Americans
A family history of diabetes
Obesity
Apple shaped bodies are more prone to diabetes than pear shaped bodies

11. Managing Diabetes When diabetes is kept in control complications can be prevented and controlled
Type 1 Diabetes
Require daily insulin injections
Maintain a balance between
Amount of insulin taken,
Food intake (especially carbohydrates), and
Exercise
The balance in measured by self monitoring blood sugar readings
Type 2 Diabetes
If caught early, Type 2 can usually be managed by lifestyle modifications including:
Weight loss
Healthier eating habits
Oral medications
Regular exercise

12. Treatment of Diabetes Self monitoring of glucose levels Insulin
Place a drop of blood on a test strip that is read by a blood glucose monitor
Important assessment for anyone with diabetes
Usually done during the school day
Insulin
Type 1 diabetes requires insulin by injection using one or a combination of
Insulin pump,
Syringe, or
Pen device
Type 2 (insulin only in later stages)
Exercise and diet control by carbohydrate counting are important for both types of diabetes

13. Insulin
Most students require at least two injections a day unless they are using an insulin pump
There are many combinations of insulin used depending on activity level, time of day, etc.
Some work faster while some last longer
Insulin pumps are battery operated devices that automatically deliver insulin
Insulin pumps are the size of a pager

14. Carbohydrate Counting
Type 1 diabetics need to “Carb Count” to balance insulin with food and activity
Type 2 diabetics need to “Carb Count” to record what they eat in an effort to eat a balanced diet and promote weight loss
The goal for Type 2 diabetics is to ward off the need for insulin injections with lifestyle modifications

15. Regular Exercise
It is recommended for 30 minutes of cardiovascular exercise daily
Promotes weight loss
Helps increase self esteem

16. Signs and Symptoms of Diabetes
Hyperglycemia
Too much glucose (sugar)
Not enough insulin
(The feeling one gets when one eats too much)
Hypoglycemia
Not enough glucose (sugar)
Too much insulin
(The feeling one gets when they are very hungry)

17. Hyperglycemia Too Much Glucose
Too much sugar in the blood
Happens when
Eat too much food
Don’t exercise enough
Body trying to compensate for
Illness or
Physical and/or mental stress

18. Signs and Symptoms of Hyperglycemia
Usually these are the first signs of developing diabetes
Frequent urination
Extreme hunger or thirst
Extreme fatigue
Dry itchy skin
Blurred vision
Frequent infections
Slow healing wounds
Teachers and school staff are key in identifying students with these symptoms

19. Treating Hyperglycemia
Drink water or other calorie free/ caffeine free liquid to dilute the blood and sugar
This will also help hydrate the body
Seek immediate medical assistance if person unable to eat or drink
If high blood sugar goes untreated for a long period of time Diabetic Ketoacidosis can result

20. Diabetic Ketoacidosis (DKA)
High blood sugar that goes untreated for a long period of time
Signs and symptoms include:
Nausea
Vomiting
High levels of ketones in urine and blood
Life threatening, so if you suspect DKA get immediate medical attention
CAUTION: Students with insulin pumps use rapid acting insulin, so they may develop DKA very rapidly if pump is not working properly

21. Hypoglycemia Not enough sugar
Also called “low” or “insulin reaction”
Usually symptoms occur when blood sugar below on blood glucose reading
Usual causes:
Too much insulin
Increased activity
Eating too few carbohydrates
Too much time between snacks and meals

22. Signs and Symptoms of Hypoglycemia
Early signs
Hunger
Shakiness
Dizziness
Sweating
Fast heartbeat
Drowsiness
Irritable, sad, or angry
Nervous
Pale, clammy skin
Important to recognize these
symptoms before late signs develop
Late Signs
Feeling sleepy
Being unusually stubborn
Lack of coordination
Tingling or numbness in tongue
Personality change
Passing out
Seizure

23. Recognizing Hypoglycemia (low blood sugar)
Frequent causes:
Late or missed meals
Exercise or activity
Change in school schedule (be on the lookout)
Fire drill
Assemblies
End of grade testing
Anything that may cause stress or alters normal patterns

24. Treating Hypoglycemia Sometimes it is hard to tell the difference between high and low blood sugar, but remember YOU WILL NOT HURT ANYONE BY GIVING THEM FOOD
If you suspect low blood sugar:
If possible, test their blood sugar with a glucose monitor
Give juice or another source of easily ingested carbohydrates
Wait 30 minutes and test blood sugar again, or reassess signs and symptoms
If blood sugar is still low, give more carbohydrates and start over with testing blood sugar

25. Hypoglycemia Busters What to give someone with low blood sugar:
2-4 glucose tablets
4 oz of apple or orange juice
4-6 oz of regular soda
4-8 Life Savers
2 tablespoons of raisins
3-4 teaspoons of sugar or syrup
1 cup of low fat milk
2 teaspoons of cake gel/icing
Resist the urge to give them too much food or drink as this can cause them to have too much sugar in their blood resulting in hyperglycemia (high blood sugar)

26. If early signs of hypoglycemia develop into late signs:
The student may have seizures or become unconscious
A medication called Glucagon must be given by a trained staff member
Try not to let this become an emergency, be on the lookout for early signs of low blood sugar (hypoglycemia)

27. Bus Drivers have Important Responsibilities
When a student is acting unusual, always assume they have low blood sugar and treat according to diabetes care plan
Students should be allowed to monitor, treat, and eat snacks while on the school bus.

28. Thank you for completing this Power Point presentation Please complete the google test by August 31, 2010