1. Diabetes affects more than 20 million Americans. Over 40 million Americans have pre-diabetes (early type 2 diabetes).

2. There are three major types of diabetes Type 1 diabetesType 1 diabetes is usually diagnosed in childhood. Many patients are diagnosed when they are older than age 20. In this disease, the body makes little or no insulin. Daily injections of insulin are needed. The exact cause is unknown. Genetics, viruses, and autoimmune problems may play a role. Type 2 diabetesType 2 diabetes is far more common than type 1. It makes up most of diabetes cases. It usually occurs in adulthood, but young people are increasingly being diagnosed with this disease. The pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to insulin. Many people with type 2 diabetes do not know they have it, although it is a serious condition. Type 2 diabetes is becoming more common due to increasing obesity and failure to exercise. Gestational diabetesGestational diabetes is high blood glucose that develops at any time during pregnancy in a woman who does not have diabetes. Women who have gestational diabetes are at high risk of type 2 diabetes and cardiovascular disease later in life.

3. Several things happen when food is digested. The Normal Process by which food is broken down and used by the body for energy is as follows: A sugar called glucose enters the bloodstream. Glucose is a source of fuel for the body. An organ called the pancreas makes insulin. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used as fuel. This is not the case for people with diabetes. People with diabetes have high blood sugar. This is because: Their pancreas does not make enough insulin Their muscle, fat, and liver cells do not respond to insulin normally or Both of the above

4. Causes and Symptoms

5. Type 1 Type I diabetes can come from many causes however it is usually brought on from a serious illness such as: Strep throat Urinary tract infection Measels Rubella Type 2 The causes for Type 2 diabetes are very similar to Type 1 however there is a difference between the two. With type 2 diabetes your body usually does not respond to insulin making you insulin resistant. As a result of that your blood sugar does not get into the cells to be stored for energy.

6. Type 1 Unexplained weight loss Excessive thirst Excessive urination Excessive eating Poor wound healing Infections Altered mental status Blurry vision Patients with type 1 diabetes usually develop symptoms over a short period of time. The condition is often diagnosed in an emergency setting. Type 2 Increased Hunger Areas of darkened skin Poor wound healing Fatigue However, because type 2 diabetes develops slowly, some people with high blood sugar experience no symptoms at all. There are many symptoms of diabetes to be aware of:

7. Treatment of Type 1 Diabetes Insulin – Insulin is used to control glucose levels. There are 2 different kinds of insulin – Long acting-usually given at home before bed. Long acting insulin levels blood sugars out for the entire day. – Short acting- given throughout the day and as needed. Testing – Testing is very important because it allows the person with diabetes to know how much insulin is needed and can lower the risk of low blood sugar due to overdosing. Doctor Visits – Meeting with an endocrinologist every 3 months is also important. They will test your Hemoglobin A1C level, which is the average blood sugar since the last appointment. Eating Healthy and Exercising – Eating a healthy diet and getting plenty of exercise can help maintain blood sugar levels. Staying hydrated is also very important. Treatment of Type 2 Diabetes Diet – Eating a balanced diet of fiber, carbohydrates, salt and fat is important – A dietician will help make a food plan especially for the person Exercise – Exercise can help manage hyperglycemia Oral Diabetes Medications – Children rarely use any type of these medications

8. Precautions to take with children with type 1 diabetes Medical Supplies – ALWAYS be sure that the student has proper medical supplies. If they are running low on syringes, strips, or insulin notify their parents before all of the supplies are gone. – During class trips/ field trips, be sure to pack extra syringes, insulin, strips, juice and crackers in case of any

9. Precautions to take with children with type 1 diabetes Hypoglycemia (low blood sugar) – When a student has a low blood sugar it is VERY important to treat it immediately!!! – Children with diabetes might not know how a low blood sugar would feel like so if the student is acting weird, ask them about how they are feeling just in case. – If a student has a low blood sugar, either walk the student to the nurses office for treatment or call the nurse and have her come to the classroom. NEVER let a student with a low blood sugar leave the room by themselves. – Common signs of a low blood sugar are: shaking, sweating, dizziness, fatigue, weakness, headache, and irritability. – Causes of low blood sugar- too little food, too much insulin, or extra activity. – Hypoglycemia happens suddenly and if left untreated, may result in insulin shock which can cause the person to become confused, drowsy, lose consciousness or even die. – To treat low blood sugar – Drink 4 ounces of juice or regular soft drink – Have the student wait 20 minutes and retest after treatment. If still low, contact the parent. – After blood sugar has raised, give 4 ounces of milk to help keep blood sugar from dropping again.

10. Precautions to take with children with type 1 diabetes Hyperglycemia (high blood sugar) – If a student is high, it is important to treat as soon as possible. – High blood sugars can in some ways be easier to detect. – Common signs of high blood sugar are: extreme thirst, frequent urination, blurred vision, drowsiness, feeling nauseated, irritability, and restlessness. – Causes of high blood sugar- too much food, too little insulin, illness or stress. – Hyperglycemia usually happens slowly over a few hours or days but can be quickly onset and can progress into dehydration, DKA (diabetic Ketoacidosis), diabetic coma or death. If hyperglycemia is left untreated for months or even years, more serious effects like nerve damage, kidney damage, loss of eyesight or stomach problems. – Being out of the child’s usual routine can cause changes in their blood sugars, so always be prepared. – To treat high blood sugar: Use the child’s sliding scale to give insulin doses if they have one. Allow the student to drink plenty of water in order to flush out the sugar in the urine which could cause DKA. Check for ketones, if ketones are present, notify the parent and do not allow to exercise. Retest frequently

11. Diagnosed with Diabetes Now What

12. Reactions to Diagnosis Denial- nothing is wrong, I’m just tired, or I haven’t been eating right, it will be fine. Fear- My life is over. No, it is not, it is just changing a few habits. Guilt- It’s my fault that she/he has it. It just happens sometimes without anyone being “at fault”. Anger- Why me, what did I do to deserve this. This is a common reaction and can be the first sign of acceptance and the ability to get treatment.

13. Moving on With Life Learning to treat the disease and the person separately. Learn to laugh, and where to get support. Laughing can actually lower glucose levels. Positive thoughts have positive effects. A sense of humor can help you get a handle on the how and when you need medication or food.

14. Get maintenance education from the healthcare professionals in how to care for your eyes, feet, health (add exercise plan), nutrition, medications (some medications and supplements are not for diabetics), and proper treatment of your type of Diabetes. Do you have Type 1 or Type II, treatments may differ. Also, at the American Association of Diabetes website, there are ways offered to deal with this disease. www.diabetes.org