deck 1

Question 1

name maternal and baby benefits of breastfeeding

Answer 1

beyond six months:

1. protective against overweight and obesity in childhood
2. immune factors in 1st and second years
3. protect against infectious illnesses - especially GI and respiratory infections

Maternal:
decrease breast cancer, protect against ovarian cancer, bonding

Question 2

when should babies get lumpy textures

Answer 2

no later than 9 months

Question 3

when can cow milk be introduced and how much

Answer 3

9-12 months of age

no more than 750 ml

Question 4

from one year of age - what type of foods should you recommend

Answer 4

little/no added salt
regular schedule of meals and snacks
encourage breastfeeding o offering 500 ml per day of homogenized milk
limit fruit juice, give water for thirst

Question 5

When can skim milk be safely given to babies?

Answer 5

after 2 years - should have homo milk until then (skim milk not appropriate in first 2 years)

Question 6

when is formula used until

Answer 6

until 1 year of age after that don’t need for healthy babies

Question 7

are soy, rice based beverages instead of cow milk an appropriate milk alternative in an 18 month old

Answer 7

no, not appropriate alternative to cow milk in first to years (regardless of whether they are fortified)

Question 8

How common is diabetes

Answer 8

1/300 children

Question 9

which age group is the fastest growing segment of the population with type I diabetes

Answer 9

chilren < 5 year old and early school-aged children - fastest growing segment of the population with type 1 diabetes

Question 10

What are some short term and long term complications of type 1 diabetes

Answer 10

1. short term: hyperglycaemia, hypoglycaemia

2. long term: stroke, heart attack, amputation, kidney failure, blindness and learning deficits

Question 11

true or false - improved blood glucose control reduces the onset and progression of diabetes related complications in kids and adolescents with type 1 diabetes

Answer 11

yes it does

optimal diabetes control is essential for individuals and society

Question 12

how often should kids check their blood glucose levels

Answer 12

at least 4 times daily - before each meal and at bedtime

some kids use continuous glucose monitoring (checks every 5 minutes)

Question 13

true or false - blood glucose control improves with more infections per day, optimized using multiple daily infections or an insulin pump

Answer 13

true

Question 14

how does insulin pump work

Answer 14

provides a continous dose of insulin, then bolus of insulin through pump before eating

Question 15

true or false - kids with diabetes should not participate in gym class

Answer 15

false - should be active

but might need to be extra careful about food intake and blood glucose around activity

Question 16

describe the effect that low blood glucose can have on learning?

Answer 16

concentration, thought processing and behaviour in the short term
can treat most episodes with fast-acting sugar
once treated, can take up to 45 minutes to have effects on intellectual function to resolve
when at the time of a test, may need special accommodation to complete it

Question 17

what level of hyperglycaemia will you expect to see effects of high blood glucose

Answer 17

hyperglycemia >15 mmol/L
accompanied by symptoms of illness - fever or vomiting
can be associate with cognitive slowing also
not a benign event
the effect is different for all different people

Question 18

True or false - in BC, non medical professional school professional can administer glucagon or insulin

Answer 18

true

Question 19

Name some strategies to avoid hypoglycaemia at school for kids with diabetes

Answer 19

1. regular meals and snacks and adequate time
2. adjust food intake or insulin dose for increased physical activity, in most cases, an extra blood glucose check or extra snack
3. clean area for blood glucose checks
4. supervise kids to help them recognize, treat and prevent hypoglycaemia
5. ready access to emergency kit
6. older kids: accommodations for tests, quizzes or exams
   * *don’t leave kids unattended after hypoglycaemia until the episode has resolved

Question 20

true or false- kids with diabetes generally have much higher absences from school

Answer 20

false - with the exception of absences for regular doctor appointments
shouldn’t punish kids with the required attendance programs

Question 21

What are some barriers to optimal and safe diabetes management at school

Answer 21

might not be able to give themselves shots/check - might lead to a 2-3 x daily insulin infections to avoid the need for a lunchtime infection

Question 22

do schools need to have a medical professional at school to help kids manage their diabetes

Answer 22

no, does not need
basic care should be provided by trained school personnel, should not make the school personal liable if they take steps to assist a student in an emergency situation

Question 23

whose responsibility is it to provide diabetes education to schools

Answer 23

regional or provincial heath authorities should identify mechanisms to ensure that personnel and resources are available to provide education to schools and that education is specific for type 1 diabetes
should give verbal and standardized written information to schools
sometimes a meeting might help

Question 24

how many school personal should be trained to provide support in a school where 1 or more children have diabetes

Answer 24

2 personel at least who are trained
may be unlicensed
will get diabetes education resources, enabled to attend annual diabetes updates

Question 25

What should an individual care plan for a child with diabetes contain

Answer 25

outline roles and responsibilities of school personal, parents and the kid
should have a standardized form from the province for this

Question 26

ways to keep school safe for kids with diabetes

Answer 26

1. supervise students’ mess and snacks to ensure they are eaten on time and in full
2. teacher/supervisor should know how to recognize and treat hypoglycaemia
   don’t leave a kid alone when suspect hypoglycaemia
   optimal treatment is glucagon
   (especially if >20 minutes for EMR time)
3. accommodations for examinations, tests and quizzes
   keep a diabetes emergency kit in their desk
   if have hypoglycaemia before (30 min) or during an exam, should get 30-60 minutes to allow for cognitive recovery from hypoglycaemia
4. should have minimal exclusions - to avoid social problems