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How Can Schools Better Support Children with Type 1 Diabetes?

Learning how to manage type 1 diabetes (T1D) is a lifelong journey. Children and teenagers are in the early stages of this learning process and need support from their family. But since they spend most of their days in school, their loved ones are not always able to help them. And unfortunately, school staff are not always prepared to manage the difficulties associated with T1D.

Limited teacher knowledge

In a study conducted in Spain, a test was distributed to 765 teachers to assess what they knew about T1D. 

  • 43% said they had or have had a student with T1D in their class.
  • 42% knew that untreated hypoglycemia can lead to loss of consciousness.
  • 59% knew that a child with T1D must always carry rapid-acting glucose with them during physical activity.

Even though 86% of respondents could explain the basic steps for managing T1D (the role of insulin) and an appropriate treatment for hypoglycemia (drinking fruit juice), only 5% of them got a score that qualified them as people who could support and advise students with regard to their T1D.

Since teachers are not health professionals, it is normal for them to be unaware of all the implications associated with treating T1D. The emergency protocols of schools for cases of severe hypoglycemia generally involve dialling 911 and injecting glucagon. However, since not every teacher has been trained to perform this injection, the introduction of nasal glucagon on the market could make it easier to administer this medication.

To ensure a safe school environment for their child, parents often need to patiently explain the implications of the disease. But it’s just as crucial for teachers to be open-minded and to listen so they can understand and apply the recommendations made by the family and health professionals.

The experience of children and teens

Even when children and teenagers with T1D are able to show some autonomy in managing their diabetes, they face many obstacles at school. For instance, keeping all their diabetes supplies in the classroom is not always allowed or possible. This means they have to walk to their locker or the nurse’s office, which can be dangerous if they have hypoglycemia. So, it would be relevant to review policies on keeping diabetes supplies in the classrooms and in strategic locations at school.

Although not a major problem, it is difficult for a child or teenager with T1D to eat food sold at the cafeteria since the carb count is rarely displayed. If some cafeterias include allergen-free or vegetarian options in their menus, why could they not display the carb count of their food for students with T1D?

Finally, managing diabetes involves many factors (physical activity, stress, illnesses, etc.), and it can affect the learning and socializing process. In fact, one study found that children and teens with T1D are more bullied on average than non-diabetics. One of the possible explanations is that having T1D means these children have special needs and appear different from their peers. For example, a child who cannot participate in gym class because they suffer from hypoglycemia could feel excluded and possibly receive disparaging comments from their classmates. 

In summary, the issues surrounding T1D are often unknown and underestimated. Without asking that teachers become experts in diabetes, it would be safer if they understood and recognized the needs associated with this disease.

Do you or your child live with type 1 diabetes in Quebec?

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References

  • Andrade, C. J., & Alves, C. D. (2019). Relationship between bullying and type 1 diabetes mellitus in children and adolescents: A systematic review. Jornal De Pediatria, 95(5), 509-518. doi:10.1016/j.jped.2018.10.003
  • Gutiérrez-Manzanedo, J. V., Laureano, F. C., Moreno-Vides, P., Castro-Maqueda, G. D., Fernández-Santos, J. R., & Ponce-González, J. G. (2018). Teachers’ knowledge about type 1 diabetes in south of Spain public schools. Diabetes Research and Clinical Practice, 143, 140-145. doi:10.1016/j.diabres.2018.07.013
  • Kise, S. S., Hopkins, A., & Burke, S. (2017). Improving School Experiences for Adolescents With Type 1 Diabetes. Journal of School Health, 87(5), 363-375. doi:10.1111/josh.12507
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