The important focus of today's episode revolves around the management of blood sugar levels in students, a matter of considerable significance. We delve into the nuances of recognizing the signs of blood sugar irregularities and explain effective strategies for students managing diabetes during the school day. Our esteemed guest, Jennifer Hanlon, the consulting school nurse for Area 5, offers invaluable insights into the critical symptoms that parents and educators should be vigilant about, as well as the interventions that can be instituted to support affected students. Moreover, we explore the broader implications of diabetes on a child's cognitive and emotional well-being, particularly during the tumultuous middle school years. This dialogue aims to give parents and educators the necessary knowledge and resources to foster an environment conducive to the well-being of students grappling with diabetes, thereby ensuring their academic success and emotional stability.

Guest:

Jennifer Hanlan

Useful links from the podcast:

• Pediatric Healthcare | Children's Healthcare of Atlanta
• School Health Services

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Takeaways:

• The management of blood sugar levels in students is crucial for their cognitive function and overall academic performance, necessitating vigilance from both parents and school staff.
• Parents should be aware of red flags indicating potential blood sugar issues in their children, such as excessive thirst and frequent urination, which warrant further consultation with medical professionals.
• School nurses act as important advocates for students with diabetes, ensuring they receive appropriate accommodations and support in the academic environment through individualized healthcare plans.
• Understanding the psychological and social implications of diabetes among peers in a school setting is vital for fostering a supportive environment for affected students, particularly during the challenging middle school years.

Whether you pronounce it diabetes or diabetes, we're talking about managing sugar levels in school today on the Inside Scoop. Hello, I'm David Owen.

Before we dive in, don't forget to, like, subscribe and share this episode with anyone who wants to stay informed about what's happening in our schools. Your doing this helps us reach more families who care about student wellness.

Today, we're tackling a topic that affects many students but often goes unnoticed. Recognizing the signs of blood sugar issues and understanding how diabetes can be safely managed during the school day.

Here to help us know what to look for and how to deal with it in a school setting is our consulting school nurse for Area 5, Jennifer Hanlan. Jennifer, welcome to the podcast.

Hi. Thank you for having me.

Everybody knows Area 5, right?

Yeah.

Maybe kind of cryptic. What school are in Area 5? Just a few of them.

Okay, so I'll name the high schools because I've also served those feeding schools. So McEachern, Hillgrove, Harrison and Allatoona high schools, and then all of those feeders. So 22 schools in Area 5.

So diabetes, you pronounce it diabetes?

I pronounce it diabetes.

Just making sure I'm not the outlier here. So how. How might untreated high or low blood sugar levels affect a student's ability to learn throughout the school day?

Good question. So the blood sugar levels in children who have diabetes is pretty important for their cognitive function.

So whether it be low, like, you know, maybe under 60, you know, it starts to impair their cognitive learning ability. They might get confused, lightheaded, shivery shakes, sweaty. You know, they're just able to comprehend, make complete thoughts and things like that.

So it makes a big difference. And if it's super high, they also have cognitive, you know, effects. So being able to learn, comprehend, test things like that are big.

That's where the nurses come in and advocate for those children.

Okay, so when we're talking about, essentially for the sake of this podcast, talking about blood sugar levels that are outside of the normal range. Right.

So if I'm a parent and I am concerned maybe about my child zoning out during class, what are some of the things that in the day to day I can look for as a red flag of not necessarily a definitive thing, but a concern that I need to maybe talk to the school nurse about?

Sure.

So there are several big red flags that would, if they were brought to us in the clinic, it would spark us to say, okay, we might need a trip to the pediatrician. Those things would be excessive thirst.

We're talking pounding water day in, day out, you know, extreme, you know, needing to use the restroom, going to the restroom a lot.

And a lot of times kids are in school seven hours a day, you know, so those teachers are huge in being able to help report that little Johnny is going to the restroom every 15 minutes. He has refilled his bottle 16 times today. You know, those are big red flags in the elementary age kids for parents.

If your kid is in 4th or 5th grade and has been, you know, not wet the bed since kindergarten and he starts wetting the bed, those are kind of red flags for parents and things to people to take notice of and bring those to the attention of a medical professional, whether it be the school nurse or your pediatrician.

And to that point, you know, we talking about teens in particular. They are sneaky. I've got a few. Yes. So when they are needing to go to the restroom, that's legitimate.

That's your red flag when they're needing to go to the restroom because, well, they don't want to take the test. That's not correct. Okay.

Correct.

Just making sure that's clear. Yes. So is there a particular age? I mean, just a moment ago you talked about elementary school versus high school, middle school.

Is there an age where is most frequently picked up on that? There is an issue?

There is not. So anyone can develop diabetes at any point during their lives.

Typically it occurs in the adolescent's age, but it's not just, you know, limited to that age. Like I was just a little more science behind it is an autoimmune disease. So an autoimmune disease. An autoimmune disease.

I'm sorry to interrupt you, but that's kind of surprising.

It is. So what happens is any kind of infection, viral, things like that, your body naturally will go to fight it.

And once you have overcome that virus and your body doesn't stop fighting it, it can start attacking other cells, which is the autoimmune issue. So in this case, your pancreas is attacked and it stops producing insulin, which.

Is very, very bad, I would think.

Yes. That is the hormone that carries or helps convert the glucose into energy.

Okay, so at that point, it would be, I mean, going back to the red flags if a kid starts passing out, that's huge.

That's super bad. Yes.

Yeah. Okay, so you've missed a few flags along the way. It sounds like.

Right.

1900S.

It sounds farther and farther away. It does. Every single Day.

So I remember one student, and I believe it was a middle school setting, his blood sugar would plummet and he would start acting, frankly, crazy. I mean, doing things that no logical, thinking human would do. Is that.

Yes.

That's another red flag.

That is a lot of kids, if they can become super hyperactive or very irritable, like uncharacteristically irritable and snippy. Yes. And they just have no control over that. Their brain doesn't have that glucose to function the way it's supposed to. Absolutely.

And a lot of teachers maybe not understand that, and they just think they're a problem child, but actually they need to come see the nurse. Let's figure out the problem and, you know, treat them and allow them to go back to school.

What are some of the things that parents should do to help advocate for their student in the setting of a school?

Absolutely. So parents, I always present this in 504 meetings for my students who have diabetes. They are that child's advocate. They are the voice of that child.

And so I really and truly want to make sure that they know what's available to them, what kind of supports are available to them and.

Excuse me for interrupting, but you said 504 meetings. That's a plan to address an unusual circumstance, medical needs.

So a 504 is kind of.

What.

They like to say is it levels the playing field for a child with a chronic illness or any kind of medical condition which could affect them academically. They have things in place that allow them to, like, check blood sugars before testing to make sure they're in an acceptable range to sit for a test.

Yeah. And the student would do that themselves.

Correct. I mean, technology is amazing. They've got the CGMs, the constant continuous glucose monitors that they wear on the back of their arms.

I'm sure you've seen those. And then it transmits to their phone or something like that. So technology is amazing.

Yeah, it is. And it takes a lot of the load off of everybody around them.

Correct.

So they can learn to manage it through their lifetime.

Of course, yes. And that is. It is a lifelong illness that they are going to have to manage throughout their entire life.

You know, whether or not they are diagnosed at 18 months or they are diagnosed at 24, it doesn't matter, you know, it's still going to be a lifelong situation.

Okay, so I pulled you off track slightly.

Sorry.

No, that's fine. That's my fault.

The 504 meeting basically helps keep everybody on the same page of what's going on and what else you were talking about in those meetings? Talking about parents advocating for their.

Yes. And a lot of times, you know, when a child is newly diagnosed with diabetes, it is life changing for the parent as well.

There's a lot of information that they need to learn and understand about diabetes to help support their child. So, you know, children's healthcare of Atlanta is amazing and they have caregiver classes that they give.

But you know, on the school side of things, they don't get that information of how we can support them at school using a 504 or an individual healthcare plan, things like that.

Okay. All right. So I'm just trying to think through the day to day picture for a student who is managing their own blood sugar levels.

What are some of the exceptions that might come out of a 504 plan?

I think you kind of mentioned it a little bit, but teachers have to deal with a full classroom of students and some of them are again, in the teenage mind trying to get away with stuff.

What are some of the things that are frequently allowed, not always perhaps, but frequently allowed for a student to do that otherwise might be an exception.

Okay, so, you know, they have. So their cell phone, like I mentioned earlier, is connected to their continuous glucose monitor.

And so that cell phone is considered a medical device. Okay. So that device has to stay within 20ft of that student at all times.

So a lot of times we write into the plan saying that their cell phone is a medical device and they have access to it at any time. Okay. Something else is they can check their blood sugars whenever they need.

They can have water and food accessible to them at all times because that's also how you help treat lows and keep things in check. Drinking water will help lower blood glucose as well. So we kind of include a lot of those.

Another big thing that maybe not a lot of people understand is on field trips. Field trips is a huge issue with a diabetic because once you, if you are super, super high and unmanaged, you can go into ketoacidosis.

I'm not going to get into the. But that's dangerous. And also if you go super low, you can go into a diabetic coma.

So and in those situations, there has to be a medical professional available to that student to help manage because there's emergency meds. There are things that we can do to help support that child if they get into a crisis situation.

See, this is one of those things that's behind the scenes that makes me love cub schools and Company man. Okay, guilty.

But the fact that as parents, we don't even have to think about having somebody who is equipped and ready to deal with this sort of unknown thing. Otherwise, hopefully, kids don't want to have the stigma of, oh, he's diabetic. They don't want to be talking about that among their peers.

So keeping that on the down low, as they say, but being prepared is huge, right?

It is.

So earlier you mentioned some of the physiological impacts of unmanaged blood sugar levels. What about the, I guess, the social impacts or psychological impacts of having a situation that's not normal among peers?

Is that something that is of concern in the school environment?

Absolutely, absolutely.

And I will say, you know, you see more of that impact, the social, emotional, mental aspect of it, come maybe in middle school where, you know, everybody knows middle school is not, you know.

Middle school is lovely.

Really? Yeah, yeah. I mean, it's such an awkward time for everyone, but that, you know, the children really don't want to be different from their friends.

They don't want to have to stop doing what they're doing to manage their blood sugar and things like that.

So it does take a huge role or toll on them, you know, emotionally, you know, and, you know, we've seen, you know, students really go through a lot in that sense, and, you know, having the nurse in the school who understand it, then we take it to another level.

So we let the teachers understand what's happening with this child, how to treat them, or just giving them a basic understanding so that they can relate to that student and maybe not bring it out in front of other people, but just having that understanding that they are going through something and be supportive, you know?

Yeah, absolutely. And you hit the nail on the head. Kids do not want to be noticed or called out for something unusual like that.

Absolutely.

I could imagine a middle schooler in particular not taking care of themselves appropriately because they don't want to stand up and go do something for fear of being noticed. Right?

You are absolutely correct. And that's a lot of what we see in the middle school. That's probably the hardest age to manage diabetes for a child.

So in preparing for this podcast, I noticed that you guys have a great resource on the school nurses website or webpage on the Cobb Schools website that might be of benefit to our viewers, our parents. Very briefly, can you give us a description of what they can find there?

Absolutely.

So on that site, you're going to have resources as, you know, kind of our policies and how we manage diabetes in the school setting as well as the forms, the medical forms that we need filled out by doctors. Also, Children's Health Care of Atlanta, I mentioned earlier is a fantastic resource for parents to be able to contact. And they are.

They are a wealth of information, to be honest. And you can always contact your local school nurse. They are more than welcome to answer any questions.

You know, maybe ease your concern or your worries about sending your newly diagnosed child to school with diabetes, because that is a huge concern for parents.

Sure. And our school nurses are well prepared. So don't fret. Well, Jen, thank you so much for coming in and sharing on this very important information.

Parents need as much info as they can possibly get, and that page of resources we will make sure is available through a link on the podcast description or in the show notes. You'll find it one place or the other. If you found this conversation helpful, be sure to like, subscribe and share.

It really helps us reach more of those families and keep everyone connected to what's happening in the schools and especially on topics of this level of importance. Could possibly even save a life. Not to put pressure on you, but do it.

And don't forget, we're also available on iHeart podcast, Spotify, Apple, and anywhere you get your podcasts. So thank you for listening to this edition of the Inside Scoop, a podcast produced by the Cobb County School.