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Diabetes Positive Approach, Issue #1306-- Cope with Diabetes; Live Healthy
June 04, 2013
How can we do this? Well research has shown that the way we look improves our self-confidence and gives us a better self image. We feel good when our appearance is good. So let us dress up once in a while because that is when we can smile a little more, laugh a little louder and enjoy life more.
Diabetes in Children requires that schools be knowledgeable on the care these kids need. Parents will have to work with the school nurse and the teachers to make sure these people know the symptoms of low and high blood sugar levels and what to do in either case. This is part and parcel of the federal law that protects the children with diabetes so they won't be afraid of being denied support from the administrators.
To follow the mandate of the law the school has to provide reasonable accommodation to ensure the children get proper education along with help with some issues that diabetes bring forth into play. The school nurse, for example, may be called upon to administer insulin and check the blood glucose level of the kids.
Some schools have taken on the responsibility to provide a healthy environment for the children. Their cafeterias offer foods that are low in fat and have a high fiber content. This means the meals are rich in whole grains and fruits and vegetables. These schools advocate a healthy mind and healthy body. Hopefully, the children will take these lessons home.
These schools embrace a healthy dose of exercise too and along with the healthy eating which are the methods used to prevent some form of diabetes. They have been tested tried and true in a lot of cases. Some schools even provide yoga lessons in class and have adopted extended periods for recess. What a difference this is from when the authorities tried to cut down on the Physical Education classes. What were they thinking?
Since obesity is rampant and there are more and more overweight children, it is imperative the schools also help out in preventing diabetes as being overweight makes one vulnerable to develop diabetes. The schools were not formed to fight diabetes, that's true, for they are supposed to be schools but educating the whole child should be part of the mission.
Some schools even go all the way out by holding family fitness nights once a week. They also hold regular family meals where they only serve healthy meals. This gives the children a chance to take control of their diabetes, be healthy and at the same time do better in school.
So what should schools do? First, know that diabetes is not contagious. There is no cure just yet but it can be managed with healthy eating, exercise, blood sugar monitoring and injection of insulin. There are two problems that may challenge the teachers. They are low blood sugar or hypoglycemia and high blood sugar or hyperglycemia.
Children with low blood sugar are sometimes, shaky, sleepy, hungry and show erratic behavior. They have to be treated right away by giving them foods with simple sugar like fruit juice, glucose tablets and regular soda. If you think the child has low blood sugar, don't leave him alone as he may lose consciousness.
Children with high blood sugar are sometimes sleepy, lethargic and very thirsty and so have to go to the bathroom a lot. They should be administered extra insulin and given sugar-free drinks like diet soda and water. They must be allowed to go to the bathroom and drink water anytime they need. If this condition is prolonged it could lead to diabetic ketoacidosis that could result in coma and death.
The schools should have a bird's eye view of how diabetes is treated. Type 1 diabetic children are treated with insulin through injection or the insulin pump. The children who need to inject insulin before lunch should be provided with extra time to do so. Those with insulin pumps can take extra insulin as needed.
Diabetic children need to monitor their blood sugar level. Essentially, it is pricking a finger with a lancet and placing a blood drop on the test strip and the meter analyzes the results. The children should be allowed to do this in school. Children who are very young may need supervision. The parents should provide the school with a blood glucose meter, lancing device and lancets, a disposal container and glucose for emergency.
Usually diabetic children follow a meal plan. The parents should provide specific instructions as to what foods to avoid. They should also provide their school children morning and afternoon snacks, usually crackers with peanut butter. If they are not allowed to eat these snacks, they are at a high risk for hypoglycemia. They must be allowed to take emergency glucose to treat hypoglycemia.
Everybody needs exercise but the diabetics face a challenge in this regard. They should be allowed to participate in all gym and outdoor activities but will need to eat a snack before joining in vigorous activities something like 15 grams of carbohydrates for every 30 minutes of activities. They should be allowed to have with them emergency glucose to counter the effect of hypoglycemia.
There you have in a nut shell what schools have to do when it comes to the children with diabetes. We know it is not easy to have to do more than the schools are already expected to do, that is educate the child. The thing is that education does not only involve the mind but rather we aim for the all-round development of every child, including those who have issues on diabetes in children.
Diabetes in children is an issue where schools have a share in the care of these kids while they are in their custody. On the previous page, we discussed the generalities on what schools can do. This time, we will concentrate on specific guidelines contained on one page that every caregiver of a diabetic child should have.
This way if the regular teacher is out, the substitute teacher will be able to take over without having to peruse voluminous material. This information can be easily contained on one page that will ease everybody's mind when it comes to the health and safety of a diabetic child. This is just an example and must be adapted to the needs of the child.
Guidelines for Taking Care of a Diabetic Child: (Name of the specific child here)
When to check the blood sugar level: When the child says he's low while exercising or even after and he is showing symptoms of being sleepy, irritable and giving erratic answers when questioned
What to do as dictated by the blood sugar reading:
For 61 to 100 reading, give one glucose pill and the child can wait if the next snack or meal will come in 30 minutes. If not, then give him a snack of crackers and milk or crackers and peanut butter.
The 101 to 125 reading shows the child is fine. However if exercise or recess is scheduled before a snack or a meal, give him a snack before joining the activities.
The 125 to 200 reading also shows the child is fine and may feel low because of a previous high which is now dropping.
The 201 to 249 reading is a bit high but is usual for this child during the early morning hours.
Over 240 reading is too high so he must be allowed to drink water and other liquids and to go to the bathroom as needed. He should also check his urine for ketones and if this is positive, call the parents or the diabetes care team for advice.
Symptoms are similar so the high and low could be confused.
Note that the following are equivalent when giving sugar:
Milk 1/2 to 1 cup
Regular soda 1/2 can
Fruit juice four oz
Two glucose pills - they come in different sizes but the 10 - 15 grams of sugar is suggested
Cake Mate 1/2 tube which can be placed between gum and cheeks if the child can't swallow
Do not use chocolate candy except in cases where sugar is not available because the fat in the candy makes it not easy to absorb fast enough. If after treatment, the child is still unable to think clearly, call the parents or the diabetes care team for advice. After a low episode, it takes hours to recuperate fully so the child may not perform well in school.
The parents should provide a diabetes bag with everything that is needed for the diabetic child's safety. There are three essentials to be put in this bag.
1. Diabetes Care Plan often called "IEP" or "504 Plan" often used in federal laws on disabilities. This should include both the school and the parents responsibilities in explicit details that should also include any accommodation that may have to be provided.
2. Information Package - The parents of the diabetic child should gather together brochures and articles that provide general information about diabetes, what it is, how it is treated, what are hypoglycemia and hyperglycemia and how they are treated. The parents can also include in this package any information that will help the school understand diabetes better.
3. Health Care Plan - This should include the child's treatment plan, his insulin schedule, target blood glucose range, eating plan, blood glucose testing schedule and instructions on what to do on certain situations.
There you have the responsibilities of both parents and the staff when it comes to the care and safety of a diabetic child while in school. It is good that with the mandate of the schools to educate the children, this responsibility has to include the whole child. It is clear therefore what the schools should do on the issue of diabetes in children.
"Learn to enjoy every minute of your life. Be happy now. Don't wait for something outside of yourself to make you happy in the future. Think how really precious is the time you have to spend whether it's at work or with your family. Every minute should be enjoyed and savored." -Earl Nightingale
6. Some Humour - Let's laugh together at this joke even if it's not funny. Here are some more benefits of laughter: Stress hormones are reduced like adrenaline and cortisol. When one laughs, the diaphragm and abdominal, facial leg and back muscles are getting a workout.
A married couple in their nineties are both forgetful so the doctor advised them to start writing things down to help them remember. One night while watching TV, the old man got up from his chair.
Husband: Do you want anything in the kitchen? br/>
Wife: Will you get me a bowl of corn flakes?
Wife: Write it down so you can remember it?
Husband: No, I can remember it.
Wife: Well, I'd like some bananas on top.
Husband: I'll remember that.
Wife: Add a teaspoon of sugar. Write it.
Husband: I got it, for goodness sake!
Then he went into the kitchen. After about 20 minutes, the old man returned from the kitchen and gave his wife a plate of bacon and eggs. She stared at the plate for a moment.
Wife: Where's my toast?
7. Do you have a question or comment for the team?
Drop us a line at our contact form and write your questions or comment there.
Answer:You'll be fine. Here's how. You need time for yourself too. At least once a month, you should have a back-up and go out to recharge your batteries. Parents of diabetic children need to nurture their relationship so they don't grow apart. To continue to be a caregiver, you have to maintain your emotional balance.
Get involved in the community. Support the fund raising effort of your local diabetes association.
Get support from the community. Ask the doctor or the hospital if they know of any support groups nearby.
You don't have to do this alone. Other people can do the yard work and gardening and you can ask help with cleaning the house.
Remember you are a human being and not a martyr so ask for help. You can swap baby sitting duties with the other members of your community.
Reaching out to others will help you feel less alone. And when you do the same thing to others you will feel empowered that you can help others.
This brings us to the question on how do you arrange a safe baby sitter? Ask friends for a sitter referral. The local YMCA will be of help. The online service at www.safesittings.com can help find baby sitters who are familiar with diabetes. Once you get one, discuss with the baby sitter the same diabetes bag you left at the school.
8. Got something to say? Please write down your questions and comments in the contact form in our website.
We are glad that despite our goal of helping the diabetic children, we are able to take inventory of what we've got so we can move ahead. Among what we have covered along this area are to improve our self-image by dressing up every once in a while. Appearance does make one smile wider and more accepting of others.
We also tried to gain more self-improvement by reading biographies of successful people and listening to the same that can inspire us to emulate them. We have done this in small steps and we're better because of them. There are others we can try as we join together on this journey of self-improvement while helping others live with diabetes in the most proactive way.
Roger and Evelyn Guzman
Did you like this newsletter? If so, please recommend it to your friends. If you have any questions or tips, please leave a comment at our contact form and write your questions or comment there. This newsletter is copyright 2013 Roger Guzman, M.D.
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