Diabetes (Type 1), Part 3 — Education, Restrictions, and Implications for School

Education

Q: "How do you eat an elephant?"
A: "One bite at a time!"

Education is critical in managing diabetes. Whether you are the person with diabetes or you are caring for a loved one with the disease, the message is the same: learn, learn, learn. Learn how diabetes affects the body; how it can be managed; how to avoid both immediate and long-term problems; and how to balance life, exercise and diabetes. The task seems daunting, but it is essential.

Basic survival skills for people with diabetes and those who care for them:

  • know how to recognize and treat hypoglycemia, or low blood sugar
  • know how to recognize and treat hyperglycemia, or high blood sugar
  • know how to do good meal planning
  • know how to administer insulin
  • know how to monitor blood glucose and urine ketones
  • know how to adjust insulin and food intake during exercise
  • know how to handle sick days
  • know where to buy diabetic supplies
  • know how to store the supplies
  • know when to call for help

Possible side effects of medication

Insulin is the medication that is used to treat diabetes. The main complications are from getting too much or too little insulin. These situations can cause hypoglycemia and hyperglycemia, and are discussed on the previous page.

Antibiotics might be given to help fight off an infections. These medicines can have their own side effects, such as stomach ache, upset stomach, diarrhea or a rash. Discuss with the doctor any expected side effects, and when to call with any concerns.

Dietary, physical and other restrictions

Diet is key to managing diabetes.

The cornerstone of good diabetes maintenance lies in diet management. Consistent and predictable food intake promotes proper balance between insulin need and dosage. Good balance yields steady blood glucose levels, which help maintain good health, both immediately and in the long term. Excessive consumption of foods that are high in sugars and other simple carbohydrates must be restricted for people with diabetes.

Consultation with a registered dietician or a nutrition counselor is very beneficial to people with diabetes. The American Diabetes Association, along with the American Dietetic Association, developed six food exchange lists that provide assistance and guidance when planning meals.

Physical activity is another important component of good diabetes management. Regular exercise helps control the amount of sugar in the blood and burns excess calories and fat, which helps achieve optimum weight. Special precautions must be taken by those with type 1 diabetes before, during and after participation in intense physical activity. Consult your physician before beginning any exercise program.

Implications for school

Diabetes at school.

Because of the complexity of managing type 1 diabetes, there can be significant school implications for a child with this diagnosis. The key to success lies in the education of school staff and peers regarding type 1 diabetes. The school nurse will play a vital role coordinating services and care for the student, and educating other staff members who work with the student. Suggested guidelines include:

  • communication between the teachers, the nurses, the student, the parents and health care providers is essential to ensure that all medical directives are understood and followed
  • blood glucose measurements at school should be supervised and recorded by the nurse or another designated school staff member
  • peers should be educated about diabetes and how they can support their friend with this diagnosis
  • physical education should be tailored to the individual needs of the student, weighing the need for physical activity against any restrictions or modifications recommended by the child's healthcare team
  • if the student experiences symptoms of hypoglycemia or signs are noticed by the teacher, the child should proceed to the nurse's office immediately, and if a nurse is not available, notify the parents immediately
  • school functions, such as birthday parties, should always include non-sugared alternative treats for the diabetic student
  • because infection might indicate that blood sugar levels are out of balance, the parent should be notified immediately if the child shows signs of infection
  • if the student is ill and must miss school, provide special attention to ensure all missed lectures and assignments are completed
  • because diabetes is a chronic illness, frequent absences due to illness or medical appointments should be expected; allowances should be made to avoid academic deficits and future school challenges

For more information, see:

Part 1 — Introduction, Incidence, Symptoms and Complications

Part 2 — Treatment and Monitoring

American Diabetes Association

ATTN: National Call Center
1701 North Beauregard Street
Alexandria, VA 22311
http://www.diabetes.org/

Contributed by:

Kathy Davis, MSEd, PhD
Associate Professor
Project Director, Connected Kansas Kids
Director, KU Kids Healing Place
University of Kansas Medical Center