Diabetic Information for Nathan Houston

Nathan (Nate) has Type 1 Diabetes.

WHAT IS IT? This disease occurs when the bodys immune system attacks and destroys the insulin producing cells (beta cells) located in the pancreas. Insulin is a hormone that helps the body move glucose (sugar) contained in food into cells throughout the body. The cells need glucose for energy. But when the beta cells are destroyed, no insulin can be produced and glucose stays in the blood instead. If glucose stays in the blood stream it can cause serious damage to all the organ systems of the body. WHAT DOES IT MEAN FOR YOU? The important thing to remember is that Nate is a healthy, happy, normal child. Caring for him requires a little extra knowledge to get him through each day safely with good blood sugar control. WHAT IS THE TREATMENT? Nate receives Insulin via an Insulin pump 24 hours a day. This type of therapy requires frequent blood sugar checks (every 2-3 hours during the day and every 3-4 hours through the night). EMERGENCY SITUATIONS: Everyone caring for Nate (including specials teachers and substitute teachers) must be aware of low and high blood sugar signs and notify the school nurse (or designated persons) promptly, so that Nates blood sugar number can be checked and then treated accordingly. LOW BLOOD SUGAR: The only emergency that could come on quickly is LOW BLOOD SUGAR. This can occur if the child gets more exercise than usual, does not eat as much as usual, or receives too much insulin, is ill, or is stressed, etc. The warning signs of low blood sugar vary, but include any of the following: 1. 2. 3. 4. 5. 6. 7. 8. Hunger Paleness, sweating, shaking Eyes appear glassy, dilated or big pupils Personality changes such as crying or stubbornness Headaches Inattention or drowsiness Weakness, irritability, or confusion Speech and coordination changes

If not treated: LOSS OF CONSCIOUSNESS, SEIZURE, BRAIN DAMAGE, DEATH When Nate is low his signs have been fairly subtlesometimes he will tell you he needs juice or a snack, he will complain of hunger, or he will appear extremely pale or greenish. If Nate complains of being low, of hunger, or appears pale his blood sugar must be checked promptly. Nate must be accompanied by an adult at all times when his blood sugar is low.

TREATMENT: Give SUGAR to help the blood sugar rise. Glucose tablets, Smarties, apple sauce and juice boxes will be kept in the health office and in Nates diabetes care kit that will be kept with Joe at all times. IF BLOOD SUGAR: Is less than 80 GIVE: 3 Glucose Tablets, OR 2 Packages of Smarties, OR 1 Juice Box, Or 1 Apple Sauce 2 Quick Sticks

Nate likes variety. He does not like to treat his low blood sugar with the same form of quick-acting carbohydrate every time he goes low. Only using apple juice to treat a low, for example, is like eating the same sandwich every single day for lunch. Thus, we give him the following options: juice, Smarties, glucose tablets, Quick Sticks and apple sauce. After treatment wait 10-15 minutes and recheck the blood sugar. Nate should not eat anything during this time, as other foods can slow down the absorption of the sugar into his system. If his blood sugar is less than 80 repeat the above steps (ie: give more sugar and wait an additional 1015 minutes to recheck the blood sugarkeep doing this until his blood sugar is greater than 80). IF NATE IS UNCONSCIOUS OR HAVING A SEIZURE/OR UNABLE TO TAKE SOMETHING BY MOUTH: 1. 2. 3. 4. 5. Have someone call 911 and then parents Give Glucagon (medication in the red container). Give .50 mg (1/2 of the medication) into the front of Nates thigh. Roll Nate on his side (This medication may cause vomiting). Turn insulin pump off (remove pod from Nates body simply peel off of his person) Wait 10 minutes and then check blood sugar. Give sips of juice, once Nate is conscious.

HIGH BLOOD SUGAR: People with diabetes may have high blood sugars and spill extra sugar into the urine on some occasions. These occasions include periods of growth, stress, illness, overeating and/or lack of exercise, medications, etc. High sugars are generally not an emergency (unless accompanied by abdominal pain or vomiting or if they persist for a prolonged period of a few hours). High blood sugar signs and symptoms can include: 1. 2. 3. Mild: Thirst, frequent urination, sweet breath Moderate: Dry mouth, nausea, stomach cramps Severe: Labored deep breathing, extreme weakness, confusion, and eventually unconsciousness (coma).

TREATMENT: Call parents for blood sugar greater than 250. Extra insulin may need to be given by the school nurse. Nate will need to drink sugar free fluids and urinate more frequently. Test Nate for ketones via Blood Ketone Meter. Please allow him to consume as much water as he wants and make bathroom privileges readily available.

WHEN TO CHECK BLOOD SUGAR? The School Nurse (or designated persons) will check Nates blood sugar before morning snack, before recess, and anytime Nate appears or complains of being LOW. WHAT SHOULD NATE EAT? I will pack Nates snacks and label the items with carb counts. If he doesnt eat his entire snack the insulin dose he received will be too much. He could become low within the following couple of hours. Also, it is important that Nate is not given food without the school nurses or parents knowledgehe would need extra insulin or he can have a high blood sugar in the next couple of hours. WHAT TO EXPECT FROM PARENTS? I (Laura) will always have my cell phone on my person and am fully expecting a call (re: low blood sugar/not acting right/high blood sugar/pump questions/etc) whenever the school deems it necessary. WHEN TO CALL PARENTS? Nates pod alarms or comes off Blood sugar is less than 60 Blood glucose exceeds 250 He has ketones Becomes nauseated, or if he begins vomiting He is injured

MEDICATION INFORMATION: Please see Pump Therapy orders for Insulin to Carbohydrate ratios, Insulin Sensitivity factor, and Basal Rates. Nates parents are fully trained in diabetes self management. Parents may adjust pre-snack insulin dosage, ratio, insulin sensitivity factor or basal rates as parents deem necessary. Parents will communicate insulin changes to school personnel.

PHONE NUMBERS: Laura (Mom)

James (Dad)

Cheryl (Grandmother)

(OmniPod)

(OmniPod)

Diabetes Educators/CMC

Parent Signature: ___________________________ Date: ______________________

Physician name: __________________ Physician Signature:___________________ Date: ______

Childrens Medical Center * Endocrinology Center * 1935 Medical District Drive * Dallas * TX * 75235