Safety Issues – The Diabetic Child at School

Children naturally spend a lot of time in school. Sending a child to school when the child has diabetes, however, is cause for worry. Most children with diabetes have Type 1, or insulin dependent diabetes. The worry stems from the fact that children can’t always be relied on to make the right decisions about their health. In school and in the school play yard, parents know their child is exposed to risks other children don’t face.  If your child has diabetes, as a parent you will need to instill in your son or daughter the knowledge and skills to be able to live a healthy life, without giving in to peer pressure, while taking care of diabetic needs. The school plays an important role in this process.

Before the First School Day

Before your child goes to school, it’s necessary to talk to the school first about the diabetes. It is very important you qualify the child under a federal Section 504 accommodation plan which prohibits discrimination in schools based on a disability.[1] You will also need to obtain a Diabetes Medical Management Plan or DMPP from the child’s doctor.[2] Both plans are designed to insure that your child receives the care, supervision and assistance needed while in school.

Going to school may mark the first time the diabetic child has been away from the direct supervision of parents. This is going to test whether the child has learned what’s been taught about diabetes. A child with diabetes must learn methods for staying healthy and how to resist unhealthy temptations and peer pressure from school friends. Fortunately, the condition rarely strikes the very young, so most children can learn the diabetes management lessons. Diabetes is generally more prominent among children who are an age at which they can understand and follow directions.

Yet, no matter what the age, it is still up to the parent to prepare the child for the relative independence of school. It is through them that the child learns to:

  • Control food and drink intake
  • Refuse candy or unhealthy fat and sugar filled junk food
  • Manage  insulin schedules
  • Have no hesitation in speaking out when not feeling well

Research indicates children, who are competent in what is termed executive functioning, are better able to adhere to their diabetic program in school. Executive functioning refers to the ability to set goals, regulate behavior and have a working memory. Individuals who establish this pattern successfully are capable of exerting glycemic control.[3]

At School

At school, the DMPP must be put into action.  The school and parents can gain a lot of valuable information from the national diabetes education program called, “Helping the Student with Diabetes Succeed: A Guide for School Personnel.” It is a composite work compiled and prepared by some of the more important and knowledgeable members of agencies in the field of diabetes. These include the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), US Department of Education and the American Diabetes Association.

The DMPP requires a team approach. It is approved by the child’s medical team and parents. It is intended to insure that a diabetic child’s special needs are met while attending school. At the same time, it tries to maintain normality, so the child can enjoy their time at school. The DMPP also clearly indicates the various special requirements of the diabetic child, and specifically notes persons involved in keeping the child healthy. These people include parents, medical advisers and school staff.

The DMPP makes available precise details about medication, monitoring blood sugar and diet. Also included are all emergency phone and communication numbers.  As the parent, you must make sure the formal plan is complete, leaving nothing to chance. Make sure you try to visualize and prepare for all contingencies and appropriate responses.

In order to ensure that the plan is the right one for your child and that everyone is comfortable and understands their role, it’s important to keep communication lines open with the school. Meet with the medical personnel, school authorities and teachers several times prior to the beginning of school year to discuss your child’s diabetes and needs. This means everybody who is involved knows about your child’s requirements and what is expected of them. Possible school officials and personnel you may want to meet with include the following:

  • School medical advisers
  • Doctor
  • Diabetes coach
  • Nutrition expert
  • School nurse
  • School teachers
  • Principal

Under the law, an appropriately trained person must be available at all times in the school. This individual can be a nurse or someone been specifically trained in the needs of a diabetic. This individual must know how to use a glucose meter and how to administer insulin and glucagon.

Fully Able to Participate

The safety of the child with diabetes is foremost. A diabetic child can be efficiently and safely cared for by a diverse group of trained medical, as well as non medical, staff while they are at school.[4] Yet this does not mean the child must be made to feel out of place or odd. Being different is alright if the child’s difference is placed in an overall context that all children have differences.  In other words, diabetes should not limit the child’s ability to take part in the various activities in school. This includes physical education and sports.

Exercise is beneficial for individuals of all ages. It must, however, be monitored since exercise impacts the actions of insulin, and can put the child at risk for hypoglycemia.[5]

Conclusion

Diabetes is the third most common chronic condition experienced by children. If the child does not learn to master proper glycemic control, it will result in both short-term and long-term serious complications. If everyone involved in the child’s care is educated and informed about diabetes, the child will have a safe school experience as a diabetic and the experience becomes a part of a dynamic course of learning. They will discover that school can teach you several things.[6]  It can teach children:

  • How to master the disease while young which makes adult management easier
  • How to develop an attitude of being comfortable with themselves and their health issue and to realize that diabetes is just one facet of life
  • To not feel different and teach that you are a full and active member of the overall community of a school
  • To not worry about what others are thinking about you

References

[1] ADA (2011). Section 504 Plan.” Retrieved from http://www.diabetes.org/living-with-diabetes/parents-and-kids/diabetes-care-at-school/written-care-plans/section-504-plan.html

[2] ADA (2011). “Diabetes Medical Management Plan.” Retrieved from http://www.diabetes.org/living-with-diabetes/parents-and-kids/diabetes-care-at-school/written-care-plans/diabetes-medical-management.html

[3] McNally,K; Rohan, J; Pendley, JS; Delamater, A; and Drotar, D (2011). “Executive Functioning, Treatment Adherence, and Glycemic Control in Children with Type 1 Diabetes.” Diabetes Care, 33 (6): 1159-1162.

[4] Hellems, MA (2007). “Safe at School: A Virginia Experience.” Diabetes Care, 30 (6): 1396-1398.

[5] Warshaw, HS; and Pape, J (2009). Real-Life Guide To Diabetes. Alexandria, VA: ADA.

[6] Wang, Y-L; Brown, SA; and Horner, SD (2010). “School-Based Lived Experiences of Adolescents With Type 1 Diabetes: A Preliminary Study.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.