diabetic-diet-foods.com

Juvenile Diabetes

Juvenile diabetes is not uncommon - some 176,500 American children — or one out of every 400 to 600 — have diabetes, according to the American Diabetes Association.

To manage diabetes, children are increasingly using insulin pumps as an alternative to multiple daily injections. The pump delivers insulin in precise amounts throughout the day, plus extra doses to cover high carb meals, exercise, and episodes of hyperglycemia. “Once they hit adolescence, they do like the pumps,” says Y.Diane Tasev, RN, BSN, school nurse coordinator for the Arizona Department of Education in nurse.com “Most elementary school students don’t use the pump.”

Blood glucose levels are taken regularly with a meter to help determine the right doses. Some childrenare now wearing continuous glucose sensors to measure the level, she added.

Another challenge facing school nurses is knowing who in the student body is diabetic. “There are probably a bunch we don’t know about,” Tasev says. “By junior high, students are more aware of their self-image. It’s a 24-hour disease and it becomes routine to them.”

Students and parents often don’t share physician orders, management plans or supplies with the school nurse such as snacks and back-up insulin, Taseve says.

Adolescence can be an age of experimentation as well, Tasev says. Some girls change their treatment plan and let the pumps run higher doses to cut their appetites so they will lose weight.

School nurses also need to train school staff to recognize problems and assist the child in managing their diabetes if the nurse is absent.

Finally, the school nurse should know each child’s symptoms of hypo- or hyperglycemia, according to Bierschbach.

“These can be very subtle, such as inattentiveness or more overt such as acting out in class,” she writes. “Should the child need a snack bolus for hypoglycemia, have a written plan from the parents about what works best for the child.”

And remember that insulin needs change as a child grows. Increased stress, changes in activity and growth hormone secretions will affect insulin needs, Bierschbach writes.