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#334761 - 08/26/06 10:36 PM Re: Student with diabetes [Re: PaulHart]
kunin Offline
hard-boiled aggression

Registered: 06/05/06
Posts: 73
Loc: - cloud-hidden in the big city
Quote:

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.



I would add one more caution here. Blood sugar imbalances can result in peripheral circulation problems and impaired wound healing. This is always something to keep in mind, even when the diabetes is under control. Just make sure that the student takes prompt and proper care of scrapes and minor cuts, especially in the feet.
_________________________
'If you have an honest mind, everywhere is a dojo.' Nicole

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#334762 - 08/27/06 05:00 AM Re: Student with diabetes [Re: Ronin1966]
PaulHart Offline
banned member

Registered: 05/23/06
Posts: 192
Loc: The Real
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.
_________________________
Paul Hart http://allshorin.org

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#334763 - 08/27/06 08:23 AM Re: Student with diabetes [Re: PaulHart]
kunin Offline
hard-boiled aggression

Registered: 06/05/06
Posts: 73
Loc: - cloud-hidden in the big city
Quote:

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.



Paul: I'm only a student nurse, so I'm inclined to defer to your experience. But I've personally seen cases where impaired wound healing was a concern upon diagnosis. The patients in question, admittedly, were not in good overall health, nor had they had regular access to medical services for a sustained period prior to diagnosis. So you're right--the wound thing is not likely to be an immediate problem for the presumably health-conscious martial artist who's just been diagnosed. Still, better to err on the side of caution, I would think.
_________________________
'If you have an honest mind, everywhere is a dojo.' Nicole

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#334764 - 08/27/06 03:52 PM Re: Student with diabetes [Re: kunin]
PaulHart Offline
banned member

Registered: 05/23/06
Posts: 192
Loc: The Real
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.
_________________________
Paul Hart http://allshorin.org

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#334765 - 08/28/06 03:45 PM Re: Student with diabetes [Re: PaulHart]
Ronin1966 Offline
Professional Poster

Registered: 04/26/02
Posts: 3113
Loc: East Coast, United States
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

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#334766 - 08/28/06 04:25 PM Re: Student with diabetes [Re: PaulHart]
Ronin1966 Offline
Professional Poster

Registered: 04/26/02
Posts: 3113
Loc: East Coast, United States
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

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#334767 - 08/29/06 12:38 AM Re: Student with diabetes [Re: Ronin1966]
PaulHart Offline
banned member

Registered: 05/23/06
Posts: 192
Loc: The Real
Quote:



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






As they say, hind sight is 20/20. You are right, of course. The Icing tubes you speak of are okay, but again not for a unconscious patient. They use to make stuff called "Glutose" that came in a glue bottle that could be given no matter the state of the patient, however that was removed from the market. Any other substance can cause chocking, even if put between the cheeks and gums. Honey is the opnly thing I would use for that as it does not require swallowing. Plus, a bottle of honey does not need refrigeration.
_________________________
Paul Hart http://allshorin.org

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#334768 - 09/06/06 09:59 PM Re: Student with diabetes [Re: PaulHart]
Ronin1966 Offline
Professional Poster

Registered: 04/26/02
Posts: 3113
Loc: East Coast, United States
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

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#334769 - 09/08/06 01:07 AM Re: Student with diabetes [Re: Ronin1966]
PaulHart Offline
banned member

Registered: 05/23/06
Posts: 192
Loc: The Real
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
_________________________
Paul Hart http://allshorin.org

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#334770 - 09/11/06 08:15 PM Re: Student with diabetes [Re: PaulHart]
paradoxbox Offline
Enthusiast

Registered: 09/15/04
Posts: 590
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. ( )

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