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This is an article written for schools and other educational and child-care contexts. It describes the medical needs of diabetic students and explores how diabetes mellitus affects behaviour and learning. It also gives general advice on the day to day management of diabetes. However, in all cases, advice of professional medical practitioners should be sought in meeting the individual needs of diabetics.

What is diabetes mellitus?

In brief, diabetes is not being able to properly regulate the amount of sugar in the blood. It can be life-threatening if not carefully monitored and treated. Even with treatment, diabetics have an increased risk of a range of serious medical conditions. There are two types of diabetes: Type 1 and Type 2.

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What is the normal blood sugar range?

Blood Sugar Levels

A healthy individual will usually have a blood sugar level of between 4 and 6 mmol/L (milimoles per litre) before eating. After eating blood sugar can rise rapidly as the body absorbs carbohydrates and other foods. A healthy individual's blood sugar should then gradually fall and be below 7.8 mmol/L about 2 hours after eating. Because diabetes is a condition of having too much blood sugar the optimum range for a diabetic is 4 to 7 mmol/L before meals and between 5 and 9 mmol/L 2 hours after meals. It is important to follow professional medical advice and guidance regarding the exact range for any specific individual.

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What is the difference between Type 1 and Type 2?

Both Type 1 and Type 2 involve the body's inability to regulate blood sugar levels. In Type 1 the body fails to produce any insulin, a hormone necessary for the transmission of sugars from the blood to the cells of the body. In Type 2, the body produces insulin but either not enough or for some reason it doesn't work properly.

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How do you get diabetes?

Type 1 diabetes is caused by a fault in the autoimmune system. For reasons still unknown, the cells in the pancreas responsible for making insulin are attacked and destroyed. Type 1 is a comparatively rare form of diabetes in the general population. However, it is usually Type 1 diabetes that children have.

About 90% of adult diabetics have Type 2. Anyone can develop Type 2 diabetes but some people are more genetically likely to develop the condition than others. Risk also increases with age particularly beyond the age of 50. Other important risk factors are weight and lifestyle. There is a correlation between increasing rates of obesity and rises in those diagnosed with Type 2 diabetes. Type 2 is very rare in children but it is increasing.

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What is a 'low' or 'hypo'?

'Low' and 'hypo' are slang terms for hypoglycemia or low blood sugar. Someone is considered hypoglycemic when their blood sugar level falls below 4 mmol/L (72mg/dL). When a person become hypoglycemic they may start to experience a range of symptoms. These usually include:

feeling dizzy
difficulty concentrating

Hypoglycemia may also cause:

being pale
feeling weak
being hungry
faster heart rate
blurred vision

If hypoglycemia is untreated:

loss of consciousness
coma and eventually death

It should be noted that it is extremely rare for hypoglycemia to be fatal. Blood sugar levels take time to be exhausted before becoming critically dangerous. However, convulsions and loss of consciousness represent a real emergency with a real possibility of death. The diabetes plan for the student should assess this risk and have clear procedures for dealing with it. This should involve both emergency services and any actions that staff should take such as the use of glucose gels rubbed into the inside of the mouth.

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