School

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The information in this section is to provide your child’s school with some information on diabetes in general.  A pdf version of this section is available to download if you would like to provide the school with some written information. 

The Diabetes Out There team will also provide training of School Staff.

Parents/guardians are responsible for ensuring school has supplies for blood glucose checking and insulin administration and they will provide current information regarding day-to-day changes in diabetes care.

What is diabetes?

Diabetes is a metabolic condition characterised by high levels of glucose (sugar) in the blood.

Difference between Type 1 and Type 2 Diabetes

Type 1 Diabetes is an autoimmune condition in which the body has destroyed the cells that produce insulin. Insulin is a hormone that controls the amount of glucose that is in the blood. This means a person with Type 1 diabetes must monitor their blood glucose level throughout the day and have insulin administered by injection or pump regularly in order to keep well.
 
Type 2 Diabetes – Insulin is still produced but the body is not able to use the insulin effectively, or it may not produce enough. People with Type 2 diabetes can often treat the condition with dietary changes and/or oral medications, but sometimes insulin injections are also required. People with Type 2 diabetes generally do not need to administer insulin.
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Diabetes and Diet

Children and young people with diabetes are encouraged to follow a normal healthy diet.  Regular meals are important and each meal should contain carbohydrate.
 
Blood glucose rises when we eat carbohydrate. In a person without diabetes insulin is released into the blood, and the rise in blood glucose is counterbalanced by insulin to control blood glucose levels in the normal range (between 4-7 mmol/l).

A person with Type 1 diabetes has to inject insulin every time they eat to achieve the same result.
 
Checking and monitoring blood glucose is an essential part of daily management for a person with diabetes. Children and young people in school usually require support to enable them to achieve this. The level of support required depends on the age and/or ability of the young person and this varies from a designated adult in school doing or supervising the check, to providing a private space for the child to do the measurement themselves.

Blood glucose levels should be monitored before eating main meals. This provides information about glucose levels and allows parents/guardians or the young person themselves to decide if any alterations are needed to insulin doses or food eaten.

In addition to mealtime checking, young people need to be able to check if they feel unwell, have symptoms of low blood glucose, after treating a low blood glucose and sometimes when participating in exercise sessions. Exercise has an effect on blood glucose levels. It can initially raise levels and then cause them to fall later in the day. The effect is individual and depends on the type and duration of exercise.

Therefore it is important that young people with diabetes are allowed access to blood checking equipment at all times during the school day, and are given the necessary support when this is required.

The aim of diabetes treatment is to keep blood glucose levels within the target range as much as possible. During the school day this is between 4 mmol/l and 7mmol/l. Sometimes this is not possible and this results in low blood glucose levels (Hypoglycaemia) or high blood glucose levels (Hyperglycaemia).
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Hypoglycaemia (Low Blood Glucose)

Hypoglycaemia is a blood glucose reading below 4mmol/l.  Common symptoms of hypoglycaemia include feeling hungry, shaky, dizzy, sweaty, irritable, sleepy, looking pale with difficulty concentrating or speaking. Speech may be slurred and movements uncoordinated.

When symptoms of low blood glucose are suspected the level should be confirmed using the blood glucose meter.

It is important to treat a low blood glucose level as quickly as possible. The treatment is with quick acting sugar. Examples are sugary juice (not diet drinks), glucose tablets, gels, fruit juice or fruit pastilles etc. Delaying treatment coupled with falling blood glucose levels results in increased drowsiness and a decreasing conscious level. The young person should be encouraged to sit down and treatment should be brought to the young person, they should not be sent alone to get it.

A “hypo” box with treatment should be kept in the classroom and taken with the pupil to the gym hall (depending on distance) and on school trips etc.

Normal activity can usually resume 10-15mins after treatment. However the blood glucose level should be rechecked first to ensure it has come up to the target range and the hypo treatment repeated if blood glucose remains below 4mmol/l.

In very rare cases where a hypo has not been detected and the pupil has become unconscious, perform basic first aid, put the child in the recovery position, and phone 999 for emergency care.
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Hyperglycaemia (High Blood Glucose)

The target level for blood glucose is 4-7 mmol/l. If blood glucose is consistently above this range, then it is worthwhile communicating this to parents/guardians. If blood glucose is greater than 14 mmol/l (hyperglycaemia) then intervention is required.

Hyperglycaemia for short periods does not require emergency treatment but prolonged high levels can result in the production of ketones in the blood. The presence of ketones in the blood is worrying and raised ketone levels will make the young person feel unwell. This can result in hospital admission and prolonged high blood glucose levels are not good for long-term health.

In school, frequent high levels should be communicated to parents/guardians and if the young person feels unwell they should be sent home as per school policy regarding illness. Children and young people with diabetes should not miss any more school than their peer group.

Common symptoms of high blood glucose are – feeling thirsty, lethargic, irritable, difficulty concentrating, excessive thirst, increased need to go to the toilet.
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Insulin

Insulin can be given either by injection or by an insulin pump.

If the young person has an insulin pump further training will be given regarding this.

Insulin injections are given with an insulin pen device and in school this would be at lunchtime. The insulin given is fast acting and should be given just before eating and no longer than 10 minutes before eating.

With a little planning, a child with diabetes should be able to participate in all the activities of his or her peers. This is important psychologically for many reasons. If there are any concerns, then either the child’s family or the dotTayside will be only too happy to help.
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Care Management Plan

Please download and complete a care management plan for your child that you can share with the school.  A member of the team can help you with this.  The form can be completed and shared electronically, or printed and filled in by hand.

Click here for a care management plan
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