By: Heather Boyd

Diabetes is a serious chronic disease that can be managed through lifestyle changes and medication. Almost 24 million Americans have diabetes. More than two million Canadians have diabetes (National Diabetes Education Program, 2008; Canadian Diabetes Association, 2008)

Most common reason for a student to regress academically are absences from school. Chronic medical illness have an impact on development by interfering with a child’s ability to participate in normal age- appropriate activities or attaining common age-related competencies. These absences occur because of hospitalization, frequent medical appointments, time spent on treatments, side effects of medication, fatigue, physical constrains, and activity restrictions, and occasionally, fears, and parental overprotectiveness. Each child and family is unique and culturally diverse, therefore we need to consider the different dynamics and situations these children and their families are experiencing.

In a healthy body, the pancreas secretes a hormone called insulin. Insulin acts as a key, unlocking cells and allowing glucose to enter and fuel them. The pancreas either stops making insulin entirely, or can't make enough insulin, or can't use the insulin it makes. Lack of insulin leads to a build up of glucose in the bloodstream (or "hyperglycemia," high blood glucose). Without a functioning pancreas, insulin must be obtained from another source -- insulin injections. Diabetes is not contagious in any way shape or form.

Type 1 diabetes Type 1 diabetes (formerly known as "juvenile diabetes") Occurs when the pancreas stops making insulin all together. Type 1 diabetes is usually diagnosed in youth. Type 2 diabetes Occurs when the pancreas makes some insulin, but either it can't make enough or the insulin it does make doesn’t work very well.

Diabetes must be managed 24 hours a day, 7 days a week. For students with type 1 diabetes, and for some with type 2 diabetes, that means careful monitoring of their blood glucose (sugar) levels throughout the school day and administering multiple doses of insulin therapy. Food makes blood glucose levels go up, and exercise and insulin make blood glucose levels go down. Check (or test) their blood glucose levels throughout the day by using a blood glucose meter. A student with hyperglycemia for them to take corrective action, they need to eat, modify their activity level, or administering insulin. The key to optimal blood glucose control is to carefully balance food, exercise, and insulin therapy or medication.

Means High blood glucose Caused by too little insulin, illness, infection, injury, stress or emotional upset, inges­tion of food that has not been covered by the appropriate amount of insulin, or decreased exercise or activity. Over a long period of time, even moder­ately high blood glucose levels can lead to serious complications, such as heart disease, blindness, kidney failure, and amputations. In the short term, hyperglycemia can impair cognitive abilities and adversely affect academic performance. If treatment does not lower blood glucose levels, if vomiting occurs, or if the student is lethargic or experiences breathing difficulties, call the parents/guardian or call for medical assistance.

Means Low blood glucose or low blood sugar. Can happen very suddenly Occurs when a student’s blood glucose level falls too low, Usually as a result of administer­ing too much insulin, skipping or delaying meals or snacks, not eating enough food as prescribed in the meal plan, exercising too long or too intensely, or a combination of two or more of these factors. It is more likely to occur before lunch, at the end of the school day, or during or after physical education classes. If it is not treated promptly, however, hypoglycemia can lead to unconsciousness and convulsions and can be life threatening.

Which are different for each student and may vary from episode to episode, can include: (U.S. Department of Health and Human Services, & National Institutes of Health and the Centers for Disease Control and Prevention, 2003)

Mild/Moderate Symptoms: As soon as symptoms are observed, give the student a quick-acting sugar product, such as: 3 or 4 glucose tablets 3 teaspoons of glucose gel 4 ounces of juice 6 ounces of non-diet soda Severe Symptoms: Position the student on his/her side Contact the school nurse or trained diabetes personnel Administer glucagon, as prescribed Call 911 Call student’s parents

The blood glucose meter gives a reading of the level of glucose in the blood at the time it is being checked. Child using a needle to inject insulin Teen using an insulin pen Child attached to Dialysis machine, when some children have kidney failure, the dialysis helps clean the blood

Students usually check their blood glucose levels: Before eating snacks or meals Before physical activity When they have symptoms of high or low blood glucose

Heart disease, stroke, blindness, kidney disease, and amputation of the foot or leg. Although there is no cure, the disease can be managed and complications delayed or prevented.

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U.S. Department of Health and Human Services, & National Institutes of Health and the Centers for Disease Control and Prevention. (2003). Helping the student with diabetes succeed. A guide for school personnel. Retrieved July 8, 2008, from Youth_NDEPSchoolGuide.pdf American Diabetes Association (2008). What is diabetes? The American Diabetes Association Web. Retrieved July 5, 2008, from /forparentsand-kids/for-schools/what-is-diabetes.jsp National Diabetes Education Program. (2008). About Diabetes and Pre-diabetes. The National Diabetes Education Program Web. Retrieved September 20, 2008, from Canadian Diabetes Association. (2008). Diabetes Facts. The Canadian Diabetes Association Web. Retrieved September 20, 2008, from Child check their blood sugar level with tester erdiabetes.jpg

Child using a needle to inject insulin fromhttp:// /diabetes-environmental-factors-insulin.jpg Teen using an insulin pen Child attached to Dialysis machine, when some children have kidney failure, the dialysis helps clean the blood health/story.asp?file=/2008/4/27/health/ McCulloch, D. (2007). Patient information: Diabetes Type 1: Insulin Treatment. Uptodate Web. Retrieved August 26, 2008, from 312F55EDF80A8F9E777B ?topiKey=~U9zUCsosMVNwg&view= print