Things have sure changed since I went to school. Some may say for the good, some may say for the worst but either way life is different than I knew it. I was raised in an era where the lunch ladies made home cooked meals, the president’s wife wasn’t worried about how much sodium we had and it was unusual to see an overweight child. We never heard of peanut or tree nut allergies, there didn’t need to be laws allowing student to carry their epi pens and (gasp) we really did walk to school no matter what the weather.
I wouldn’t trade those years for anything.
I was also a student with type 1 diabetes. And as I see what children encounter with their diabetes in schools I am thankful I grew up when I did. I took my insulin at home, in the morning and evenings, watched what I ate and when I did check my blood sugar it was at home. There were no school staff reviewing numbers making me feel “good” or “bad” based on a reading I often couldn’t control. My sister and friends looked out for me, and the one time I drank a regular Pepsi in front of a teacher she called my dad (who also happened to be a principal).
Diabetes care has advanced tremendously since that time, but it’s also made things a bit more challenging for both students and teachers. For students, it has to feel somewhat like being under a microscope. Over the years I have had well-meaning staff do things that would make any child hate to come to school. Checking blood glucose becomes an ordeal as does taking insulin. Counting carbohydrates is a challenge and well-meaning people question what kids are eating. With that, I would just like to offer school staff a few thoughts about children with diabetes from the perspective of someone who has been around the block a bit.
1- Diabetes is always there. Kids do not get a day off. 24/7 children with diabetes are living with this often exasperating condition. Please do all you can to make their routine “normal”. Depending on the age and developmental ability of kids some are fine checking blood glucose in the classroom. Often they know much more about their bodies than anyone else. Give kids as much flexibility as you can in making those decisions.
2- Don’t refer to children as “the diabetic”. Granted, I hear this more in my nursing peers than I do from other school staff. As someone with diabetes I am offended when someone tries to define me with that label. I happened to develop a condition that I didn’t choose but it does not describe who I am. It’s much less offensive to use language like “the child with diabetes” etc. Just be aware of the impact of your words.
3- Learn what to do. The biggest worry in school is low blood sugar (hypoglycemia). Know the signs and be prepared to respond. I would hope that everyone has nurses in the schools to help provide training (but as we know this is an area sorely lacking in our prosperous country). If you don’t have someone to train you, talk to parents and access information available for school staff on the American Diabetes Association website.
4- Make sure you have what you need to respond to a low blood sugar reaction. Parents should supply snacks and supplies but unfortunately not every child has parents who do so on a regular basis. Rather than spend your time fighting, ask the nurse or principal to get a tube or two of glucose gel. You can also use cake gel (it must be GEL, not icing, the icing has more fat and takes longer to absorb). That way you have a cheap and quick way to respond and prevent an emergency situation.
5- Know that if he/she has high blood sugar then there will need to be extra trips to the bathroom. I’ve heard lots of staff talk about how kids abuse the system to “take advantage”. There are lots of psychological issues than can come with diabetes that become classroom management issues. That is a topic for another blog! But do know that it is very real for a child to need extra trips to the bathroom when blood sugars are running high.
6- Low or high blood sugar levels can interfere with test-taking abilities. These kind of things should all be addressed in a health plan, and often students with diabetes will also have a 504 plan.
7-Families are taught to count carbohydrates not limit foods. Children with diabetes have the same nutritional needs as any other child. They can eat cupcakes and other treats, it just has to be covered with insulin (either via pump or by an injection)- they should have access to the same treats the other students have.
Over my years in school health I have seen the number of students with type 1 diabetes increase. It’s the rare occasion for schools not to have at least one student with diabetes. Please know they often feel “alone” in their condition. When I was a child my parents packed me off to “Camp Kno-Koma” for two weeks every summer (I am NOT making the name up- that’s what it was called) where for once I was not the weirdo. We all had to do the same thing and I didn’t feel like everyone was staring. Be aware of those feelings in your students. Those thoughts will vary by child but sometimes kids just want to have a “normal” day.
Diabetes care at school is a team effort, and some days are easier than others. The more you know, the more comfortable parents will feel sending their child to school and the more confident you will feel in being able to respond to the needs of the kids in your care!!