Diabetes has a major impact on children and their families. The daily life of the child is disrupted by the need to monitor blood glucose levels, take insulin, and balance the effects of activity and food. Diabetes can interfere with the normal developmental tasks of childhood and adolescence, including educational success and the transition to adulthood. In order to help the child and family cope, and achieve the best possible physical and emotional health, care should be delivered by a multidisciplinary team with good knowledge of pediatric issues. Support must also be given to caregivers and to school personnel.
Compared to the management of diabetes in adults, diabetes in children and adolescents presents particular challenges. These include:
- Maintaining normal physical and psychological growth and development.
- Involving the whole family. This is particularly true when the child is too young to understand or manage the diabetes.
- Organising care for the child with diabetes outside of the home environment.
Diabetes in the school
In many countries, children spend an average of seven hours a day at school. It is important to provide children with diabetes with an environment that allows them to overcome any diabetes-related challenges that can arise during the school day. Many circumstances that are a normal part of the school day will affect a child’s blood glucose levels. These include physical activity and dietary changes. In order to maintain blood glucose levels within their target range during physical activity, adjustments may be required to insulin and food intake. Children with diabetes in the school should be able to freely access what they need to manage their diabetes – blood glucose testing equipment, insulin delivery systems, snacks and fast-acting carbohydrates.
It is important for the child with diabetes that the family, and healthcare provider or diabetes care team work together to develop a diabetes management plan that is then communicated to school staff. The plan should include the following elements:
- The current insulin and monitoring routine of the child
- The child’s ability to self-manage his/her diabetes
- The common signs, symptoms and treatment for high and low blood glucose
- Necessary equipment and supplies
- Meals and snacks
- Physical activity
- Emergency contact information for parents or guardians
By working together, staff, parents and students can ensure a safe learning environment and equal access to educational opportunities for all children with diabetes at school.