Hypoglycaemia

It is important that all staff in supervisory roles of the student know about low blood glucose levels - hypoglycaemia and how to respond. All school staff must if necessary reasonably assist in an emergency. For this reason, all staff who could be called on to respond to a diabetes emergency should be appropriately trained and should respond in accordance with the agreements documented in the emergency section of the student's individual health care plan

Hypoglycaemia occurs when the blood glucose level drops to less than 4mmol/L or when symptoms are being experienced at a level close to 4mmol/L.

A hypo (hypoglycaemia) may occur at any time and the signs may progress from mild to severe. Treatment is needed promptly to prevent a mild hypo from progressing to a severe hypo. The significance of this situation in the classroom, on the playing field or in the school playground is that the student with diabetes must be allowed to stop activity to restore the blood glucose level to normal by eating or drinking.

Regardless of age, the student may require assistance to treat their hypo and may find it difficult to concentrate on school work for a period of time following the hypo.

Mild to moderate hypos are treated by giving foods or drinks containing sugar. Parents provide the school with the preferred hypo food (easily absorbed carbohydrate such as a juice, glucose tablets or jelly beans and long acting carbohydrate to follow, for example, two biscuits). As appropriate, the hypo food can be kept in various locations in the school and students can be allowed to carry their hypo food with them, for example, a small juice in their pencil case or a small packet of jelly beans in the pocket of their school uniform. Students should have ready access to their hypo food at all times.

The procedure for recognising and treating hypoglycaemia forms the emergency response component of the individual health care plan. Information is also available in the Diabetes School Pack.

Schools can display the Diabetes Emergency Information Poster provided in the Diabetes School Pack in appropriate places. The poster is a step-by-step guide for treatment of hypoglycaemia.

A severe hypo may result in the child becoming unconscious.

Staff will provide a general emergency response, place the child in the coma or recovery position and maintain a clear airway and call an ambulance and the parent.

The only treatment for severe hypoglycaemia is either an injection of glucagon which can be given by a parent or paramedic or an injection of glucose into the vein (given by a doctor or a trained paramedic).

Glucagon is a hormone which raises the blood glucose within 15-20 minutes. It can be given by parents. School staff can volunteer to administer glucagon as part of a negotiated individual health care plan for a specific student and where they are trained. The administration of glucagon by school staff is not mandatory. Further information on glucagon is available in the Diabetes School Pack.

Where more information is needed, there is usually a diabetes educator attached to the student's medical team. You may also wish to contact the DIABETES kids and teens CARELINE at Australian Diabetes Council on 1300 136 588 and ask for the Paediatric Diabetes Educator Monday to Friday 9am to 4pm.

Acknowledgement: These materials have been put together with assistance from Australian Diabetes Council.