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Diabetes Care Tasks at School:

What Key Personnel Need To Know

INSULIN BASICS

Accurate and timely insulin dosing is a vital

piece of a comprehensive plan.

GOAL: OPTIMAL STUDENT HEALTH

AND LEARNING

VOCABULARY

Target Range – a range of numbers that represents an individual’s ideal blood glucose level; determined by health care team with the individual (student with diabetes and parent/guardian)

Basal Insulin – sometimes

called “background” insulin, the insulin working steadily throughout the day

Bolus Insulin – a single

dose of insulin, given for food

or correction

Carb or Meal/Snack

Bolus – insulin doses with

food

Correction Bolus – insulin dosed when blood glucose level is too high and needs to be corrected (made lower)

INSULIN IN SCHOOLS TODAY

• Most students need to take insulin in school
• Insulin dosing varies from student-to-student and changes

over time

• Student’s need for assistance will vary as the student

progresses in self-management

• Insulin dosing and timing will be specified in the DMMP;

physician orders may include provisions for the parent/

guardian and/or capable students to modify dosing

• Specific school procedures for administration should be

documented

Insulin syringe Insulin pen

Insulin pump or pod

INSULIN DELIVERY METHODS

BASAL AND BOLUS INSULIN

Breakfast Lunch Dinner Snack

STORING INSULIN

• Review the product storage instructions and check

the expiration date

• Generally store at room temperature less than 86

degrees

• Refrigerate unopened vials and insulin pens
• Be careful NOT to freeze

WHEN TO GIVE INSULIN

DMMP should specify dosing clearly

Generally:

• Before meals or snacks
• For blood glucose levels significantly above target range
• For moderate or large ketones

DOSING INSULIN AT SCHOOL

Generally, students will only take rapid or

short acting insulin at meal or snack times:

• Some students will use a standing insulin dose
• Others will have a varied dose, depending upon:

− what food is eaten (carb bolus)

and/or

− whether blood glucose is within the target range (correction

bolus)

CARB BOLUS TO COVER

MEALS/SNACKS

The insulin to carb ratio varies student

to student, is specified in the DMMP:

• Recorded as 1 unit insulin per X gms of carb
• Example: 1:10 ratio; 1 unit of insulin for every

10 grams of carb eaten

• Calculate: Meal of 60 grams CHO
  • 60/10 = 6
  • 6 units of insulin are needed to cover this meal

INSULIN BOLUS FOR BOTH CARBS

AND CORRECTION

• For some students, dosing at meal time may

include both a carbohydrate ratio dose and a

correction dose

• Total dose = Carb ratio dose + Correction dose
• If student’s blood glucose is below target range,

the correction may mean giving less than the

usual dose; follow DMMP for each student

ROUTINE AFTER GIVING INSULIN

Check site for leakage

Document on log sheet

Correction doses:

• Retest per DMMP to check effectiveness

Meal/snack doses:

• Timeliness in relation to eating
• Supervision of food amount per DMMP

1. Insulin is that moves glucose from the blood into the cells for energy. 1. A steroid 2. A hormone 3. A pain killer 4. An oral medication 2. Bolus insulin is given to cover meals/snacks and: 1. Increased physical activity 2. To make the student more alert 3. To correct hyperglycemia 4. None of the above 3. Insulin is administered through a: a. Mouth b. Syringe c. Pump or pod d. Meter e. Pen f. b, c, e g. None of the above 4. Basal insulin is a slow steady stream of insulin. a. True b. False

WHERE TO GET MORE INFORMATION

American Diabetes Association

1-800- DIABETES

www.diabetes.org/safeatschool