Care of Children with Diabetes in the School and Day Care Settings

Care of Children with Diabetes in the School and Day Care Settings

Diabetes is one of the most common chronic diseases of childhood, with an incidence of approximately 1.7 affected individuals per 1000 people younger than 20. In the U.S., approximately 13,000 new cases are diagnosed annually in children. About 125,000 individuals younger than 19 have diabetes in the U.S. The majority of these children attend school and/or some type of day care and need knowledgeable staff to provide a safe school environment. Both parents and the health care team must work together to ensure school systems and day care providers have the information and training they need to allow children with diabetes to participate full and safely in school

Federal laws that protect children with diabetes include the Rehabilitation Act of 1973, Section 504, the Individuals with Disabilities Education Act of 1991, and the Americans with Disabilities Act of 1992. Under these laws, diabetes has been determined to be a disability, and it is illegal for schools and/or day care centers to discriminate against children with diabetes. Any school that receives federal funding or any facility considered open to the public must reasonably accommodate the special needs of children with diabetes. The required accommodations should be provided within the child's usual school setting with as little disruptions to the school's and the child's routine as possible and allowing the child full participation in all school activities. Federal law requires an individualized assessment of any child with diabetes.

Despite these protections, children in the schools and day care setting still face discrimination. For example, some day care centers have refused admission to children with diabetes. Children in those classrooms have not been provided the assistance necessary to monitor blood glucose and/or have been prohibited from eating needed snacks. Appropriate diabetes care in the school and day care setting is necessary for the immediate safety of the child and for the child's long-term well being and optimal academic performance.

School and day care personnel must have an understanding of diabetes and its management to facilitate the appropriate care of the child with diabetes. Knowledgeable personnel are essential if the child is to achieve the good metabolic control required to decrease risks for later development of diabetes complications.