Health Services
School nursing, a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success. Through the promotion of physical, mental, and social growth, school nurses work to maximize the achievement and well-being of students. The school nurse is the primary health care provider in the school system and shares responsibility to ensure that students are happy, healthy, and ready to learn. The school nurse is the leader and coordinator of the school health services team. School sites are each staffed with health assistants who, under the direction, training, and advice of the school nurses, carry out basic first aid needs, medication delivery, and emergency care as needed. If you have any questions, do not hesitate to reach out to your school nurses at the following contact information:
- Noel Weeks, RN, SNC, MSN weeksn@mhusd.org
Type 1 Diabetes
Type 1 diabetes (T1D) is a chronic condition that is diagnosed when your body stops producing insulin causing blood sugar levels to rise, sometimes to dangerously high levels. T1D is not preventable or curable, but it is manageable. T1D is an autoimmune disease that may be caused by genetic, environmental, or other factors. T1D is usually first diagnosed in children or young adults, but it can occur at any age with peak diagnosis being between 13 and 14 years of age.
Risk Factors
It is recommended that students displaying or possibly experiencing the risk factors and warning signs associated with type 1 diabetes be screened (tested) for the disease. In the United States, White people are more likely to develop type 1 diabetes than African American and Hispanic or Latino people. Currently, no one knows how to prevent type 1 diabetes.
Type 1 diabetes is thought to be caused by an autoimmune reaction (the body attacks itself by mistake). Risk factors are not clear for T1D. Known risk factors include:
- Family history (parent, brother, or sister with T1D)
- Age (T1D can occur at any age, but it usually develops in children, teens, or young adults)
Warning Signs and Symptoms
Type 1 diabetes symptoms can develop in just a few weeks or over a period of months and can be severe. If you or your child have any of the following symptoms, speak with your physician about the need for blood sugar testing:
- Urinate (pee) a lot, often at night (bedwetting may occur in a potty-trained child)
- Very thirsty
- Lose weight without trying
- Very hungry
- Blurry vision
- Numb or tingling hands or feet
- Very tired
- Very dry skin
- Wounds that heal slowly
- Have more infections than normal
People who have type 1 diabetes may also display nausea, vomiting, stomach pains, or fruity smelling breath; these can be late warning signs of elevated blood sugar levels. Following a diagnosis of T1D, parents/guardians should work with the primary care provider to develop a lifestyle and medical treatment plan, which may include consultations with and examinations by specialty care providers, including an endocrinologist.
Diabetes Screening Tests
Parents/Guardians of children displaying signs/symptoms possibly related to T1D should consult with your primary care provider to determine if screening for diabetes is appropriate. Your provider may have your child take one or more of the following blood tests to confirm a diagnosis:
- Glycated hemoglobin (A1C) test. A blood test measures the average blood sugar level over two to three months.
- Random (non-fasting) blood sugar test. A blood sample is taken at a random time; this test must be confirmed with a fasting blood glucose test.
- Fasting blood sugar test. A blood sample is taken after an overnight fast; a high level on two separate tests indicates diabetes.
- Oral glucose tolerance test. A test measuring the fasting blood sugar level after an overnight fast with periodic testing for the next several hours after drinking a sugary liquid.
If the primary care provider thinks your child has type-1 diabetes, blood may also be tested for autoantibodies (substances that indicate the body is attacking itself) that are often present with T1D. Your child's urine might be tested for ketones (produced when the body burns fat for energy), which may also indicate T1D.
References
- American Diabetes Association
- What is diabetes? | CDC
- https://codes.findlaw./ca/health-and-safety-code/hsc-sect-104250/
- Type 1 Diabetes Information - Health Services & School Nursing (CA Dept of Education)
- California Code, Education Code - EDC § 49452.7
The information provided on this webpage is intended to raise awareness about T1D. Contact your child's primary care provider, the MHUSD Special Education Department, your school nurse, or school administrator if you have questions. [EC 49452.6, 49452.7; HSC 104250]
Type 2 Diabetes
Type 2 diabetes is the most common form of diabetes in adults. Until a few years ago, type 2 diabetes was rare in children; it is becoming more common, especially for overweight teens. According to the U.S. Centers for Disease Control and Prevention (CDC), one in three American children born after 2000 will develop type 2 diabetes in their lifetime.
- Type 2 diabetes affects the way the body is able to use carbohydrates for energy.
- The body turns the carbohydrates in food into glucose; the basic fuel for the body's cells.
- The pancreas makes insulin which is a hormone that acts as a key to move glucose from the blood to the cells to generate energy.
- In type 2 diabetes, the body's cells resist the effects of insulin, and blood glucose levels rise.
- Over time, glucose not transferred to the cells by insulin reaches dangerously high levels in the blood, which is called hyperglycemia.
- Long term effects of hyperglycemia can lead to a multitude of serious health problems including: heart disease, blindness, and kidney failure.
Risk Factors
The following risk factors are associated with an increased risk of type 2 diabetes in children:
- Being overweight. The single greatest risk factor for type 2 diabetes in children is excess weight. In the U.S., almost one out of every five children is overweight. The chances are more than double that an overweight child will develop type 2 diabetes.
- Family history of diabetes. Many affected children and youth have at least one parent with type 2 diabetes or have a significant family history of the disease.
- Inactivity. Being inactive further reduces the body's ability to respond to insulin.
- Specific racial/ethnic groups. Native Americans, African Americans, Hispanics/Latinos, or Asian/Pacific Islanders are more prone than other ethnic groups to develop type 2 diabetes.
- Puberty. Young people in puberty, because of normal rises in hormone levels that can cause insulin resistance during this stage of rapid growth and physical development.
Warning Signs and Symptoms
- Warning signs and symptoms of type 2 diabetes in children develop slowly; initially, there may be no symptoms. However, not everyone with insulin resistance or type 2 diabetes develops these warning signs, and not everyone who has these symptoms necessarily has type 2 diabetes.
- Increased hunger, even after eating
- Unexplained weight loss
- Increased thirst, dry mouth, and frequent urination
- Feeling very tired
- Blurred vision
- Slow healing of sores or cuts
- Dark velvety or ridged patches of skin, especially on the back of the neck or under the arms
- Irregular periods, no periods, and/or excess facial and body hair growth in girls
- High blood pressure or abnormal blood fats levels
Prevention Methods and Treatments
The first step in treating type 2 diabetes is to visit a doctor. A doctor can determine if a child is overweight based on the child's age, weight, and height, and a doctor can request tests of a child's blood glucose to see if the child has diabetes or pre-diabetes (a condition which may lead to type 2 diabetes).
Healthy lifestyle choices can help prevent and treat type 2 diabetes. Even with a family history of diabetes, eating healthy foods in the correct amounts and exercising regularly can help children achieve or maintain a normal weight and normal blood glucose levels.
- Eat healthy foods. Make wise food choices. Eat foods low in fat and calories.
- Get more physical activity. Increase physical activity to at least 60 minutes every day.
- Take medication. If diet and exercise are not enough to control the disease, it may be necessary to treat type 2 diabetes with medication.
References
- Type 2 diabetes in children - Symptoms and causes - Mayo Clinic
- Type 2 Diabetes | CDC
- Type 2 Diabetes - Symptoms, Causes, Treatment | ADA
The information provided on this webpage is intended to raise awareness about type 2 diabetes. Contact your child's primary care provider, the MHUSD Special Education Department, your school nurse, or school administrator if you have any questions.
Fentanyl Awareness & Narcan Program
In Fall 2022, MHUSD received Naloxone (Narcan) kits for each school site from the Santa Clara County Office of Education (SCCOE). Narcan emergency kits are available in each Health Office and/or automated external defibrillator (AED) box. At our secondary school sites, the Narcan kits are located in multiple locations throughout campuses. The Narcan emergency kits will remain on school sites and stocked at all times. The kits will not go on field trips, but the kits will be available for use as needed during athletic events and other after school activities.
The school nurses, administrators, health assistants, and/or School Resource Officer (SRO) will train volunteer school staff in Narcan use, including: how to recognize symptoms of an opioid overdose, how to administer naloxone, and provide the standards for storing and restocking Narcan. Any volunteer staff will be trained annually and as needed.
Naloxone is a medication that works to rapidly reverse an opioid overdose when administered properly and at the right time. It is available as an injection or nasal spray. The Narcan MHUSD has is a nasal spray and is just one brand name of naloxone.
Signs of an opioid overdose may include:
- Slow, shallow or no breathing
- Unresponsive
- Cold or clammy skin
- Pinpoint pupils (pupils that are abnormally small in normal lighting)
- Difficult to wake, or will not wake
- Heavy gurgling or snoring sounds
- Blue or gray skin, lips, or nails
Narcan can very quickly restore normal breathing for a person whose breathing has slowed down or stopped due to an overdose of fentanyl, prescription opioids, counterfeit laced prescription pills, or heroin. Narcan onset occurs within two to three minutes and can last for 30 to 90 minutes. Sometimes a second dose of Narcan is necessary if symptoms of overdose return.
Immediately call 9-1-1 if a person is found unconscious or an overdose is suspected. Even if the victim responds well to naloxone, opioids can remain in the body for several hours, and respiratory depression can recur. Emergency Medical Services personnel are trained to manage opioid overdose; transporting the patient for further care at a local hospital is required.
If you have questions regarding the MHUSD Naloxone Program, please contact MHUSD.