Archdiocese of Canberra and Goulburn
Catholic Education Office

Diabetes – Support of Students

Related Policies:

Legal Responsibilities and Authority
Excursions

Purpose:

The purpose of this policy is to provide:

• guidelines to ensure appropriate and equitable treatment of students with diabetes undertaking classroom tests and examinations;
• information about the causes, symptoms and duty of care for students with diabetes; and
• a standard school care plan for students with diabetes in schools in the Archdiocese of Canberra and Goulburn.

Policy:

Duty of Care

Schools have a legal responsibility to provide a safe environment and adequate supervision. For the student with diabetes this includes:

• ensuring supervising staff know of the child/student's diabetes and their routine and emergency support plans;
• recognising that if the student's behaviour is unusual this may be due to a low blood glucose level and the student may require something to eat;
• enabling the student to eat meals or snacks on time;
• allowing the student to eat at additional times, especially before exercise or an exam;
• allowing the student access to the toilet when requested outside usual times;
• ensuring supervision if unwell. Students with diabetes should never be sent to the sick bay alone or left unattended when feeling unwell;
• if vomiting is present, contact the parents/guardians. If this is not possible contact the school doctor or transfer the child/student by ambulance to hospital;
• ensuring privacy when testing blood glucose levels or injecting insulin at school;
• providing a written log, as requested, of any episodes of hypoglycaemia and the action taken while supervised by staff; and
• ensuring information relevant to recognition and treatment of hypoglycaemia is in a prominent place in the staff room and also in the First Aid room, and that all staff are conversant with the information.

Definitions:

Hypoglycaemia (low blood glucose or hypo)

Hypoglycaemia deprives the brain of energy.

The causes of a hypoglycaemia include:

• too much insulin;
• exercise;
• not enough food.

Hypoglycaemia may occur at any time, but there is a greater chance of this happening with exercise or before the next meal or snack is due. The signs of hypoglycaemia can progress from mild to severe.

In MILD hypoglycaemia signs develop which include:

• sweating, paleness, trembling, hunger, weakness;
• changes in mood and behaviour (eg crying, argumentative outbursts, aggressiveness);
• inability to think straight; lack of coordination.

In MODERATELY SEVERE hypoglycaemia, additional signs develop, including:

• inability to help oneself;
• glazed expression;
• being disoriented, unaware or seemingly intoxicated;
• inability to drink and swallow without encouragement;
• headache, abdominal pains or nausea.

In SEVERE hypoglycaemia, the signs have progressed to include:

• inability to stand;
• inability to respond to instructions & extreme disorientation (may be thrashing about);
• inability to drink and swallow (leading to danger of inhaling food into lungs);
• unconsciousness or seizures (jerking or twitching of face, body or limbs);

Procedures:

Mild to Moderate low blood glucose

1. Act swiftly.
2. Give sugar immediately, eg 4 large or 7 small jelly beans, or 125-200 mls of sugary soft drink or 2 – 3 teaspoons of sugar, jam, honey. Repeat this treatment if there has been no response within 10 – 15 minutes.
3. When recovery begins to occur give slowly absorbed carbohydrate food (eg sandwich, biscuits, fruit).
4. Supervise - do not leave the student alone.

1. Lie student on side and protect from injury.
2. Maintain A irway, B reathing, C irculation.
3. Call ambulance.
4. Notify emergency contacts.

Most Importantly

If a student with diabetes is unwell and exhibits the following symptoms the parents should be contacted or if they are unavailable a doctor should be contacted or the student transferred by ambulance to hospital.

• Vomiting.
• Rapid laboured breathing.
• Drowsiness.
• Abdominal Pain.
• Sweet acetone smell to the breath.
• Severe dehydration.

Hyperglycaemia (high blood glucose level) occurs from time to time and is not usually a problem in the short term. During periods of hyperglycaemia the student with diabetes may need to drink extra water and go to the toilet during class. Students experiencing hyperglycaemia may find it difficult to concentrate and can be irritable.

Key points to note re: hyperglycaemia

• Hyperglycaemia happens from time to time to all people who have diabetes.
• Hyperglycaemia can be a very serious problem if it is not treated.
• Long-term hyperglycaemia is a major cause of many of the complications that happen to people who have diabetes. For this reason, it's important to know what hyperglycemia is, what its symptoms are, and how to treat it.
• Untreated hyperglycaemia in Type 1 diabetics can lead to a life threatening condition called diabetic ketoacidosis (DKA).

Students exhibiting signs of hyperglycaemia should be monitored and parents contacted if there are concerns.

Examinations

Specific Documentation :

Specific documentation is required in some instances. In the case of Australian Scaling Test examinations conducted in the Australian Capital Territory , this is to be provided on the form “Application for Special Case Treatment for AST”.

Provision Required :

• The student is to provide all food, drink, blood glucose equipment.
• Bite size food, appropriately packaged so as not to disturb other students when opened, and suitable drink eg. water, fruit juice, cordial may be required.
• Toilet privileges must be allowed, as circumstances require.
• A blood glucose monitor is allowed. If the monitor is used, the reading is to be noted and recorded by the teacher.

Seating Requirement :

The student needs to be seated at the side, or back of the examination room, with easy access to an exit.

Additional Requirements :

Additional time may be necessary for the student with diabetes to undertake an initial reading of blood glucose. This should normally take less than five minutes.

If blood glucose reading is less than FIVE (5.0mmol/L) the student is allowed an extra seven minutes to take remedial action (eat carbohydrate-based food) and retest the blood glucose level. During this time the student will not have access to the exam paper. If, after the second reading, the blood glucose level is still less than FIVE (5.0 mmol/L) the student is then considered an Illness/Misadventure case.

Further Information:

In 1988 an information package about Diabetes was released to all schools in Australia . The package was the result of an initiative of the International Diabetes Federation's Consultative Section on Childhood and Adolescent Diabetes, all member organizations of Diabetes Australia and endorsed by the Juvenile Diabetes Foundation Australia . This package is a useful reference and consists of a coloured flip chart, a coloured poster and a medical alert information card.

Copies of the Package are available from the Catholic Education Office, Student Health Sport and Safety Education Officer, phone (02) 6234 5456 or fax (02) 6234 5496.

Forms:

Care Plan for Students With Diabetes Attending Archdiocesan Schools.

Last updated on December 2, 2006