Tag: Teens

Back to School and Hypoglycemia

Starting a new grade, new school or beginning university can be very stressful even without having diabetes, particularly during the COVID pandemic.  Many students went to school virtually last year so this autumn may be the first time going to school in person in over a year. 

No matter the grade, getting back into the school routine requires a lot of preparation and planning.  It is always good to have a plan that includes emergency numbers along with insulin plan info, and how to treat low and high blood sugar levels. 

In a perfect world, all school teachers and staff would understand how to manage T1D. Since this isn’t always the case, communication is key.  It is important to educate teachers on T1D before school begins.  Providing information to the school and classmates on T1D management, especially recognizing the signs of hypoglycemia, will help kids feel comfortable returning to school and importantly will keep them safe and healthy, no matter what the school day brings.

Here’s some information on causes and signs of hypoglycemia.

Low blood sugar can be caused by1:

  • Changes to eating patterns such as skipping or delaying meals
  • More exercise or activity than usual, or exercising for a long time without eating a snack or adjusting insulin before exercise
  • Too much insulin or a change in the time taking insulin
  • Stress (presentations, tests, exams, etc.)
What are the symptoms chart


It is important always to BE PREPARED!

In case blood sugar levels fall below 4 mmol/L, school staff should be provided in advance with fast-acting glucose (e.g. Dex4 tablets, gels, and liquids).  If teachers notice a difference in behaviour related to the signs of low blood sugar or children feel warning signs of hypoglycemia, blood glucose should be checked immediately and treat low blood sugar promptly if needed. If a blood glucose meter is not available but low blood sugar is suspected, treat right away.

Treatment options include1:

Afterwards, wait 15 minutes, then check blood sugar again. If blood sugar cannot be tested, monitor the child closely to ensure symptoms of hypoglycemia improve. 

As low blood sugar can happen at anytime, it is important to be prepared.  Dex4 Glucose products help raise glucose levels FAST. 

Dex4 Glucose products are:

  • Fast-acting
  • Pre-measured so you know exactly how much glucose you are consuming
  • Fat-Free
  • Caffeine, gluten, cholesterol free
  • Great-tasting flavours

Additional Resources:

The Diabetes Hope Foundation supports mentorship programs for youth.  Buddy systems are available, for more information visit www.diabeteshopefoundation.com/mentor-biographies

1 Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes 2013;37(suppl 1):S1-S212.

Disclaimer:

Information in this article is provided for informational purposes only and is not a substitute for professional medical advice.

JDRF-funded clinical trial of adjunct-to-insulin therapy seeks T1D teen participants

Adolescence can be a challenging time to manage type 1 diabetes (T1D). Life (and hormones!) change in all sorts of ways, and many teenagers experience higher than recommended blood glucose levels as a result, which can mean an increased risk of complications later in life. The study of novel therapies that can improve glycemic control in teens with T1D and reduce the risk of diabetes complications and is critical to improving the lives of youth living with diabetes.

Adjunct-to-insulin therapy – ie, taking another drug alongside usual insulin treatment – is one approach that could help on both fronts. For example, SGLT2 inhibitors are a class of oral medications approved for type 2 diabetes that stop glucose from the blood from being absorbed by the kidneys, instead encouraging glucose to be released in urine. Dr. Farid Mahmud and his team at the Hospital for Sick Children in Toronto are now recruiting for a JDRF-funded clinical trial that will test the safety and efficacy of an SGLT2 inhibitor called dapagliflozin in teens with T1D.

The research team is seeking participants aged 12-18 years with established type 1 diabetes in the Greater Toronto Area (Hospital for Sick Children) and Southwestern Ontario (Children’s Hospital of Western Ontario, London) who may be eligible to participate in the Adolescent Type 1 Diabetes Treatment with SGLT2i for Hyperglycemia & Hyperfiltration trial – also known as ATTEMPT attempt.study@sickkids.ca.

SGLT2 inhibitors such as dapagliflozin can improve blood sugars, increase time in range and decrease kidney pressure, called hyperfiltration. Studies in adults with T1D have shown that SGLT2 inhibitors can lower HbA1c, insulin dose and weight. By alleviating glucose absorption in the kidneys, these drugs can also help prevent long term damage to these organs.

What is the ATTEMPT study?

ATTEMPT is a 22-week clinical trial that aims to determine the safety and effectiveness an SGLT2 inhibitor called dapagliflozin on managing blood glucose and on improving kidney function in adolescents aged 12 to 18 with T1D. The study is being conducted to determine how this therapy can benefit and be used effectively in adolescents with T1D.

ATTEMPT is led by Dr. Farid Mahmud, an endocrinologist and researcher at The Hospital for Sick Children in Toronto. Dr. Mahmud’s overall research focus is diabetes, clinical and translational research relating to other autoimmune conditions (such as celiac disease), and early evaluation and prevention of diabetes-related complications. His research interests include the evaluation of medication and lifestyle interventions in high-risk pediatric groups and the evaluation of impact of the social determinants of health in youth with diabetes. He is also actively engaged in patient-centered research as part of the CIHR Strategies for Patient Oriented Research (SPOR- Can-SOLVE CKD) and as part of the JDRF-funded AdDIT (Adolescent Diabetes Cardio-renal Intervention Trial). 

What does joining the ATTEMPT study entail?

Once enrolled in the study, a participant can expect:

  • 5 in-person visits over 22 weeks
  • A random assignment to the dapagliflozin group, or the placebo group (a small pill that contains no active medicine)

While part of the study, participants will:

  • Keep taking insulin
  • Wear a continuous glucose monitor (CGM)
  • Test for blood ketones
  • Report any adverse events

Study participants will be compensated and provided support for costs associated with travel or parking. To learn more about the study and how to enroll, please contact: 416-813-7654 ext. 204517 or email  attempt.study@sickkids.ca