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‹= ;footer›Diabetes in the Schools
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Diabetes Care T= asks at School:
What K= ey Personnel
Need to Know
DIABETES BASICS
This training is based on and should be used in conjunction with  “Helping the Student with Diabetes Succeed: A Guide for School Personnel”, a guide developed = by the National Diabetes Education Program (NDEP), which is a federally sponsored partnership of the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention and over 200 partner organizations. Training participants should read the NDEP  guide prior to this training in = order to gain a full understanding of the requirements of appropriate school diabetes care. Participants should have a copy of the guide during this training and for future reference.
Some Key points about the overall training:
Overall objective: The overall goal is to optimize both health and learning f= or students with diabetes by providing diabetes care training to school nurs= es and to other school personnel about how and when to perform routine and emergency diabetes care tasks for students. Completion of training will h= elp prepare school personnel to perform diabetes care tasks.
Rationale: The school nurse, when available, is the most appropriate person in the school setting to provide care for a student with diabetes. However, many schools do not have full-time nurses. Even for schools that do, the nurse= may not always be available during the school day, during extracurricular activities, or field trips, etc., to assist with routine care and emergen= cy care, so trained non-medical school staff members must be available to provide coverage.

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2
= Overall Goal:
Optimal Student Health and Learning<= /span>
Exercise
Legal
Rights
Glucagon
Administration
= Health
= &
= Learning
Nutrition=
Insulin
Regimen
Ket= ones
Monitoring
Blood Glucose
= 3;
Hypoglycemia= & Hyperglycemia
This training component is one of eight components created
specifically for school nurses and  non-m= edical school personnel who
perform diabetes care tasks at school.

 These components are:

•Diabetes Basics
•Hypoglycemia and Hyperglycemia
•Blood-Glucose Monitoring
•Insulin Administration
•Glucagon Administration
•Ketone Testing
•Nutrition and Exercise
•Legal Considerations


This unit is Diabetes Basics.
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H7DHV3c5EHn5l61Thh6ol0DEcCW3TcVncli7t17tRZ7u1UBVohCGyEAct4jFQSr2tV/1JZ/VxzKK UnOQ2TI82Jli9IMFYUaTCFSmcX69dhDkBylzKIBIyX6sJRgGIWYepp0LmCUd1hBRmZou821WGJv9 1l4okSpG6BBZqTyKmRLVVyoPgYDD+ROp16Iu+qIRyE3GyXOu0ZGBlaDgwSEliIOSYWwxuhzAxV7s FSLWd18sU19PiBvgl3oEUmno92ARVqAx0mmg4WkeNiAC9AAOQHzxkhABAQA7 ------=_NextPart_01C9D482.22ED16D0 Content-Location: file:///C:/8A4B30D3/diabeticbasics_files/slide0069.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" PowerPoint Presentation
3
Learning Objectives
4Participants will learn:
4What is diabetes?
4Why care at school is required
4Basic components of diabetes care at school =
4Short and long term consequences of diabetes = ;
4
Our objectives are to learn the following:
•What&n= bsp; is diabetes?
•Why care at school is required.<= br>
• Basic components of diabetes care at s= chool
•Short and long term consequences of dia= betes
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4
What is Diabet= es?
●Body does not make or properly use insulin:
<= span style=3D'mso-special-format:bullet;color:#3F0066;position:absolute;left:-4= .31%; top:.61em;font-family:Wingdings;font-size:60%'>lno insulin production
<= span style=3D'mso-special-format:bullet;color:#3F0066;position:absolute;left:-4= .31%; top:.61em;font-family:Wingdings;font-size:60%'>linsufficient insulin production
<= span style=3D'mso-special-format:bullet;color:#3F0066;position:absolute;left:-4= .31%; top:.61em;font-family:Wingdings;font-size:60%'>lresistance to insulin’s effects
<= span style=3D'font-size:56%;visibility:hidden'>●<= /span>
●No insulin to = move glucose from blood into cells:
<= span style=3D'mso-special-format:bullet;color:#3F0066;position:absolute;left:-4= .31%; top:.91em;font-family:Wingdings;font-size:50%'>lhigh blood glucose means:
h<= /span>fuel loss.  cells starve
h<= /span>short and long-term complications
<= span style=3D'font-size:94%;visibility:hidden'>l
Diabetes is a chronic disease in which the body does not make or properly
use insulin, a hormone that is needed to convert sugar, starches, and other
food into energy by moving glucose from blood into the cells.

People with diabetes have increased blood glucose (sugar) levels for one or
more of the following three reasons:  Either
1.No insulin is being produced,
2.Insulin production is insufficient,  and/or
3.The body is resistant to the effects of insulin.

As a result, high levels of glucose build up in the blood, and spill into the<= /font>
urine and out of the body. The body loses its main source of fuel and cells
are deprived of glucose, a needed source of energy.  High blood glucose
levels may result in short and  lon= g term complications over time.




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5


 Type 1 Diabetes
=
=
<= span style=3D'font-size:81%'>·auto immune disorder
<= span style=3D'font-size:81%'>·insulin-producing cells destroyed
<= span style=3D'font-size:81%;visibility:hidden'>·
=
<= span style=3D'font-size:121%'>·age of onset: usually childhood, young  adulthood
=
·d= aily insulin replacement necessary
=
·most prevalent type of diabetes in children and adolescents
Type 1 Diabetes
Type 1 diabetes is a disease of the immune system, which is the body’s sys= tem for fighting infection.

In people with type 1 diabetes, the immune system attacks the beta cells, the insulin-producing cells of the pancreas, and destroys them.

The pancreas can no longer produce insulin, so people with type 1 diabetes ne= ed to take insulin daily to live.

Type 1 diabetes can occur at any age, but the disease develops most often in children and young adults.

Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States.




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hSYMPTOMS:
h
Type 1 Diabetes
lincreased urination =
ltiredness
lweight loss
CAUSE:
uncertain, likely both genetic and environmental factors
increased thirst = <= /b>
hunger
blurred vision
ONSET:
relatively quick
Symptoms.  The symptoms of type 1 diabetes usually develop over a short period of time.  They include increased thirst and urination, constant hunger, weight loss, and blurred vision.  Children may also feel very tire= d all the time.  If not diagnosed = and treated with insulin, the person with type 1 diabetes will eventually lap= se into a life-threatening condition known as diabetic ketoacidosis (KEY-toe-asi-DOE-sis) or DKA.

Risk factors.  Though scienti= sts have made much progress in predicting who is at risk for developing type 1 diabetes, they do not know exactly what triggers the immune system’s attack on beta cells.  They believe that type 1 diabetes is due to a combination of genetic and environmental factors.
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Type 2 Diabetes
=
<= span style=3D'mso-special-format:bullet;color:#3F0066;position:absolute;left:-7= .24%; font-family:Symbol'>·Insulin resistance – first step &= #13;
<= span style=3D'mso-special-format:bullet;color:#3F0066;position:absolute;left:-7= .24%; top:.1em;font-family:Symbol'>·Age at onset:
<= span style=3D'font-size:113%;visibility:hidden'>·
=
·Most common in adults
·Increasingly common in children
·overweight
·inactivity
Type 2 Diabetes
The first step in the development of type 2 diabetes is often a problem with = the body’s  response to in= sulin, called insulin resistance.  = This means that the body needs increasing amounts of insulin to control blood glucose.  The pancreas tries= to make more insulin, but after several years, insulin production may drop o= ff.

Type 2 diabetes used to be found mainly in adults who were overweight and over a= ge 40.  Now, as more children a= nd adolescents in the United States become overweight and inactive, type 2 diabetes occurs more often in young people. Many people with type 2 diabe= tes are overweight.


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hSYMPTOMS:
h
ONSET:
Type 2 Diabetes
= hsome children show no = symptoms at diagnosis <= /span>
in children
variable timeframe
tired, thirsty, hunger, increased urination <= /span>
Onset in children:  variable timeframe.  Some children de= velop type 2 diabetes rather quickly, other more slowly.
Some symptoms similar to type 1:
Tired, thirsty, hunger, increased urination

Some children show no symptoms at diagnosis.
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9
Diabetes is Managed,
But it Does Not Go Away. <= /div>
●GOAL:
To maintain ta= rget blood glucose
Whether we consider type 1 or type 2 diabetes, the goal of effective diabetes management is to control blood glucose levels by keeping them within a ta= rget range that is individually determined for each child.  Optimal blood glucose control he= lps to promote normal growth and development and allows for optimal learning.  It is also needed to prevent the immediate dangers of blood glucose levels that are either too high or too low. Research has shown that maintaining blood glucose levels within the target range can prevent or delay the long-term complications of diabetes such as heart attack, stroke, blindness, kidney failure, nerve disease, and amputations of the foot or leg.

When insulin is no longer made, it must be obtained from another source--insul= in shots or an insulin pump.  A= ll people with type 1 diabetes must take insulin. People with type 2 diabetes use diet and exercise, and oral medications, and/or insulin to manage the= ir disease.  Neither insulin nor other medications, however, are cures for diabetes: they only help control the disease.



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10
● Co= nstant Juggling:
●
● Insulin/medication
¡
¡ with: <= /i>
¡
¡ Exercise
¡
¡      Food intake
= Diabetes Management 24/7
BG
BG
BG
&= ;
Maintaining good blood glucose control is a constant juggling act, 24 hours a day, 7 = days a week.

The key to optimal diabetes control is a careful balance or juggling of food, exercise, and insulin and/or oral medication.
•As a general rule, insulin/oral medicat= ion and exercise/activity makes blood glucose levels go down.
•Food makes blood glucose levels go up.<= /font>
•Several other factors, such as stress, = illness or injury, also can affect blood glucose levels.





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