1. Diabetes at School Level II Training GCISD High School Edition

2. Diabetes at School House Bill 984 Passed by the79th Legislature »Effective September 1, 2005 »Health and Safety Code Sec. 168

3. Diabetes at School Rehabilitation Act – Section 504  Protects persons with disabilities from being excluded from participation in any program or activity receiving federal funding  A 504 plan may be written to specifically state the accommodations necessary to meet the student’s needs at school.

4. Diabetes at School Self-care by the student: In accordance with the student’s individualized health plan, a school shall permit the student to attend to the management and care of the student’s diabetes, which may include: Performing blood glucose checks Administration of insulin Treating hypo and hyperglycemia Student can be in possession of supplies Management of the disease in the classroom, on school grounds and at any school related activity

5. Diabetes at School “ Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both.” (American Diabetes Assoc. 2003)

6. Diabetes at School Diabetes means “to run through” in Greek Mellitus means “honeyed” in Latin Diabetes Mellitus translates as excessive, sweet urine.

7. Diabetes at School Diabetes is a serious, chronic disease that impairs the way the body uses food. In diabetes, the pancreas does not make insulin or the body cannot use the insulin properly.

8. Diabetes at School As a result, diabetics must carefully balance Food…..Medications…..Activity Levels Medications Food Activity Levels

9. Diabetes at School Type IType II Pancreas does not produce insulin Insulin is produced, but not used properly Must receive injectionsDisease may be managed through diet and exercise Most common type among school-age children May need oral medications and/or injections Obesity is considered a high risk factor

10. Diabetes at School Special considerations:  The student may need to visit the nurse during class for management  It is the responsibility of the teacher, student and nurse to ensure testing/medications are administered on time. * most high school students are self care and can treat in class. Please talk with the nurse to find out if your student is self care or requires assistance  Special arrangements should be made for field trips and class parties.

11. Diabetes at School Special considerations:  The student may need to eat a snack in the classroom to maintain targeted blood glucose range. This should be determined by blood testing.  Depending upon maturity, glucose testing may be performed in the classroom. * The nurse has orders from the physician determining if self care is appropriate.

12. Diabetes at School Special considerations:  Quick acting sugar should be available at all times. We are trying to train our older students to carry their own.  A diabetic snack is small and should be quick. Please notify the nurse if you are seeing your diabetic snacking throughout class.

13. Diabetes at School Special considerations:  Students should always have free access to water, allowed to carry a water bottle  Students should have free access to the restroom.  Students should be allowed to go to the clinic at any time.

14. Diabetes at School Special considerations:  Insulin will be administered in the clinic (except in high school, according to DMMP/IHP)  Some students may wear an insulin pump which automatically administers calculated amounts of insulin.

15. Diabetes at School Hypoglycemia… Caused when the body gets too much insulin, too little food, a delayed meal, or more exercise than usual. What to watch for: Light-headedness Irritability Confusion, inability to follow directions Sleeping in class Headache Hunger Shakiness/fainting Low sugar/glucose level

16. Diabetes at School Hyperglycemia… Occurs when the body gets too little insulin, too much food, or too little exercise May be caused by illness and stress What to watch for: Increased thirst Frequent trips to the restroom Blurred vision Fast heart rate, rapid breathing Nausea/vomiting

17. Diabetes at School Treatment: Allow a student with symptoms to go to the nurse Never send a student with symptoms to go to the clinic alone. They can be escorted by another student. Only staff members (RN, Sub RN, UDCA) who are trained in diabetes management should treat a student with symptoms.

18. Diabetes at School Treatment: Hyperglycemia Hypoglycemia Insulin Quick acting sugar Water Emergency treatment Glucose gel Glucagon Juice Snacks Glucose tablets

19. Diabetes at School Untreated symptoms can lead to... EMERGENCIES Hypoglycemia and hyperglycemia can be potentially life threatening if the symptoms are not treated Hypoglycemia may lead to seizures and/or unconsciousness (must be treated with glucagon and 911 called)

20. Diabetes at School Remember to…. Check with your school nurse for questions, concerns regarding your diabetic student Clip the “A Guide to Managing Diabetes at School” to your attendance/grade book for your substitute’s reference Give ADVANCE notice of field trips to your school nurse

21. Diabetes at School Sources: Richardson ISD Texas Diabetes Council American Diabetes Association (ADA) Pediatric Education For Diabetes in Schools (PEDS)