1. Walton County School District
Diabetes Training
for Transportation
By Cheryl Tillman, RN
WCSD Lead Nurse
7/2012

2. Diabetes
What is Diabetes?
Diabetes is a serious, chronic disease that impairs the
body’s ability to use food. Diabetes must be managed
24 hours a day in order to avoid the potentially life-
threatening consequences of blood glucose levels that
are either too high(hyperglycemia) or too
low(hypoglycemia)

3. Two types of Diabetes
• Type 1 Diabetes
• Type 2 Diabetes

4. Type 1 Diabetes
• Type 1 Diabetes: the pancreas stops producing
insulin. Type 1 requires daily insulin injections for
survival.
• It can occur at any age but typically starts in children
or young adults.
• The cause is unknown but research indicates it may
involve a disorder in the functioning of the body’s
immune system.
• In Type 1 Diabetes the body destroys its own insulin-
producing beta cells.

5. Type 2 Diabetes
• In Type 2 Diabetes the body still produces insulin, but
the body does not use the insulin normally
• The body does not adequately convert carbohydrates
into the energy the body needs.
• Usually develops in adults over 40; however there is
an increasing incidence of newly diagnosed Type 2
Diabetes in the youth of the United States.

6. Factors for Developing Type 2
Diabetes
• Obesity
• Physical inactivity
• Family history of Type 2 Diabetes
• Exposure to diabetes in utero
• Non-European origin (Hispanic, African-American,
Native American)
• Signs of insulin resistance called acanthosis
nigricans(dark, velvety patches on the skin around
the neck or armpits)

7. Symptoms of Hyperglycemia
High Blood Sugar
• Frequent urination
• Excessive thirst
• Dry, hot skin
• Abdominal pain
• Chest pain
• Drowsiness, lethargy
• Increased hunger
• Weight loss
• Fatigue
• Slow, healing wounds
• Fruity, sweet or wine-like odor on breath
• Stupor, unconsciousness
• Seizure
• Death

8. Causes of Hyperglycemia
• Too little insulin or other glucose lowering
medication
• Food intake that has not been covered
adequately by insulin
• Decreased physical activity
• Illness
• Infection
• Injury
• Severe physical or emotional stress
• Pump malfunction

9. Treatment of Hyperglycemia
• Check blood glucose level
• Glucometer: a small machine that records
blood glucose
• Finger prick for blood to be applied to strip
inserted in glucometer
• Administer insulin dose according to medical
plan
• Encourage person to drink more fluids

10. Hyperglycemia
• Check blood glucose/sugar level
• If sugar is over 300, check for ketones
• Ketones are substances made when the body breaks
down fat for energy
• To check for ketones:wash hands, put on gloves;
apply urine sample to strip and follow directions and
chart on ketone bottle
• If ketones are present, the person needs medical
attention
• Follow sliding scale for insulin dosages
• After procedure, remove gloves, dispose of
gloves,wash hands

11. Symptoms of Hypoglycemia
Low Blood Sugar
• Headache
• Sweating
• Pale, moist skin
• Cold, clammy
• Extreme/sudden hunger
• Weakness, dizziness
• Shakiness
• Fatigue, tiredness
• Rapid pulse rate
• Blurred, double vision
• Shallow breathing
• Confusion/inattention
• Loss of coordination
• Changed behavior or personality
• Combative
• Seizure/Death

12. Causes of Hypoglycemia
• Too much insulin
• Missing or delaying meals/snacks
• Not eating enough food; carbohydrates
• Getting extra, intense or unplanned
physical activity
• Illness especially a gastrointestinal
illness

13. Treatment of Hypoglycemia
• Hypoglycemia or low blood sugar/glucose, a level below 70, is an
EMERGENCY
• Check blood glucose level with a glucometer
• Treat at once with fast acting carbohydrate such as 3-4 glucose
tablets, fruit juice or regular soda; follow with some type of protein
• Monitor glucose levels every 15 minutes until level returns above 70
• Never leave a person with a low blood glucose level alone
• Always treat for low blood sugar levels if unsure whether is low or high
• Follow the student’s medical care plan for treatment guidelines
• Administer glucagon if person is unconscious and unable to swallow;
Glucagon is only given if blood glucose is low and person is
unconscious

14. Signs to watch for
• Erratic behavior, such as aggression,
abnormal hostility or profanity, could indicate
abnormal blood sugar levels.
• Low blood sugar levels require food or drink
immediately.
• Unusual complaints of thirst, needing to use
the restroom, extreme drowsiness, all could
indicate abnormal blood sugar levels.

15. Diabetic Ketoacidosis
• DKA results from untreated
hyperglycemia
• Hyperglycemia is considered an
emergency if symptoms of DKA occur
• Symptoms of DKA: nausea, vomiting,
deep breathing, decreasing levels of
consciousness; coma

16. Treatment of DKA
• Can generally be reversed by providing
adequate insulin and fluids over time
• Check ketones
• Monitor blood glucose levels
• Administer insulin according to medical
care plan