1. Diabetes Caring for children with diabetes in a community program 2013-06-26

2. Diabetes Type 1 –Pancreas is unable to produce insulin –Daily insulin injections required Type 2 –Pancreas does not produce enough insulin or body does not effectively use insulin –Insulin may be required Lack of insulin - used to transport glucose from the blood into cells

3. Management of Diabetes Insulin FoodExercise

4. Food Eat same amount of food (carbohydrates) each day Eat same time each day No trading or disposing of food Plan for special events

5. Needle & syringe Insulin pen Insulin pump Community program personnel are not responsible for giving insulin Insulin

6. Exercise Regular exercise helps lower blood glucose levels Plan for vigorous physical activity –Sports or other physical activities that take place during meal time require extra planning –Notify parent/guardian of days that involve extra physical activity

7. 7 Hypoglycemia (low blood glucose) Blood glucose below 4 mmol/L Emergency situation Can happen within minutes Possible causes –not eating enough food –missing or delaying a meal –more physical activity than usual –taking too much insulin

8. 8 Signs of Hypoglycemia Cold, clammy or sweaty skin Shakiness; lack of coordination Irritable, hostile, poor behavior Tired Sudden moodiness or behavior change Difficulty concentrating, confusion Staggering gait Child may complain of –nervousness –excessive hunger –headache –blurred vision –dizziness –abdominal pain or nausea Fainting, unconsciousness

9. 9 Responding to Hypoglycemia 1.Give child fast-acting sugar. 2.Wait 10-15 minutes. If no improvement, give another fast- acting sugar. 3.Wait 10-15 minutes. If no improvement after 2nd treatment, call parent/guardian. 4.If unable to contact parent/guardian or emergency contact, call 911/EMS. IF IN DOUBT, TREAT!

10. If child seizures or becomes unconsciousness 1. Call 911/EMS. 2.Put child in side lying position. 3. Notify parent/guardian. DO NOT give food or drink DO NOT leave the child alone 10 Severe hypoglycemia

11. 11 Hyperglycemia (high blood sugar) Blood glucose higher than child’s target range Not an emergency situation Possible causes –too little insulin –too much food –less than the usual amount of activity –illness –stress

12. 12 Signs of Hyperglycemia –increased thirst –tiredness –urinating more often Inform parent/guardian as directed in child’s health care plan.

13. 13 When Child is Sick 1.Contact parent/guardian. 2.If child is vomiting and cannot retain food/fluids and parent/guardian or emergency contact cannot be reached, call 911/EMS.

14. Child specific information Type of diabetes Location of fast acting sugar Plans for meals, exercise, special events and blood glucose monitoring Health Care Plans are located in child file and binder