Diabetes question

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Specializes in Cardiology, School Nursing, General.

Just a quick question, can stress contribute with low or high blood sugar?

I have a TD-1 and this is my second year with him, but he always seems to have really high blood sugar, and I'm not sure if can be contributed that he's just nervous or stressed since it's basically the 4th day of school. (Hurricane Harvey interrupted our first week of school.) But I am a bit worried, and have mentioned this to his mom and doctor already.

Specializes in Pediatrics Retired.

Yes, any factor affecting the metabolism can effect blood glucose but that is just a blanket statement; without knowing this guy's history it may, or may not, apply.

Specializes in School nursing.
Yes, any factor affecting the metabolism can effect blood glucose but that is just a blanket statement; without knowing this guy's history it may, or may not, apply.

This. Puberty can also affect blood glucose. Middle school students with diabetes can be all over the map. But, knowing not much about this student's history, it is hard to see if stress alone is the true variable at play here.

Specializes in School Nurse.

I'll guess, not because of my experience as a nurse, but my experience of the mother of a diabetic.

The kid needs his morning insulin increased. The tranition from the "running around free" all summer to the "sitting in the class" all day is enough of a change in activity to merit it.

Just a quick question, can stress contribute with low or high blood sugar?

I have a TD-1 and this is my second year with him, but he always seems to have really high blood sugar, and I'm not sure if can be contributed that he's just nervous or stressed since it's basically the 4th day of school. (Hurricane Harvey interrupted our first week of school.) But I am a bit worried, and have mentioned this to his mom and doctor already.

Stress definitely can. One thing to also consider, has he recently had his calculation or ratios changed? Our new T1D student is really high and kind of all over the place but he also just had his ratios and calculation adjusted. His edocrinologist said it can take several days to adjust to new levels.

Specializes in Cardiology, School Nursing, General.
Stress definitely can. One thing to also consider, has he recently had his calculation or ratios changed? Our new T1D student is really high and kind of all over the place but he also just had his ratios and calculation adjusted. His edocrinologist said it can take several days to adjust to new levels.

he's a 4th grader and he's been high all the time last year, so when he came back, I believe it did because the machine didn't pick up on the 240 BG and accepted it as normal, which is unusual for it count that as normal (OmniPod). I'll keep having an eye on him, but I was asked by the mother to check him a third time before school ends to see how he's glucose is, because usually I don't unless I have to or he come to visit me, but since between lunch and end of the day, his BG gets super high.

Specializes in ICU/community health/school nursing.

In addition to the excellent comments - is he on any other medication with an excipient/filler that has sugar, glucose, or any kind of starch in it? One of my kids troubleshot herself this summer when she realized the medication she'd been prescribed had an effect on her BSG. She was essentially not counting and not treating those carbs.

Specializes in Cardiology, School Nursing, General.
In addition to the excellent comments - is he on any other medication with an excipient/filler that has sugar, glucose, or any kind of starch in it? One of my kids troubleshot herself this summer when she realized the medication she'd been prescribed had an effect on her BSG. She was essentially not counting and not treating those carbs.

As I said, he's on the OmniPod, which automatically calculates what he's eating. He does bring homemade lunches sometimes, but that's harder to calculate than a lunchable that he brings with the carbs counted. Is there a way to count those carbs?

Specializes in kids.

Calorie King is a great little book with many common foods. Your food service drirector may be able to help as well.

Specializes in Med-surg, school nursing..
As I said, he's on the OmniPod, which automatically calculates what he's eating. He does bring homemade lunches sometimes, but that's harder to calculate than a lunchable that he brings with the carbs counted. Is there a way to count those carbs?

Good question. Any diabetic students I have had, if they bring lunch from home, it has been the parents responsibility to count the carbs and provide me with a number. I'm not going to try and figure out what brand of bread/chips/whatever they have and it would waste a good 5 minutes or more of their lunch for me to do so. Thus far, all of the parents have been great at providing me numbers, and if they don't want to then their student eats school lunch.

Maybe I'm just mean.

Good question. Any diabetic students I have had, if they bring lunch from home, it has been the parents responsibility to count the carbs and provide me with a number. I'm not going to try and figure out what brand of bread/chips/whatever they have and it would waste a good 5 minutes or more of their lunch for me to do so. Thus far, all of the parents have been great at providing me numbers, and if they don't want to then their student eats school lunch.

Maybe I'm just mean.

Not mean at all - I do the same. I will figure out the carbs if the kid is buying from our cafe, we have an easy to read list of carb counts for the cafe lunch items. If bringing from home I ask parents to either email carb count or put a note in the lunch box - rarely do I need to call parents for the info.

Specializes in Cardiology, School Nursing, General.

I do ask the mother, she tells me the carb count, but I was wondering if she maybe counting wrong?

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