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What does effective school-based diabetes management entail?

If you are a teacher and have a child (or children) in your class with diabetes, it is important to understand what the condition is about and to receive training in case of an emergency. In broad terms, diabetes happens when a person’s body cannot make enough insulin. Insulin is the body’s natural way to break down glucose. Glucose (a type of sugar) comes from many foods, mainly starches and carbohydrates like breads, pasta and cereals.

Children with diabetes have high levels of glucose in their blood. This is because they do not make enough insulin to break down the glucose they eat. This can be dangerous. In children, diabetes is treated with insulin injections, healthy eating and exercise. Eating alone cannot control diabetes in children, and diabetes is not contagious. Diabetes is also not caused by eating “too much sugar.”

Rita Juray
Nursing Specialist

I would first make an appointment with the school nurse. Discuss what the child's needs are. Is the child at risk for hypoglycemia? Must the child have a source of rapid acting carbohydrate available? Is the child in need of frequent glucose monitoring? Children have rights and schools usually do everything they can to insure a safe environment for the children. Communication is the key. If your child has diabetes, and you feel your child is not getting his/her needs met, go to the school board meetings to discuss this. The American Diabetes Guidelines have a section discussing Diabetes Care in schools. This may be of interest to you.

Your child’s school may already have a policy in effect to deal with the needs of children with chronic illnesses, including diabetes. However, you and your child’s health care team will need to develop a Diabetes Medical Management Plan (DMMP)—to address your child’s specific health care needs.

The plan spells out the medical care your child should receive at school, including information about blood glucose monitoring, meals and snacks, insulin and emergency care, which may include the administration of glucagon. Some children are capable of self-care, whereas other children will need a great deal of help. All children with diabetes will need help in the event of an emergency.

At its core, effective school-based diabetes management requires three things:

  1. All school staff members who have responsibility for a child with diabetes should receive training that provides a basic understanding of the disease and the child's needs, how to identify medical emergencies, and which school staff members to contact with questions or in case of an emergency.
  2. The school nurse holds the primary role of coordinating, monitoring and supervising the care of a student with diabetes. In addition, a small group of school staff members should receive training from a qualified healthcare professional in routine and emergency diabetes care so that a staff member is always available for younger or less experienced students who require assistance with their diabetes management.
  3. Children possessing the necessary skills and maturity to do so should be permitted to self-manage their disease in the classroom or wherever they are in conjunction with a school-related activity. Such self-management should include monitoring blood glucose and responding to blood glucose levels with needed food and medication while utilizing appropriate safety protocols.

These principles are based on recommendations from the diabetes healthcare community and form the cornerstone of effective school diabetes care.

Written materials are available from the ADA that explain diabetes care in a school setting. The ADA’s packet on school discrimination can be obtained at www.diabetes.org or by calling 1-800-DIABETES. You can also discuss a specific school or day care problem with an ADA legal advocate.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.