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question for Sharon...

Posted by Suzanne D on 8/20/03 at 17:32 (127440)

Hi, Sharon! Without too much effort on your part, could you point me to a good site to read about juvenile-onset diabetes? A little first grade boy in the room next to mine was diagnosed last weekend. I do some teaching to that class, too, so he will be in my room at different times during the day. It is scary to me - trying to do everything right for him. (We do not have a school nurse. Luckily for the child, our school secretary is diabetic, and she uses the machine to test his sugar each day before lunch and records it in a notebook for the parents.)

His teacher had commented how often he needed to go to the bathroom, and I said he always asked when he was in my room, too. So she wrote to his mother who took him to the doctor last Thursday. They sent him to a children's hospital in Louisville where he stayed 2 or 3 days. He is on two insulin shots a day and comes with glucose tablets and snacks and drinks which he places in my mini-refrigerator (left over from my daughter's days in college). Today his teacher was out, and I tried to make sure he was o.k. all day. His sugar reading was over 300 before lunch, so before his 2:00 snack, I asked that his sugar level be read again even though that was not prescribed to be done any other time of the day. It just worried me. It was still over 300, so the secretary said he should NOT have the orange juice he brought, but drink water. She called his aunt who said he could have the goldfish crackers he brought.

Sorry to take up so much space about this, but I am really concerned for the child. If you can give me any more understanding, I sure would appreciate it! You seem to know so much about everything medical and have so many sites that are helpful.

Thanks,
Suzanne :)

Re: question for Sharon...

Peter R on 8/20/03 at 17:53 (127447)

I understand your concern as to this childs condition but be very careful about trying to handle his sugar level. Despite what his parents say about giving you the OK to do it if something goes wrong some very snakey lawyer will see to it that he shares in whatever you own. A parent cannot absolve you from any liability in handling this situation for their child.

Re: question for Sharon...

Sharon W on 8/20/03 at 18:15 (127451)

Suzanne,

OH, I'm sorry to hear that... it's a rough thing to happen to a little kid. I had a childhood friend (later my college roommate) with type I diabetes. They do have to learn a kind of responsibility for their own health that most kids their age could never imagine...

I wasn't a diabetes educator but I did help to translate the diabetes nurse's words to Spanish for some of our hospital patients.

Your student's diabetes obviously isn't under control yet. It isn't uncommon for it to take a while to get the medications just right, and I'm sure you will encourage his family to be sure that his doctor is aware of those (high) 300 blood sugar readings.

Here's the American Diabetes Association website:

http://www.diabetes.org/main/application/commercewf

Here are two articles showing the importance of keeping blood sugar under control from the beginning, for people with type 1 diabetes:

http://story.news.yahoo.com/news?tmpl=story&cid=571&ncid=751&e=5&u=/nm/20030814/hl_nm/sugar_nerves_dc

http://story.news.yahoo.com/news?tmpl=story&cid=571&ncid=751&e=5&u=/nm/20030814/hl_nm/sugar_nerves_dc

I don't think any of those are really what you're looking for... I'll look around a bit more after I make dinner for my family, and if I find anything specifically about caring for children with diabetes, I'll let you know.

Sharon
.

Re: question for Sharon...

Sharon W on 8/20/03 at 18:46 (127457)

Suzanne,

Sorry -- that last one came out wrong. Hopefully this will work:

http://diabetes.diabetesjournals.org/cgi/mjgca?sendit=Get+All+Checked+Abstract%28s%29&SEARCHID=1061420334269_2619&TITLEABSTRACT=monitoring+children+with+diabetes&JOURNALCODE=&FIRSTINDEX=0&hits=10&RESULTFORMAT=&gca=diabetes%3B33%2F8%2F790

Sharon
.

Re: question for Sharon...

Sharon W on 8/20/03 at 19:25 (127462)

Here are a couple more articles on kids with diabetes (and excerpts follow):

http://care.diabetesjournals.org/cgi/content/full/25/2/313 ?

'This study demonstrated the difficulties that nutrition management and, specifically, mealtimes present for parents of young children with type 1 diabetes. ...parents of young children with type 1 diabetes perceive mealtime behaviors as more problematic, report more concerns about their abilities to manage mealtime behavior, and experience more overall parenting stress than parents of young children without a chronic illness. In addition, parents of young children with type 1 diabetes that reported higher parenting stress levels also reported more problems with child mealtime behaviors and concerns about their mealtime behavior management abilities. The findings have important implications because nutrition management is a cornerstone of type 1 diabetes care, and young children with type 1 diabetes are understudied in clinical research.'

http://care.diabetesjournals.org/cgi/mjgca?sendit=Get+All+Checked+Abstract%28s%29&SEARCHID=1061425263374_5847&AUTHOR1=EJ%2BHauenstein&FULLTEXT=Stress+in+parents+of+children+with+diabetes+mellitus&JOURNALCODE=&FIRSTINDEX=0&hits=10&RESULTFORMAT=&gca=diacare%3B12%2F1%2F18

'No differences in the level of glycosylated hemoglobin (HbA1) existed between children whose mothers reported high levels of stress in themselves and their children and those whose mothers reported little stress. Hierarchal regression analysis demonstrated a significant relationship between the child stress scale of distractibility, the use of self-monitoring blood glucose assessment, and low levels of HbA1.'

I hope this helps a little bit.

Sharon
.

Re: question for Sharon...

Suzanne D on 8/20/03 at 19:31 (127464)

You're right, Peter, in reminding me of the liability issue. I always think of the child first, and then someone has to point me in that direction. Once a child fell in the bathroom and cut a large gash above her eye. I was sitting, holding her in my lap applying pressure to the wound, and my principal said, 'Where are your gloves?' When a child came in saying, 'Laura's bleeding on the floor!', I didn't even think about the gloves.

It is a hard situation when you are sent notes to give the snack and take the reading, but if it is this high, then do this...That is why I kept checking with the office and asking them to call the family as well. I really wish they had kept the child a little longer in the hospital until he was more regulated. But I am sure insurance would have balked. Seems like we end up being controlled by insurance and liability issues!

Thanks for the reminder.
Suzanne :)

Re: question for Sharon...

Suzanne D on 8/20/03 at 19:32 (127466)

THANKS SO MUCH, Sharon! I appreciate the time it took to post those sites. I will look at them shortly.

Suzanne :)

Re: question for Sharon...

Sharon W on 8/20/03 at 19:48 (127471)

Here's the Children With Diabetes site; it may be more like what you're looking for:

http://www.childrenwithdiabetes.com/index_cwd.htm

Sharon
:)

Re: I think I found JUST what you're looking for!

Sharon W on 8/20/03 at 20:23 (127486)

Suzanne,

This is a link from the Children With Diabetes site; it's info specifically about diabetic children at school and I think it's JUST what you're looking for!

http://www.childrenwithdiabetes.com/d_0q_000.htm

:D

Re: I think I found JUST what you're looking for!

Suzanne D on 8/20/03 at 21:15 (127497)

Thanks so much, Sharon! I am printing out the information for teachers as I type. This is just what we needed. I really do appreciate it! I will share with my team teacher tomorrow.

Suzanne :)

Re: I think I found JUST what you're looking for!

Kathy G on 8/22/03 at 08:49 (127635)

Suzanne,

My sister's nephew, at fourteen, was just diagnosed with juvenile diabetes at the beginning of the summer and I did a search and came up with some of the same sites that Sharon gave you. My sister wanted as much information as possible so that when he came over, because when he visits, she wants to understand his condition and maybe get a feel for what he's going through. She also wanted to be able to educate her thirteen-year old about his cousin's disease.

He has been hospitalized twice because they are having a tough time regulating his insulin. It's a lousy disease and I'm glad that your student has a caring teacher like you to help him through this adjustment period.