3.9.14 Notification: Diabetes Information

In accordance with CA Education Code 59452.6 and 49452.7 information regarding Type 1 and Type 2 diabetes, including risk factors, is required to be provided to every incoming family to raise awareness about this disease. Contact the Nurse of the Day through the Student Family & School Resource Link at (415) 340-1716 if you have questions.

Type 1 Diabetes Information 

(CA Education Code 59452.6)

Type 1 diabetes in children is an autoimmune disease that can be fatal if untreated, and the guidance provided in this information sheet is intended to raise awareness about this disease. 

Type 1 diabetes usually develops in children and young adults but can occur at any age

• According to the U.S. Centers for Disease Control and Prevention (CDC), cases of type 1 diabetes in youth increased nationally from 187,000 in 2018 to 244,000 in 2019, representing an increase of 25 per 10,000 youths to 35 per 10,000 youths, respectively.
• The peak age of diagnosis of type 1 diabetes is 13-14 years, but diagnosis can also occur much earlier or later in life.

Type 1 diabetes affects insulin production

• As a normal function, the body turns the carbohydrates in food into glucose (blood sugar), the basic fuel for the body’s cells.
• The pancreas makes insulin, a hormone that moves glucose from the blood into the cells.
• In type 1 diabetes, the body’s pancreas stops making insulin, and blood glucose levels rise.
• Over time, glucose can reach dangerously high levels in the blood, which is called hyperglycemia.
• Untreated hyperglycemia can result in diabetic ketoacidosis (DKA), which is a life-threatening complication of diabetes.

Risk Factors Associated with Type 1 Diabetes

It is recommended that students displaying warning signs associated with type 1 diabetes, which are described below, should be screened (tested) for the disease by their health care provider.

Researchers do not completely understand why some people develop type 1 diabetes and others do not. However, having a family history of type 1 diabetes can increase the likelihood of developing type 1 diabetes. Other factors may play a role in developing type 1 diabetes, including environmental triggers such as viruses. Type 1 diabetes is not caused by diet or lifestyle choices.

Warning Signs and Symptoms Associated with Type 1 Diabetes and Diabetic Ketoacidosis

Warning signs and symptoms of type 1 diabetes in children develop quickly, in a few weeks or months, and can be severe. If your child displays the warning signs below, contact your child’s primary health care provider or pediatrician for a consultation to determine if screening your child for type 1 diabetes is appropriate:

• Increased thirst
• Increased urination, including bed-wetting after toilet training
• Increased hunger, even after eating
• Unexplained weight loss
• Feeling very tired
• Blurred vision
• Very dry skin
• Slow healing of sores or cuts
• Moodiness, restlessness, irritability, or behavior changes

DKA is a complication of untreated type 1 diabetes. DKA is a medical emergency. Symptoms include:

• Fruity breath
• Dry/flushed skin
• Nausea
• Vomiting
• Stomach pains
• Trouble breathing
• Confusion

Types of Diabetes Screening Tests

• Glycated hemoglobin (A1C) test. A blood test measures the average blood sugar level over two to three months. An A1C level of 6.5 percent or higher on two separate tests may indicate diabetes.
• Random (non-fasting) blood sugar test. A blood sample is taken any time without fasting. A random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher may suggest diabetes.
• Fasting blood sugar test. A blood sample is taken after an overnight fast. A level of 126 mg/dL or higher on two separate tests may indicate diabetes.
• Oral glucose tolerance test. A test measuring the fasting blood sugar level after an overnight fast with periodic testing for the next several hours after drinking a sugary liquid. A reading of more than 200 mg/dL after two hours may indicate diabetes.

Type 1 Diabetes Treatment

There are no known ways to prevent type 1 diabetes. Once type 1 diabetes develops, medication is the only treatment. If your child is diagnosed with type 1 diabetes, their health care provider will be able to help develop a treatment plan. Your child’s health care provider may refer your child to an endocrinologist, a doctor specializing in the endocrine system and its disorders, such as diabetes. Contact your student's school district nurse, school administrator, or health care provider if you have questions.

Type 2 Diabetes Information

(CA Education Code 49452.7)

Type 2 diabetes is the most common form of diabetes in adults.

Until a few years ago, type 2 diabetes was rare in children, but it is becoming more common, especially for overweight teens.

According to the U.S. Centers for Disease Control and Prevention (CDC), one in three American children born after 2000 will develop type 2 diabetes in their lifetime.Pre-diabetes is a precursor to Type 2 diabetes and one in five youth aged 12-18yo has pre-diabetes.

Type 2 diabetes affects the way the body is able to use sugar (glucose) for energy.

The body turns the carbohydrates in food into glucose, the basic fuel for the body’s cells.

The pancreas makes insulin, a hormone that moves glucose from the blood to the cells.

In type 2 diabetes, the body’s cells resist the effects of insulin, and blood glucose levels rise.

Over time, glucose reaches dangerously high levels in the blood, which is called hyperglycemia.

Hyperglycemia can lead to health problems like heart disease, blindness, and kidney failure.

Students displaying or possibly experiencing the risk factors and warning signs associated with type 2 diabetes should be screened (tested) for the disease.

Risk Factors Associated with Type 2 Diabetes Link to this section

Researchers do not completely understand why some people develop type 2 diabetes and others do not; however, the following risk factors are associated with an increased risk of type 2 diabetes in children:

• Being overweight. The single greatest risk factor for type 2 diabetes in children is excess weight. In the U.S., almost one out of every five children is overweight. The chances are more than double that an overweight child will develop diabetes.
• Family history of diabetes. Many affected children and youth have at least one parent with diabetes or have a significant family history of the disease.
• Inactivity. Being inactive further reduces the body’s ability to respond to insulin.
• Specific racial/ethnic groups. Native Americans, African Americans, Hispanics/Latinos, and Asian/Pacific Islanders are more prone than other ethnic groups to develop type 2 diabetes.
• Puberty. Young people in puberty are more likely to develop type 2 diabetes than younger children, probably because of normal rises in hormone levels that can cause insulin resistance during this stage of rapid growth and physical development.

Warning Signs and Symptoms Associated with Type 2 Diabetes Link to this section

Warning signs and symptoms of type 2 diabetes in children develop slowly, and initially there may be no symptoms. However, not everyone with insulin resistance or type 2 diabetes develops these warning signs, and not everyone who has these symptoms necessarily has type 2 diabetes.

• Increased hunger, even after eating
• Unexplained weight loss
• Increased thirst, dry mouth, and frequent urination
• Feeling very tired
• Blurred vision
• Slow healing of sores or cuts
• Dark velvety or ridged patches of skin, especially on the back of the neck or under the arms
• Irregular periods, no periods, and/or excess facial and body hair growth in girls
• High blood pressure or abnormal blood fats levels

Type 2 Diabetes Prevention Methods and Treatments Link to this section

Healthy lifestyle choices can help prevent and treat type 2 diabetes. Even with a family history of diabetes, eating healthy foods in the correct amounts and exercising regularly can help children achieve or maintain a normal weight and normal blood glucose levels.

Eat healthy foods. Make wise food choices. Eat foods low in fat and calories.

Get more physical activity. Increase physical activity to at least 60 minutes every day.

Take medication. If diet and exercise are not enough to control the disease, it may be necessary to treat type 2 diabetes with medication.

The first step in treating type 2 diabetes is to visit a doctor. A doctor can determine if a child is overweight based on the child’s age, weight, and height. A doctor can also request tests of a child’s blood glucose to see if the child has diabetes or pre-diabetes (a condition which may lead to type 2 diabetes).

Types of Diabetes Screening Tests That Are Available Link to this section

Glycated hemoglobin (A1C) test. A blood test measures the average blood sugar level over two to three months. An A1C level of 6.5 percent or higher on two separate tests indicates diabetes.

Random (non-fasting) blood sugar test. A blood sample is taken at a random time. A random blood sugar level of 200 milligrams per deciliter (mg/dL) or higher suggests diabetes. This test must be confirmed with a fasting blood glucose test.

Fasting blood sugar test. A blood sample is taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL is normal. A level of 100 to 125 mg/dL is considered pre-diabetes. A level of 126 mg/dL or higher on two separate tests indicates diabetes.

Oral glucose tolerance test. A test measuring the fasting blood sugar level after an overnight fast with periodic testing for the next several hours after drinking a sugary liquid. A reading of more than 200 mg/dL after two hours indicates diabetes.