Lowell — With his lunch on a table in front of him, Lucas Diaz added up the carbohydrates in his crackers, grapes and pastries.
“Seventy-eight,” he told Kendra Dixon, Lowell Middle School administrative assistant, who jotted down the number in Lucas’ file. In the school’s health room, the seventh-grader had already given himself a finger poke and tested his blood sugar on a glucometer. The reading was in the 80s, safely within the range of 70 and 300, where it needs to be.
He then gave himself an injection of seven units of insulin, the amount needed to regulate the number of carbohydrates he planned to eat.
Managing diabetes requires tracking lots of numbers, he explained. Daily care is a group effort between himself, mom Sara Nelson, Dixon, administrative assistant Teresa Goldner and school nurse Delynn Wright.
“I have to constantly check my blood sugar,” said Lucas, who the day before had to eat many Starburst candies to bring low blood sugar up into the safe range before heading back to class.
Lucas, who was diagnosed in September, is one of seven students at the middle school and 18 in the 3,500-student district who have Type 1 diabetes. Most of them, like Lucas, stop by the school office at least twice daily for monitoring.
That number of students is the most that current administrators and school nurses at LAS have experienced, and mirror an increase in prevalence of the disease, Wright said.
“Type 1 diabetes is definitely on the increase for all ages of students. I’m not sure why that is,” Wright said. “Medical experts are trying to determine what the cause is. It’s a nationwide issue, not just here in Lowell.”
‘The goal is always to get the blood sugar into that safe range so they are able to go to class. (Students) are really trusting us to get them back up and guide them through their day.’— Lowell Middle School administrative assistant Kendra Dixon
Both Type 1 and Type 2 diabetes are on the rise in young people, according to a study published in the American Diabetes Association publication Diabetes Care.
The amount of care required every day also demonstrates the work being done by school nurses who are often serving several buildings in a district and secretaries, who, on top of tracking student records, meetings and attendance are also tracking carbohydrates, blood sugar readings and insulin units.
“The last few months have been quite a whirlwind,” said Lucas’s mom, Sara Nelson.
She said the office staff made the process of managing care at school seamless.
“They have been nothing short of amazing, and are extremely communicative if he’s having a hard day with the lows and the highs,” she said.
How Schools Help Manage Diabetes
Type 1 diabetes is thought to be caused by an autoimmune reaction. The pancreas stops producing enough insulin. Risks include hypoglycemia, which is low blood sugar. Unchecked, it can lead to unresponsiveness, coma, seizures and death. Hyperglycemia, or high blood sugar, causes increased thirst, blurred vision, headaches and other symptoms.
“Our office staff goes through an extensive amount of training to care for those students,” said Wright, who spreads her time between the middle school and Cherry Creek, Bushnell and Murray Lake elementary schools.
She and fellow district nurse Linda McElroy, who serves LAS’s other buildings, lead ongoing training on diabetes, insulin and management tools including injections and pumps, rescue medication and emergency response.
“I’ve learned a ton about diabetes since I’ve worked here,” said Dixon, who started in the job last year and spends about two hours a day managing care for diabetic students and administering medicine to students with other needs.
She also works closely with parents to meet students’ individual needs. Some students are independent when it comes to diabetes management and have insulin pumps that work automatically to keep them stable.
Other students, especially those recently diagnosed, need help verifying and recording calculations and using dosage charts for insulin. On-the-spot corrections to insulin doses are sometimes needed if the student wants to eat a special treat like a doughnut or Halloween candy.
Caring for the student also involves helping them feel better. Almost every day a couple diabetic students come to the office with symptoms of high blood sugar, Dixon said.
“They may have a headache, be really tired, feel super thirsty. They may have mood changes,” she said. “They never leave until we’ve diagnosed what’s going on and they are beginning to feel a little better.”
Other times students experience low blood sugar symptoms, or the sensor they wear indicates it is low. That requires eating fast-acting carbs and monitoring blood sugar until it’s high enough.
“The goal is always to get the blood sugar into that safe range so they are able to go to class,” she said. “They are really trusting us to get them back up and guide them through their day.”
Lucas was diagnosed thanks to Nelson, who noticed he had “fruity smelling breath” that wouldn’t go away. She knew that was a symptom of diabetic ketoacidosis, and had also noticed his excessive thirst and tiredness. She brought Lucas to the doctor and discovered his blood sugar was very high. He spent the next two days in intensive care.
“I was really sleepy all the time. I could not get enough sleep, and I was always thirsty,” said Lucas, who plays soccer, baseball and four instruments including the viola in the school orchestra.
Lucas said he is learning the ropes of day-to-day management. He will eventually get an insulin pump and be able to manage care more and more on his own as he gets older.
He loves math and wants to be a statistician when he grows up, so doing the medical calculations isn’t so bad. “He does it in his head faster than I can do it,” Nelson said.
It’d been a difficult adjustment, especially planning ahead, but he said he feels better than he did before he was diagnosed. “I have a lot more energy now.”
Nelson is thankful for the support Lucas is receiving. Teachers make sure he doesn’t fall behind and accommodate for what he needs, a relief to Lucas and to her.
“It’s a lot for a kid to take this on and realize this is with them for the rest of their life. (The staff) make it feel like less of a burden for him, and they have made it less scary for him to get this diagnosis.”
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