Student with diabetes

I've had a diabetic student at the dojo once. He actually did get too low on sugar and went faint. Luckily he had a candy bar on him to bring it back up.

Honestly I would suggest keeping sugar packets or honey (never spoils) on hand. In my first aid class that I had they suggested this.

Hello

<<I've had a diabetic student at the dojo once.

It is quite likely that you've had several diabetic folks at the dojo but one of the two of you were probably unaware of that fact... or perhaps both of you were unaware. It is not a scare tactic, but in what is known as Type 2 diabetes, (aka Adult Onset Diabetes) most have no idea they possess the illness-condition, until they are actually diagnosed. It can be that subtle, unless somone knows what to look for... it is a bone-fide Epidemic and shows no signs of decreasing.

Now back to your post, in the event of LOW blood sugar (regardless of the type of diabetes) a candy bar would not be the ideal "cure", or frankly even a slightly good one from the standpoint it will take a longer time to breakdown the nutrients, and when you add in the Chocolate, the fats... (ie getting access to the sugars in the candybar...) it is a very poor choice... of the many available anyway.

Consider instead something you can get at any pharmacy, and many grocery stores these days called GLUCOSE Gel which comes in a small tube. It is a brand name product which has many generic variations these days all of which defacto are essentially a small tubes of cake icing +/-. (ie which btw is also a viable alternative in place of the brand name Glutose product, simply some tubes of the normal cake icing that you get at the grocery store)

In terms of an emergency, or even a small incident, it requires nothing except removing the cap and squeezing the tubes contents into the diabetics mouth... (typically in 2 or 3 squeezes to prevent spillage/gagging... if you squeezed the entire thing in...)

As a cure for a low bloodsugar incident, it's a little over the top most times but if/when woozy or unable to communicate clearly it does the trick, fast and easy... 15-30 minutes.

Ask your student what they want you to do if/when they are "low" (aka Hypoglycemic, aka HYPO, shocky, etc., etc.). But the small tubes of cake icing, or the Glutose Gel are an easy addition to the First Aid Kit and a heck of a lot easier than a can of NORMAL soda, Smarties Candies, whatever the typical solution-cure for a "low" sugar might be. It fits into the first aid kit, cheap, lasts forever, just like on the grocery store shelves). Easily eaten even by combative diabetics... (there's a pun there someplace)

Its merely my opinion, and I could SURELY be mistaken,
Jeff

Good Morning Davera:

What word re: your diabetic student/s? Did you acquire a plan or modifications of same specific to their condition?

Jeff

I'm surprised given the HEAVY viewing traffic, more folks have not commented, or asked more questions re: diabetes and the respective arts, even given the forum???

Diabetes is a serious illness which its many potential challenges demand a literal plan (sic Business and otherwise) how to cope with the assorted issues/challenges if even purely from the business standpoint. Given the potential seriousness I am genuinely surprised more traffic has not been generated....

Jeff

The kind of excirses the MA offers is good for the students that suffer from this type diease as long as he eats well, takes his medication and excirsise it wil help his body ward off the affects of this diease. His stamina may start lacking he may tire quickly, he may show no ill effect because the condition he is in. He may not heal as quickly as a normal. He/she should be able to participate in all MA activities except heavy full contact sparring, where 6 or more 3 minuets rounds are required. Unless he/she is tip top shape.

The MAs is one of the best Aerobic and Energy challenging classes for a person of this illiness.

Hello Neko4456:

<<His stamina may start lacking he may tire quickly

Both instructor & ALL students must be sentient, aware... fatigue/exhaustion will harm in many ways

<< He may not heal as quickly as a normal.

True, largely due to circulation issues brought on by blood sugar levels, by in large.

<<He/she should be able to participate in all MA activities

Absolutely.

<<except heavy full contact sparring, where 6 or more 3 minuets rounds are required.



That is identical for anybody whether diabetic or not. ~Unless he/she is tip top shape...~

Jeff

In the new year, most schools get an influx of ~new bodies~, eager to "...try something they've always wanted to do..."

Presumedly many of them will be diabetic folks (of various and assorted types). Given the number of views the thread has gotten perhaps there are more questions lurking specifc to "diabetic" martial artists old or new...



Anybody?
J

Hello:

I am curious if any instructors have diabetic students or, or perhaps might be diabetics themselves and in either case who are using the "latest gagets" known as Insulin Pumps ie Minimed, Disatronics, disatronix <sp.?>, etc.

Its a variation on the topic, but one I've never seen mentioned in-depth on the net anywhere else. Here is as good a place as any.... and far better than most diabetes, martial arts, etc.

Anybody,
J

Hello Davera:

Merely wanted to follow-up on your original posting re: having a diabetic student. How are things going for both of you???

Anything come up for either side which others (whether diabetic or the teacher of one) might want to factor-in to what they were doing??? I searched the internet last night and was appalled there was almost nothing specific to discussion concerning diabetes and martial arts. I was hoping to rekindle the thread... keep it alive anyway!

J

Considering he hasn't posted here in 7 months of continuous discussion of this topic, I doubt you are going to get any reply from him.

I would suggest you contact him via PM or email if you are truely interested in an answer.

I just wanted to tell my story here. April 05 I was diagnosed with type 2. I had quite a high number. Using metformen, very good diet, and plenty of excersise (weight lifting), I was able to control it. I started karate Jan 06. Between karate 2-3 times a week, and workingout at home another 3 days a week, I am off the drugs and maintaining the sugar level naturally. Since in most cases type 2 means a high blood sugar level, it can be maintained with low body fat, no sugar intake, plenty of sweat, and brown pastas and breads. This is what I do now. It is unfortunate that I had to get diabeties to wake up and live a healthy life. I am 38 years old, and feel 10 years younger because of my new life style. I recently went for a blood test, and I was in the "non-diabetic" catigory.

I take the term "Karate for Life", two ways now.

Hello Wadoryu:

Which "hits" harder your art or the illness ?
Gotta love the blood tests that show "you don't have" what you've worked so blessed hard to keep in check

Amused Sigh...
J

Hi Ronin1966

Well, its funny you asked that. Since I wrote the above comment, I have had a chipped elbow, very broosed ribbs, skin missing from my shins, and sprained toes. When I went to the hospital for xrays for my ribs and elbow, I told the nurse my story and she couldnt stop laughing. She said " so you have your long term illness taken take of, but you have a whole wack of new short term ones popping up".

Living Longer...In Pain,
wadoryu

Lucky it is type II and not type I. It should be simple, if just diagnosed he will feel low blood sugar, or hypoglycemia coming on. Good to have glucose tablets, available at Walgreens, CVS and other drug stores as well as Walmart around. He will tell you when he need a break most times.

If you however notice that he is becoming confused, sweaty, or acting unlike his usual self, this could be a sign of a low. Also, he may act one way one time, and completely different another. If it should happen that he actually passes out, call the paramedics. They keep IV glucose on the rig. Lastly, if his blood sugar goes to low and he has not been drinking, and does not have liver disease, it will more than likely not kill him because of the bodies safe guards, this is called the Somoji effect, or the Dawn Syndrome, where your body compensates for a low blood sugar with its fat stores and turns them into glucose which is stored in your body.

One important thing, this illness does not limit him in any way. Let him work as hard as he can, and do not be afraid to require as much from him, with the exception of him asking for a break due to a low blood sugar.

Hello Moderator Hart:



Respectfully I don't think there is a "luckily" in this case. Restricted to only those choices type two would clearly be my preference as well... but it would be akin I think to choosing between which "poison" one gets to take, bleech or amonina ? Neither is desirable.... no wins in that choice.... both are bad to have....

The Glucose GEL in the tubes I find far more preferable & useful than the tablets in the "worst case". Either works but if unconscious the gel (ie in the little cake icing tubes) is absorbed and does not require multiple tablets to get the "job" done.... Maybe both in the first aid kit are a good idea?

Now the real question how do any of us tell with the "new student" if they are merely pushing themselves, sweating like we all should <g> and because of that a little wobbley or in "diabetic trouble"? Only working with someone for a short while we might not "perceive" the Jeckyl/Hype personality shift sometimes seen in low blood sugar easily.....

This illness does not limit him/her in any way. Work as hard as they can... pay attention but work hard!

Respectfully,
Jeff

I prefer the gel as well, however, either one should not be given if the PT is not conscious. At that time, unless you are a medic qualified to administer IV glucose, it is beyond you. The gel tends to break open with age and movement and creates a mess. The tablets, which taste like SweetTarts are easier to keep and allows more on hand. A bottle of Honey works wonders as well, and can be kept in a glue type bottle bought from a craft store (a new one, not one that had glue in it before)since Honey does not need to be swallowed but can be absorbed through the membranes of the mouth, this is something that can be given when the PT is out, but with caution and training.

Someone brought up the lack of healing. This is a long term problem, and will not be an issue until 10 to 20 years down the road. This as well applies to Hypoglycemic Unawareness, after a tightly controlled Diabetic PT has had so many episodes, his or her body tends to not recognize the Hypoglycemic state as an emergency. I have never seen this before the ten year mark in Type 1 or Type II.

Having worked for a number of years as a Paramedic and also in ADA camps in the summer, I have had a bit of experiance with Diabetic Patients. My one suggestion would be to trust them and learn as you go, as each Diabetic is different. If you like, contact your local ADA chapter about training to handle a Diabetic emergency.

Yes, I would think caution would be in order. I think that as Instructors we sometimes make the person with the problem feel less than he is by singling him out and making a big deal of a small scrap. I would say, with any student who sustained an injury, to take good care of it. I may even make a sugestion on how to go about it. A cut on the foot can be a problem with anyone, the older we get the worse circulation is for us all. You are right, but lets take it a step farther. We, as Instructors should always place safety first, with all the Deshi. Good point, Sir.

Yes, you are right. If an elderly or obese person, who had circulation problems to begin with, had contracted Diabetes, it could be a problem from onset. I was only speaking of Diabetes as being the cause. It usually takes at least 10 years of poor control to get to that problem.

Hello Moderator Hart:



<<I prefer the gel as well, however, either one should not be given if the PT (sic patient) is not conscious.

The tubes I was/am speaking of are identical to the cake icing tubes (both mini & the larger ones), except some brands (of Glucose Gel) possess a few more grams of carbohydrates (ie sugar) than the cake icing typically does I believe... not by too much I don't think, but some... I'll have to check now....

Cake icing tubes seem a workable parallel to me, but regardless neither requires anything but removing the top (unscrewing/twisting) then squeezing the contents into the mouth. But regardless, conscious or not, the tube is gently placed between the cheek and gums and squeezed slowly until empty. Might take one squeeze, might be two or three (with the mini-tubes anyway)... you don't want to empty the entire thing in one squeeze because just like anything you might pour into your mouth, you don't want to choke/gag on one huge glob of whatever..... So I've been told.

Should take c. 15 minutes to see some effect, sometimes more sometimes less they say.

<<contact your local ADA chapter about training to handle a Diabetic emergency.

The local hospital might have an diabetes educator/group that could train as well....

Jeff

Hello Mr. Hart:

Other instructors I know who have had foot doctors/nurses as students proposed that we should all check our feet carefully, daily whether diabetic or not. Don't ignore the dryness, the redness, the fungus, cuts, ingrown toenails whatever the particular problem might be. Ignore foot problems, issues and they often get worse...(sic. with sharp teeth)

The diabetic student merely has to be more vigilant because of the potential for trouble specific to feet among other issues. Students with chronic illnesses require definate self-awareness.

And defiantely as you said open discussion should be had how they wish "problems" handled. We had a student who had been with us probably a decade at that point that gave so little thought to their particular condition (because it was innocious <sp.?> & easily treated from their perspective) hense they failed to mention it....

I think its safe to say we all now ask far, far more ~thorough~ and pointed questions...

Jeff

Hello Moderator Hart:



I'll have to re-check the shelves of my local pharmacy. I'm further North than you are but would have sworn I saw the brand name tubes (Glutose) & some kind of generic both there and in several other pharmacies in my local area when I happened to be picking up some scripts over the holiday for family....

Not sure what you mean by being in a glue bottle??? The brand name stuff was 100% identical to the tiny cake icing tubes, not the big ones mind you... but the small ones. Not a bottle by any stretch....

Regardless agreed as to anything being put into the mouth of an unconscious person. Dead wrong & bad idea... with the singular above exception we are discussing above!



Jeff

The stuff I am speaking of was in a bottle that looked like a Elmer's Glue bottle, three doses in a bottle. The stuff you are talking about isn't the same stuff, it is flavored and has a lot less carbs in it. This stuff was about the consistancy of glue, but clear. It worked wonders for the kids at the Diabetic camp, but tasted like warm snot, or at least thats what I percieve that warm snot may taste like.

I'll see your and raise you a

Diabetic students should beware of chokes and extreme over exertion.

Chokes could cause a stroke in some diabetics, and over exertion could cause blood sugar problems which can kill a guy deader than bricks. ( )

Hello Paradoxbox:

Interrupt the blood supply to my brain, if you don't know exactly what you are doing, AND how to reverse the unconscious... bad things will happen, regardless of any chronic condition...

Interrupt blood supply to the brain... BAD idea

<<extreme over exertion.

By definition "extreme" anybody needs to be careful. But likely their particular blood testing protocol should cover that situation.... they'll no more dead than the next person... merely has to factor in, consider assorted factors and make an informed judgement...

Diabetes
Jeff

Hi Ronin1966,
Sorry I haven't replied to your post. It's been a long time since I've been back to this forum and I just saw it tonight. Anyway, thanks for asking about my student with diabetes. He is still training with me and doing fine. He continues to take medication and is on a modified diet. He has to leave class a half-hour early each time in order to get home to eat according to a strict schedule. Otherwise, he is training with everyone else just the same.

Hello Davera:



It is wonderful to hear from you again! Doubley so to hear your diabetic student is still with you and doing well!

Hummmmmngh... must leave a half hour early in order to eat according to their strict schedule. Interesting... do not know if your student has considered or not but they could snack (obviously food, they understand whats in it)... finish training and then proceed home to eat. The snack would be something nutritionally they would subtract from whatever they were going to have at dinner.

Obviously whatever works for them, but some other options are available. What do they do when literally they are not able to eat... dinner is not thawed...Uncle Tommy's receipe was incorrect and more time was mandatory... the restaurant has a party that is gorging overtime... not letting him be seated?

Regardless, glad to see you back!
Jeff

Jeff,
The idea of having my student snack a little bit so he can finish class sounds like a good one. I'll bring it up with him and see if it's feasible. Thanks.