Sweet - School, Uni & Work

School Issues

Heading to High School

High school is different from primary school in many ways and when you have diabetes there are a few extra things you need to think about.

High schools are usually a lot bigger in size than primary schools so it takes a lot longer to get around. You are constantly on the move, usually the classes are held in different buildings. You may find that you end up on the other side of the campus away from your bag or locker. So it’s a good idea to carry some ‘hypo’ food with you just in case. Try keeping your ‘hypo’ food in your pencil case that way you will always have something with you.
Once you start high school you are more likely to be travelling alone on public transport. In case of an emergency, make sure that you have some identification on you, saying that you have diabetes.

Education Queensland www.education.qld.gov.au

Giving Insulin at School

All schools have different policies about students keeping medication (including insulin) and blood glucose testing equipment with them at school. You need to find out what your schools policy is regarding this.

Ideally, if you are using insulin pens and taking multiple injections of insulin a day, you should keep your insulin with you at school. If you are allowed, then it’s a good idea to keep your insulin pen in your pencil case along with your ‘hypo’ food. Try not to leave your insulin in your school bag particularly if it is left in the sun. If your insulin over heats it can go off and not work as well as it should.

Be careful with your insulin pens/needles and make sure you dispose of any sharps in a safe place. Some schools have ‘sharps’ containers in their sick rooms that they allow you to use. Remember to check what your school’s policy is.

Blood Glucose Testing at School

You need to check your schools policy to find out if you can keep your testing equipment with you at school. It’s a good idea to test your BGL at school before you give any insulin, play sport or at anytime you don’t feel right. If you are allowed to keep your BG testing meter with you ensure it is kept in a safe place and don’t let any of your friends play around with it. Remember to dispose of any sharps in a safe place.

Sport & Hypoglycaemia

You will probably be involved in sport of some kind at high school. It’s a good idea to always test your BGL before playing sport or exercising. Someone on your team, preferably your coach, should know something about diabetes and know how to help you if you have a ‘hypo’. Remember to always carry some ‘hypo’ food with you especially if you are down on the oval or gym.

To prevent hypo’s when playing sport or exercising, do one of the following, either:

eat extra carbohydrate (CHO) to cover the exercise, or
reduce your dose of insulin that is working at the time of the exercise

A lot of young people exercise and play sport so they can keep in shape, so the last thing they want to do is eat a whole lot of extra CHO to avoid ‘hypos’! If you are unsure of which insulin to reduce or by how much, speak to your diabetes doctor or educator.

Exams

As you move through high school exams become really important. To perform at your best you need to have a good blood glucose level. When your BGL is too high you will be thirsty, tired and want to go to the toilet a lot. When it is too low, you will have trouble concentrating. It is worth making the extra effort to try and get your BGL’s under control before exam time starts.

You will need to make sure that you have access to ‘hypo’ food and your BG testing meter during exams. So make sure the school knows that you may have to test, eat or go to the toilet during the exam.

Special Consideration for Examinations

Each of the states in Australia have ‘special provisions’ for year 10 and 12 exams. This information can be found on the individual state education websites or by contacting them directly.

School Camps

Having diabetes doesn’t mean you can’t go on school camps. Camps are a great opportunity to be with your friends and have some fun.

To attend a school camp you need to be able to draw-up, dial up or deliver an accurate dose of insulin. If you are taking injections you need to be able to inject yourself. If you are on an insulin pump you will need to be able to re-site an infusion set. You will also need to be able to test your blood glucose levels (BGL’s).

If you can’t do these things, then you won’t be able to go. That is unless your mum or dad, a school nurse or a teacher’s aide (who has been trained in giving injections or looking after insulin pumps) is also going to the camp. So it is much better for you to be able to look after your own diabetes.

Planning is the key to having a great time at camp. Here are some tips that will help you look after your diabetes while you are at camp.

Camp Tips

Exercise and Hypoglycaemia Prevention for Camp

To ensure that you can join in all the activities without having heaps of ‘hypo’s’, the following are recommended:

Your insulin dose should be reduced back before you go to camp. Your diabetes doctor or educator can help you with this.
In the written instructions there must be information on how to manage ‘hypo’s’ in case you are so ‘low’ that you can’t treat it by yourself.

General Safety Issues

While sleeping on the top bunk is fun, it is probably better if you sleep on a lower bunk (it makes it easier if you need to get up to treat a ‘hypo’ during the night)
It is really important to do a BGL before you go to bed every night while you are at camp. You need to know what to do if your level is low. Your diabetes doctor or educator will discuss this will you at your appointment. Usually the BGL before bed at camp should be above 7mmol/L.
You must have an emergency supply of ‘hypo’ food (e.g lucozade®, glucose tablets, jelly beans) in case of a ‘hypo’ during the night.
It is a good idea to keep your BG monitor, a torch and your ‘hypo’ food under your bed or bunk so you will know where everything is if you have a ‘hypo’ in the middle of the night.
If you are having injections and you don’t want to inject in front of your friends, ask your teacher if there is somewhere you can go to do this in private.
You need to have a safe way of disposing of any sharps (syringes and needles), so take a sharps container with you.
Always carry some ‘hypo’ food with you at all times.

For more detailed information follow the link to the Queensland Government Diabetes Care Advance Website Module 11: Other Diabetes Related Issues.

There is also a module for Teachers that will provide more information: Module 12: Information for Teachers.

Diabetes Camps

Did you know that there are some great camps run for young people with diabetes? Diabetes camps are one of the best experiences that a young person with diabetes can have. They are also a great place to learn more about diabetes, improve your self-confidence and independence and simply have a great time. If you want to know more about diabetes camps in Queensland go to www.campdiabetes.com.au .

'Schoolies' Week

The tradition of going away at the end of your final year of school is really popular amongst young people. It is a great way to relax with your friends after an often stressful end to your 12 years of schooling.

The key to having a great time at ‘schoolies’ as well as keeping the peace with your parents, is being well prepared, and staying in control. This means making sure that you understand how to look after your diabetes in all of the different situations that you might find yourself in.

It is a good idea to have a chat with your diabetes educator about the following situations before heading to ‘schoolies’. You might think that you know what to do, but it is very different when your parents aren’t around to ask them for advice on:

being prepared for a week of ‘no set plans’
timing of injections when you are sleeping in late and staying up late
drinking alcohol
looking after your diabetes during a ‘hang-over’
looking after your diabetes if you get sick
sex and alcohol
general safety information you need to know to make sure nothing goes wrong so you can have the best week.

By learning how to look after yourself you will be able to take the right action if any problems arise. Being prepared is the best way to ensure that you will have a trouble free week (at least as far as your diabetes goes).

Sleeping Late

Schoolies week is about staying up late partying and sleeping in. You have probably already worked out that if you get up late, and have breakfast late your morning insulin injection is going to be given later. If all of your insulin doses are moved later it is not a problem. The important thing to remember is not to miss any injections and that your short or rapid acting insulin is given at the same time as a meal. It is really important to check your Blood Glucose Level’s (BGL’s) regularly to make sure that all is OK.

Having No Set Plans

Another great thing about ‘schoolies’ is hanging out with your friends and not having set plans. You might meet at the beach then meet up with other friends then, go somewhere else to eat. You will often not go back to your place for hours at a time. So that you can feel comfortable to do what everyone else is doing, it is a good idea to take everything you are likely to need for the day or night with you. That means take your insulin, BGL meter and some food with you. Because it is usually hot in November, it’s a good idea to take your insulin in an insulated pack so it won’t go off in the heat. The insulated pack is also good for keeping you drinks cool. Don’t forget to pack your sunscreen!

Drinking Alcohol

Underage drinking is not recommended for any teenager. Lots of young people go to ‘schoolies’ week and have a great time without drinking or getting drunk. Remember, it is against the law to drink alcohol if you are under 18 years of age.

If you do drink alcohol and you have diabetes then you need to know the following information:

alcohol, particularly sweet alcohol drinks can initially raise the blood glucose levels and later cause them to fall
alcohol may inhibit glucose release from the liver, increasing the risk of a ‘hypo’
alcohol can mask the early symptoms of a hypoglycaemia
alcohol can lead to confusion which may affect your ability to manage a ‘hypo’ and may cause you to forget to take your insulin
alcohol may cause your friends and others to mistake the signs of a severe ‘hypo’ (reduced level of consciousness) with being drunk and leave you to “sleep it off”

Tips on Preventing Problems with your Diabetes

Before going out, have a meal which includes plenty of carbohydrate (carb’s)
Don’t drink too much and avoid ‘binge’ drinking
Don’t swap alcohol for food
Drink slowly and take a break occasionally - have a non alcohol drink or water in between alcoholic drinks
Never leave your drink unattended and don’t let others top up your drinks
If you are going to be doing a lot of activity like dancing you may need to take less insulin before you go out and before going to bed
Drink low-alcohol beers or wine rather than spirits
Eat some ‘carb’s’ while you’re drinking and before going to bed
Take a BGL before going to bed
Always carry some ‘hypo’ food with you
Carry some identification in case a ‘hypo’ is mistaken for you being drunk
Make sure a friend that is staying with you knows what to do like, call an ambulance if you cannot be woken
Never leave your drink unattended in case it gets ‘spiked’.

Alcohol and Sex

Alcohol impairs your thinking and your judgement and some people are more likely to engage in unsafe sex when they have been drinking. Be aware that getting drunk can increase the risk of being ‘date’ raped.

Hangovers

If you are feeling ‘sick’ or you are vomiting and can’t eat, you still need insulin. Insulin must never be stopped. Start your ‘sick day’ plan.
Continue to monitor BGL’s regularly. Set an alarm (on your mobile phone) in case you fall asleep so you will wake in a couple of hours to check your BGL
If vomiting continues, see a doctor or go to the emergency room at the local hospital.

Note: If you are ‘hung over’ and can’t eat anything then you may need to take less insulin. Never stop your insulin. Make sure you take your BGL’s so you know what’s happening with your diabetes. Start your ‘sick day’ plan and check for ketones if your BGL is above 15.

Ideally: You should take a written plan for ‘hangovers’ with you and check it to make sure you are doing the right things to keep your diabetes out of trouble. Talk to your parents or diabetes educator about your ‘sick day’ plan before you leave, to make sure you know what to do.

Drug Taking

Some of you will be offered drugs during ‘schoolies’. For many it won’t be the first time. Some of you may know people who chose to use drugs. It is important to remember that most young people do not use drugs during ‘schoolies week’. You need to make the right choices for you and not be pressured into anything that does not feel right. It’s OK to say NO.

Taking drugs even if it is only occasionally, can affect you making decisions about your diabetes as well as increase your risk of developing mental health problems. Most recreation drugs alter mood, perception and thinking ability which can lead you to forgetting to take your insulin or ignoring ‘hypo’s’. Some drugs make you feel like you don’t want to eat which can lead to hypoglycaemia.

Marijuana is different as it may cause you to get the ‘munchies’ and really over-eat causing high BGL’s. It may also stop you from feeling ‘sick’ and stop you from vomiting which can disguise the early symptoms of diabetic ketoacidosis (DKA). DKA can make you really sick and in some cases be life threatening. Remember to check your BGL and if it is over 15 check for ketones.

To make sure you have a great ‘schoolies’ week be prepared and have a plan so you will know what to do to keep yourself safe and well.

For more information check out these websites:

The National Drug and Alcohol Research Centre | www.ndarc.med.unsw.edu.au/ndarc.nsf
Children, Youth & Women's Health | www.cyh.com.au
Australian National Council on Drugs (ANCD) | www.ancd.org.au
Reachout | www.reachout.com.au
Reality Check | www.realitycheck.org.au
Diabetes Australia NSW | www.diabeteskidsandteens.com.au