How to Manage the Student with Diabetes At School

A training module for school staff

Safe at School - DiabetesPlease watch the video below before proceeding...

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 DiabetesA person with type 1 diabetes makes NO insulin.

They are dependent upon multiple insulin injections/day for survival. (This used to be called insulin dependent diabetes or juvenile diabetes.)

Most people develop type 1 diabetes at a younger age. Most students with diabetes have type 1.

Type 2 DiabetesA person with type 2 diabetes makes some insulin

so they do not usually need to start out on daily insulin injections. They are often able to control their blood sugars with a combination of oral medications, healthy diet, exercise, and stress management.

Most people develop type 2 diabetes later in life. However, with the growing obesity epidemic, more and more children are now being diagnosed with type 2.

What do I need to know to keep my student with diabetes safe at

school?You 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 and/or emergency health care plans.2. Know how to recognize and treat a very high blood

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

sugar

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. When blood sugar is >80, provide snack.

Notify parent/school nurse.

Severe Low Blood SugarSymptoms: 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)

*Follow student’s Diabetes Medical Management Plan1. 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 SugarTreatment*Follow student’s Diabetes Medical Management Plan*

Allow student to drink water and use the restroom as needed, send student to nurse/clinic aide for blood sugar check. 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.

Things to Remember:Your school nurse will tell you which of your students has

diabetes and will provide you with their 504 plans and/or emergency health care plans to read and sign at the beginning of each school year.

Be 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.

Diabetes GlossaryHyperglycemia- Higher than normal blood sugar. Hypoglycemia- Lower than normal blood sugar; usually

defined as blood sugar <80Insulin- Medication used to lower blood sugar; hormone

produced by the body to help control blood sugars. Insulin is absent/deficient in people with diabetes. Insulin can be given from a vial and syringe, insulin pen, or insulin pump.

Glucagon- Medication used to treat severe low blood sugarsCarbohydrate- Type of food that will increase blood sugar

the most; includes things like breads, pasta, potatoes, milk, fruit, fruit juice, rice, starchy vegetables, and sweets.

“Fast acting” carbohydrate/sugar source- Juice, milk, regular soda, glucose gel, glucose tablets

Go to the site below to take the Diabetes Quiz. A passing score is required to submit your completion.Diabetes Training QuizAlternately, you can access the quiz from our

website, on the Health page, by clicking the Health Module Exams link.