Diabetes Management at School

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Diabetes Management at School
American Diabetes Association

Effective diabetes management at school has numerous positive outcomes. It can:

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Promote a healthy, productive learning environment for students with diabetes
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Reduce absences of students with diabetes
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Reduce classroom disruption
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Help assure effective response in case of diabetes-related emergency
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Promote full participation in all areas of school curriculum and extra-curricular activities

Diabetes Control

The key to good diabetes control is a careful balance between food, exercise, and insulin. It's a juggling act to keep blood glucose levels within the target range. In a nutshell, food makes blood glucose levels go up, and exercise and insulin make blood glucose levels go down. People with diabetes have to check their blood glucose levels throughout the day using a blood glucose meter. The meter tells them how much sugar (glucose) is in their blood at that time, and they take insulin, eat, or modify activity to try to stay within their target range.

Hyperglycemia (high blood glucose) occurs when blood glucose levels are above the target range. Everyone has moderate hyperglycemia every now and then. In people with diabetes, hyperglycemia can be caused by skipping an insulin dose, using bad or expired insulin, or if there is a clog in insulin pump tubing. When blood glucose levels are high a lot or when the level is extremely high, the consequences can be very serious. Very high blood glucose levels can lead to diabetic ketoacidosis ("DKA"), or a "diabetic coma."

Hypoglycemia (low blood glucose) occurs when blood glucose levels are below the target range. Hypoglycemia can be caused by taking too much insulin, skipping a snack, too much exercise, or a combination of the three. Hypoglycemia can lead to dizziness, sweating, headaches, confusion, and unconsciousness. For these reasons, it's important that children with diabetes stick to their scheduled blood check, insulin injection, and snack times. Even small deviations from their diabetes care plan schedule can cause problems in blood glucose levels.

Diabetic Ketoacidosis ("DKA") occurs when the cells can't get the energy they need from glucose. They begin burning fat and other body tissues for energy. This causes the release of byproducts, called ketones. Small amounts of ketones are probably not harmful, but the fat burning that occurs when there's no insulin can cause dangerous levels of ketones. Ketones become like poison to the body. They build up in the blood and spill over into urine. Symptoms of diabetic ketoacidosis -- when there are too many ketones in the blood -- appear.
Three Elements of a School Plan

Your school may have different names for the written document(s) that make up a diabetes care plan. There are the three elements that should be included in the diabetes packet the parent gives to you (or the principal):

Information packet. The child's parent should put together a diabetes information packet. This packet may contain various brochures and articles with general information on diabetes. It should include information on what diabetes is and how it's treated, what hypoglycemia and hyperglycemia are and how they're treated, and anything else that will help you and the other school staff gain a better understanding of diabetes.

Health Care Plan. This plan should outline the child's diabetes treatment -- his target blood glucose range, insulin schedule, eating plan, and usual blood glucose testing times. It should also include instructions on what to do in various situations (treatment for hypoglycemia, for example). This information may be included in the Diabetes Care Plan instead of as a separate document, depending on the procedures in your state or school.

Diabetes Care Plan. This plan is often called a "504 Plan" or "IEP" after terminology used in federal laws on disabilities (see above for more details). The child's diabetes care plan should cover the responsibilities of both the parent and the school in specific detail. It should also list any accommodations that may need to be made for the child. Download a sample 504 plan.