Hypoglycemia (Low Blood Sugar)

HYPOGLYCEMIA (LOW BLOOD SUGAR)

Hypoglycemia is abnormally low blood sugar. Hypoglycemic episodes are sometimes referred to as “insulin reactions”. Hypoglycemic episodes are more likely to occur prior to lunch or snacks. Symptoms of hypoglycemia may begin abruptly. Hypoglycemia may be the result of too much insulin, not enough food, and/or excessive physical activity; sometimes the cause in not clear. It may be necessary for diabetic students to consume between meal snacks to maintain normal blood sugar levels. Some individuals will need extra food before physical exertion. Hypoglycemia may be life threatening and requires prompt recognition and immediate treatment.

CAUSES OF HYPOGLYCEMIA

·  Delayed or missed meal or snack

·  Too much insulin

·  Stress or emotional tension

·  Unplanned extra exercise

·  Imbalance between exercise and food intake

POSSIBLE OBSERVATIONS / SYMPTOMS

EARLY WARNING SIGNS (Adrenaline “Stress Response”)

·  Sudden hunger

·  Restlessness, anxiety

·  Weakness, lightheadedness

·  Shakiness, tremors

·  Jittery feeling

·  Rapid, strong pulse (tachycardia)

·  Sweating or excessive perspiration

·  Pale appearance

CENTRAL NERVOUS SYSTEM SIGNS (Caused By Lack of Sugar To The Brain)

·  Visual disturbances, dimness of vision, dilated pupils

·  Headache

·  Behavioral changes, disorientation, confusion or inappropriate responses

·  Drowsiness

·  Cold, clammy skin

·  Dizziness

SEVERE REACTIONS

·  Unresponsiveness or unconsciousness

·  Seizure

ACTION

GENERAL MANAGEMENT OF HYPOGLYCEMIA

·  Never leave students with suspected hypoglycemia alone.

·  Notify school staff that students with suspected hypoglycemia should never be sent to the health room alone.

·  Instruct school staff to notify the school nurse/health assistant for each episode of hypoglycemia.

·  Test blood sugar when hypoglycemia is suspected.

·  Consult with the cluster nurse regarding the schedule for extra snacks and meals when physical education and activities are planned.

·  Store extra snacks and sugar in the health room.

·  Notify the cluster nurse and the parent/guardian of episodes of hypoglycemia.

·  Follow the individual health care plan for episodes of hypoglycemia. If a health care plan is not in place following Health Services procedures for care of hypoglycemia.

HEALTH SERVICES PROCEDURES FOR TREATMENT OF HYPOGLYCEMIA

·  If within fifteen minutes of a scheduled snack or lunch:

-  Have the student eat the snack or lunch and consume juice or fruit first.

-  Keep the student in the health suite so that observation and assistance can be provided as needed.

-  Return the student to usual activities when symptoms have resolved.

·  At other times, have the student take one of the following:

-  4 to 6oz. of fruit juice or non-diet soda.

-  1 tablespoon of sugar

-  10 lifesavers

-  Other treatment such as glucose, Insta-glucose, glucose tablets, or Cake-Mate as supplied by parent/guardian.

·  Improvement should be noted within 10 minutes, if not, repeat the treatment. If the student still does not respond to treatment, call 911 and give more juice, soda, or candy in the same amount.

·  Notify the Safety, Environment, and Risk Management Office of all 911 calls.

·  Notify parent/guardian, administrator, and cluster nurse.

·  Document according to Health Services procedures

EMERGENCY TREATMENT OF UNCONSCIOUSNESS OR DIABETIC-RELATED SEIZURE

·  Call 911.

·  Administer glucagon as ordered by physician.

·  Position student on side and keep warm.

·  Do not give liquids or food that may be aspirated.

·  Take pulse, respiratons, and blood pressure.

·  Begin CPR if needed.

·  Notify parent/guardian, administrator, and cluster nurse.

·  Report any 911 call to Office of Safety, Environment and Risk Management.

·  Document according to Health Services procedures.

HYPERGLYCEMIA

Hyperglycemia means a high blood sugar level. There are several factors that contribute to hyperglycemia.

·  Consumption of too much food or sweets

·  Illness

·  Stress

·  Decreased activity

·  Growth spurts

·  Not enough insulin is given or dose is missed

·  Use of medications that contain sugar

·  Sudafed and steroids can cause hyperglycemia

POSSIBLE OBSERVATIONS / SYMPTOMS

·  Increased urination

·  Increased thirst

·  Blurry vision

·  Increased hunger

ACTION

·  Test blood sugar.

·  Refer to the health care plan for individualized instructions for this student.

·  Increase fluids.

·  Increase exercise.

·  Administer insulin as instructed by physician and cluster nurse.

·  Notify the cluster nurse and parent/guardian of all episodes of hyperglycemia.

·  Document according to Health Services procedures.