Intensive Diabetes Education

Diabetes Education

Information in this section may be used by all staff to
meet annual training requirements for Care of Students with Diabetes.
However, it is information specific for designated diabetes care managers.

Senate Bill 911-Care of Children With Diabetes
Diabetes Overview
Type I Diabetes
Type II Diabetes
Necessary Tools for Diabetes Management
Compliations of Diabetes

Senate Bill 911 – Care of School Children with Diabetes

  • September 5, 2002 – became law
  • Provides a standardized Emergency Action Plan (EAP) for children with diabetes –  parent’s responsibility to complete
  • Parents must request in writing that an action plan be developed.
  • School must ensure that the EAP’s guidelines are implemented.
  • The completed EAP clearly describes the responsibilities of the student, parent, and  school staff.
  • If no EAP is completed by the parent/guardian, the student may provide self-care and/or the parent may come to the school to provide care. 
  • In an emergency with a diabetic student, 911 must be called.
  • All school personnel 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.

Diabetes Overview

Diabetes is a chronic disease that affects the body’s 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 doesn’t make insulin or the body can’t use it properly.  Without insulin, glucose (sugar) – the body’s main energy source – builds up in the blood.  There are 2 types.  The normal blood sugar range is between 70-110.

Type I Diabetes

  • Used to be known as Juvenile-onset or insulin-dependent diabetes
  • 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.

Type II Diabetes

  • Used to be known as adult-onset or non-insulin dependent diabetes
  • The body makes insulin.  The body either doesn’t use the insulin it makes or it doesn’t make enough.
  • Fast growing epidemic in our young population
  • 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 don’t improve blood sugars, and eventually insulin may be needed.

Necessary Tools for Diabetes Management

  • Glucometer for self-monitoring of blood sugar
  • Carbohydrate counting and the meal plan
  • Appropriate snacks and beverages  
  • Insulin

Complications of Diabetes: Hyperglycemia (high blood sugar) and Hypoglycemia (low blood sugar)

Hyperglycemia (high blood sugar)

  • Occurs when the body gets too little insulin, too much food, or too little exercise;  when a child has an illness/infection;  when a child is under extreme stress
  • Definition – blood sugar greater than 240
  • Signs & symptoms: frequent urination, extreme hunger, extreme fatigue, unusual thirst, irritability, blurred vision

Treatment of Hyperglycemia

  • Insulin is given according to the student’s Emergency Action Plan.
  • The urine may be tested for ketones, if ordered.
  • If able, the student should drink calorie-free, caffeine-free liquids such as water ora diet soda.
  • If unable to drink liquids because of vomiting, seek medical attention.
  • Do not have the student exercise in order to bring the blood sugar level down.

Hyopglycemia (low blood sugar)

  • Sometimes called an insulin reaction
  • Definition:  blood sugar is below 70
  • Caused by: too much insulin, increased activity, eating too few carbohydrates, missing or delayed meals, and/or changes in the school schedule
  • Early signs & symptoms: hunger, shakiness, dizziness, sweatiness, fast heartbeat, nervousness, confusion, pallor (pale in skin color).  These early signs of low blood sugar are caused by the release of the hormone epinephrine.
  • Later signs & symptoms: feeling sleepy; being stubborn; lack of coordination; tingling or numbness of the tongue; feeling irritable, sad, or angry; passing out; seizure; loss of consciousness 

Treatment of Hypoglycemia

  • Provide a fast-acting sugar (15-gram carbohydrate) source
  • Follow the fast-acting sugar with a snack of more substance such as peanut butter and crackers, cheese sandwich, etc.

Fast-acting sugar sources (15-gram carbohydrate) sources

  • 2-4 glucose tablets
  • 4 oz. apple or orange juice
  • 4-6 ounces of regular soda
  • 4-8 life savers
  • 2 tablespoons of raisins
  • 3-4 teaspoons of sugar or syrup
  • 1 cup of lowfat milk
  • 1 tube of cake gel

Severe Hypoglycemia

  • Means not enough sugar is getting to the brain 
  • The student can lose consciousness and/or have convulsions. 
  • Glucagon may be given by injection (if available and ordered by the physician).  Glucagon is a substance that makes the liver release sugar into the bloodstream.
  • Do not give anything by mouth & call 911, then the parent/guardian.

Contact the School Nurse with any questions/concerns relating to students with diabetes.  Also, please review the above information if you are a diabetic care manager at your school, and see the school nurse upon completion.  This needs to be done within the first two weeks of school.