Managing Type 1 Diabetes in the School Setting | A Guide for Non-Medical Personnel in Schools And COLLEGE
Managing Type 1 Diabetes in the School Setting | A Guide for Non-Medical Personnel in Schools And COLLEGE
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| Managing Type 1 Diabetes in the School Setting |
Beaumont
children's is proud to present this program as part of our continuous
commitment to addressing type 1 Diabetes in school settings it is an
orientation tool and is not intended to replace hands-on medical
training the following video presentation is made possible by the generous support of Beaumont children's the Philip and Elizabeth
filmer memorial charitable trust Children's Miracle Network Hospitals
and the Juvenile Diabetes Research Foundation this is what type
1 The diabetes looks like it's children leading normal lives by eating on a schedule testing their blood sugar levels consistently adjusting their insulin is needed and exercising regularly it's also a parent worried about Diabetes management while being away from her child it's a teacher who needs to know how to handle a diabetic emergency it's a principle working in a school like most in Michigan without a school nurse as
you can see type 1 diabetes affects more than the child, we all need to help especially when it comes to managing type 1 Diabetes in the school setting that's why Beaumont children's created this video in partnership with JDRF don't worry you don't have to memorize all this we've included an easy-to-follow guide that explains everything in detail by no means does this replace hands-on training this is about becoming familiar with what you need to do first things first what is
Diabetes a healthy pancreas makes insulin a hormone that turns glucose in the blood into energy glucose also known as sugar comes from what we eat and drink if your pancreas stops producing insulin you have type 1 Diabetes this is sometimes called Juvenile Diabetes because it usually develops some children adolescents and young adults without insulin glucose builds up in the blood causing high blood sugar someone with type 1 Diabetes must put insulin in their body through injections or an insulin pump now
if someone's pancreas can produce their own insulin but it's not enough or ineffective and turning blood sugar into energy that person has type 2 Diabetes type 2 can sometimes be managed with diet and exercise alone or with oral medications and in some cases with insulin injections most school-age children with Diabetes have type unfortunately, as our society becomes more overweight and sedentary type 2 has become more common in school-aged
children part of keeping type 1 diabetes under control is regular blood glucose checks you'll find a lot of different glucose meters out there these glucose meters also called glucometers are all simple to use they work in similar ways you should get specific instructions from the parents about their child's meter basically you take a drop of blood usually from the fingertip and place it on a special test drip in a glucometer to get a blood sugar reading now some people use a continuous glucose monitor or Sugiyama,
it attaches to the body like an insulin pump and requires fewer finger pucks and meter tasks during the course of the day remember when dosing insulin a glucometer reading not a continuous glucose monitor reading must be used before we go into what these readings mean you should first be familiar with what we call food doses and correction doses both types of doses do require some
simple math and understanding all of the terminology does take some practice so remember if you ever get confused you can always refer to your guide a food dose is how much insulin you give someone at his or her scheduled meal time this is part of a child's daily management routine just take the total grams of carbohydrates in a meal and divide it by the student's insulin to carbohydrate ratio that the ratio
should be in the school management plan whatever number you get is your food dose of insulin let's say the student's blood sugar level is elevated above 150 you will need to do the following math to administer a correction dose of insulin the correction dose of insulin corrects high blood sugars at mealtime first take the child's actual blood glucose level you've obtained from the glucometer and then subtract the child's target number which is often
150 the answer we get is a variable we'll call X take X and divide that by the students correction factor this factor is a number that should be in the school's management plan the answer you get is the correction the dose of insulin add that number to the food dose of insulin the sum you get is the total mealtime insulin dose you need to inject we know this is a lot to digest so we've put all of this information and the equations in your guide and if you're ever in doubt confirm the insulin dosage with the child's parent understanding how to administer insulin is something you should know because you may be asked to help students that administer their insulin at mealtime on a daily basis if you're injecting insulin in a syringe you'll need to prepare the bottle first instructions are on your guide once it's ready find a clean injection site on a student give that area of skin a gentle pinch touch the needle to the skin and push it through release the pinch and inject the insulin slowly and steadily wait for 10 seconds then pull the needle out make note of any drops of insulin leaking back insulin can also be injected using an insulin pen this is what a typical pen looks like first, you need to insert an insulin cartridge into the pens cartridge holder twist it on and attach a new the needle holding the pen upright select two units and press the dose button until it says zero this will remove any possible air keep testing the pen until insulin sports from the needle tip select the dosage you need then inject it into the child's skin the counter will read zero when the entire dose has been administered count to ten and remove the needle with some pens you don't have to insert a cartridge because they're prefilled each pen is
a little different so parents should give you instructions on the pen their child uses now let's go back to those glucose readings a normal range for a school-aged child is typically between 80 and 180 a correction dose may be required with blood glucose more than 150
if the reading is above 150 that the child has high blood sugar which is called hyperglycemia besides the number you should also look for symptoms like thirst frequent urination and drowsiness the full list is in your guide this doesn't put a child in any immediate danger but high levels over time
can lead to serious health complications that's why you still need to treat this condition this is why you administer a correction dose of insulin during a student's scheduled meal time now if a child's blood glucose level is higher than 300 you must first check for urine ketones to do this you need a keto diet stick strip to have the student urinate in a clean cup then dip
the strip into the cup let any excess urine drip off the strip wait 15 seconds then compare the test area with the color chart found on the side of the keto diet sticks bottle different color results call for different courses of action your the guide will tell you what to do now let's talk about if a student's blood glucose level is 80 or lower he or she has low blood sugar which is called hypoglycemia this is the most common and potentially dangerous condition for someone with
type 1 Diabetes if left untreated it may lead to severely low blood sugar which could be life-threatening mild hypoglycemia means a child's blood glucose is less than 65 or less than 80 with symptoms like dizziness shakiness and hunger the full list of symptoms is in your guide to treat mild hypoglycemia follow the rule of 15 provide 15 grams of fast-acting carbohydrates such as a 4-ounce juice box or 4 glucose tablets wait 15 minutes and recheck the blood glucose if it's still below 80 repeat the treatment if you need to treat a third time notify the parent immediately if the students next meal are more than two hours away give him or her an additional 15-gram carbohydrate snack that includes protein severe hypoglycemia is when the blood glucose is so low that there's a loss of consciousness or seizure with an inability to swallow if this happens first call 911 have someone find a trained school employee and don't give the student anything by mouth check the child's blood glucose level and give them an injection of glucagon if their glucose level low notifies the student's parents start by prepping the vial of glucagon and injecting a full syringe of liquid into the vial shake the vial until the powder dissolves withdraw as much of the liquid as needed for a child fifty pounds or more that would be one milligram or a full dose for someone under fifty pounds 0.5 milligrams or a half dose turn the child on his or her side pull the syringe and needle out from the vial inject the child in the mid-thigh muscle area as soon as the child wakes up feed him or her if the child isn't awake after 15 minutes give another dose when the child awakens have them sip on some juice and notify his or her doctor once again refer to your guide for detailed instructions the key to managing type 1 diabetes in the school the setting is being prepared students should have a file at their school that includes a school management plan an emergency plan and what is called 504 plan samples of these plans are included as a PDF with your guide what should you expect from the students themselves that depends on their age parents usually take care of everything for children under 8 children between 8 and 12 may be able to start doing their own shots insulin doses and blood glucose levels should still be checked by an adult between 13 and 18 most students are pretty independent when it comes to their management some however still require assistance or supervision these students will need individuals at school who know what to do for a diabetic emergency regardless of age students would type 1 Diabetes have a right
1 The diabetes looks like it's children leading normal lives by eating on a schedule testing their blood sugar levels consistently adjusting their insulin is needed and exercising regularly it's also a parent worried about Diabetes management while being away from her child it's a teacher who needs to know how to handle a diabetic emergency it's a principle working in a school like most in Michigan without a school nurse as
you can see type 1 diabetes affects more than the child, we all need to help especially when it comes to managing type 1 Diabetes in the school setting that's why Beaumont children's created this video in partnership with JDRF don't worry you don't have to memorize all this we've included an easy-to-follow guide that explains everything in detail by no means does this replace hands-on training this is about becoming familiar with what you need to do first things first what is
Diabetes a healthy pancreas makes insulin a hormone that turns glucose in the blood into energy glucose also known as sugar comes from what we eat and drink if your pancreas stops producing insulin you have type 1 Diabetes this is sometimes called Juvenile Diabetes because it usually develops some children adolescents and young adults without insulin glucose builds up in the blood causing high blood sugar someone with type 1 Diabetes must put insulin in their body through injections or an insulin pump now
if someone's pancreas can produce their own insulin but it's not enough or ineffective and turning blood sugar into energy that person has type 2 Diabetes type 2 can sometimes be managed with diet and exercise alone or with oral medications and in some cases with insulin injections most school-age children with Diabetes have type unfortunately, as our society becomes more overweight and sedentary type 2 has become more common in school-aged
children part of keeping type 1 diabetes under control is regular blood glucose checks you'll find a lot of different glucose meters out there these glucose meters also called glucometers are all simple to use they work in similar ways you should get specific instructions from the parents about their child's meter basically you take a drop of blood usually from the fingertip and place it on a special test drip in a glucometer to get a blood sugar reading now some people use a continuous glucose monitor or Sugiyama,
it attaches to the body like an insulin pump and requires fewer finger pucks and meter tasks during the course of the day remember when dosing insulin a glucometer reading not a continuous glucose monitor reading must be used before we go into what these readings mean you should first be familiar with what we call food doses and correction doses both types of doses do require some
simple math and understanding all of the terminology does take some practice so remember if you ever get confused you can always refer to your guide a food dose is how much insulin you give someone at his or her scheduled meal time this is part of a child's daily management routine just take the total grams of carbohydrates in a meal and divide it by the student's insulin to carbohydrate ratio that the ratio
should be in the school management plan whatever number you get is your food dose of insulin let's say the student's blood sugar level is elevated above 150 you will need to do the following math to administer a correction dose of insulin the correction dose of insulin corrects high blood sugars at mealtime first take the child's actual blood glucose level you've obtained from the glucometer and then subtract the child's target number which is often
150 the answer we get is a variable we'll call X take X and divide that by the students correction factor this factor is a number that should be in the school's management plan the answer you get is the correction the dose of insulin add that number to the food dose of insulin the sum you get is the total mealtime insulin dose you need to inject we know this is a lot to digest so we've put all of this information and the equations in your guide and if you're ever in doubt confirm the insulin dosage with the child's parent understanding how to administer insulin is something you should know because you may be asked to help students that administer their insulin at mealtime on a daily basis if you're injecting insulin in a syringe you'll need to prepare the bottle first instructions are on your guide once it's ready find a clean injection site on a student give that area of skin a gentle pinch touch the needle to the skin and push it through release the pinch and inject the insulin slowly and steadily wait for 10 seconds then pull the needle out make note of any drops of insulin leaking back insulin can also be injected using an insulin pen this is what a typical pen looks like first, you need to insert an insulin cartridge into the pens cartridge holder twist it on and attach a new the needle holding the pen upright select two units and press the dose button until it says zero this will remove any possible air keep testing the pen until insulin sports from the needle tip select the dosage you need then inject it into the child's skin the counter will read zero when the entire dose has been administered count to ten and remove the needle with some pens you don't have to insert a cartridge because they're prefilled each pen is
a little different so parents should give you instructions on the pen their child uses now let's go back to those glucose readings a normal range for a school-aged child is typically between 80 and 180 a correction dose may be required with blood glucose more than 150
if the reading is above 150 that the child has high blood sugar which is called hyperglycemia besides the number you should also look for symptoms like thirst frequent urination and drowsiness the full list is in your guide this doesn't put a child in any immediate danger but high levels over time
can lead to serious health complications that's why you still need to treat this condition this is why you administer a correction dose of insulin during a student's scheduled meal time now if a child's blood glucose level is higher than 300 you must first check for urine ketones to do this you need a keto diet stick strip to have the student urinate in a clean cup then dip
the strip into the cup let any excess urine drip off the strip wait 15 seconds then compare the test area with the color chart found on the side of the keto diet sticks bottle different color results call for different courses of action your the guide will tell you what to do now let's talk about if a student's blood glucose level is 80 or lower he or she has low blood sugar which is called hypoglycemia this is the most common and potentially dangerous condition for someone with
type 1 Diabetes if left untreated it may lead to severely low blood sugar which could be life-threatening mild hypoglycemia means a child's blood glucose is less than 65 or less than 80 with symptoms like dizziness shakiness and hunger the full list of symptoms is in your guide to treat mild hypoglycemia follow the rule of 15 provide 15 grams of fast-acting carbohydrates such as a 4-ounce juice box or 4 glucose tablets wait 15 minutes and recheck the blood glucose if it's still below 80 repeat the treatment if you need to treat a third time notify the parent immediately if the students next meal are more than two hours away give him or her an additional 15-gram carbohydrate snack that includes protein severe hypoglycemia is when the blood glucose is so low that there's a loss of consciousness or seizure with an inability to swallow if this happens first call 911 have someone find a trained school employee and don't give the student anything by mouth check the child's blood glucose level and give them an injection of glucagon if their glucose level low notifies the student's parents start by prepping the vial of glucagon and injecting a full syringe of liquid into the vial shake the vial until the powder dissolves withdraw as much of the liquid as needed for a child fifty pounds or more that would be one milligram or a full dose for someone under fifty pounds 0.5 milligrams or a half dose turn the child on his or her side pull the syringe and needle out from the vial inject the child in the mid-thigh muscle area as soon as the child wakes up feed him or her if the child isn't awake after 15 minutes give another dose when the child awakens have them sip on some juice and notify his or her doctor once again refer to your guide for detailed instructions the key to managing type 1 diabetes in the school the setting is being prepared students should have a file at their school that includes a school management plan an emergency plan and what is called 504 plan samples of these plans are included as a PDF with your guide what should you expect from the students themselves that depends on their age parents usually take care of everything for children under 8 children between 8 and 12 may be able to start doing their own shots insulin doses and blood glucose levels should still be checked by an adult between 13 and 18 most students are pretty independent when it comes to their management some however still require assistance or supervision these students will need individuals at school who know what to do for a diabetic emergency regardless of age students would type 1 Diabetes have a right
to a
safe school environment there are laws that make sure students would
type 1 Diabetes get the same opportunities as their peers I'd like to
thank Beaumont children's for providing this video for our schools in
their staff blood glucose checks insulin doses knowing what to do in
an emergency these are all important parts of type 1 Diabetes treatment now no one expects you to memorize everything you've seen
today but there is one thing you should remember you are not alone
you have the support of many and it starts with the child's parents
you can also use your local JDRF chapter as a resource and don't be
shy about talking with the child's pediatric endocrinology team you
see this is what treating type 1 Diabetes looks like it's parents
teachers doctors nurses everyone working together to keep our
children happy and healthy
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