Colorado Diabetes Prevention and Control Program - Diabetes and School Care in Colorado

Colorado Diabetes Prevention and Control Program

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Diabetes and Children

Diabetes is one of the most common chronic childhood diseases. In the United States about 125,000 youth (younger than age 19) have diabetes and about 13,000 new cases are found each year. Most children with diabetes go to school or day care and need trained staff to provide a safe environment.

What is diabetes?

Diabetes is a serious disease that stops the body from making or properly using insulin, a hormone needed to change sugar, starches, and other food into energy required for daily life.

Type 1 Diabetes

Type 1 diabetes is an immune system disease where the body makes little or no insulin. It usually begins in childhood or teens. Children with type 1 diabetes need daily insulin shots to help their bodies use food. Type 1 diabetes often runs in families, and whites have a higher rate of type 1 diabetes than other racial groups.

Warning Signs of Type 1 Diabetes (These symptoms may come on suddenly):
Extreme thirst
Frequent urination
Drowsiness, lethargy
Sugar in urine
Sudden vision changes
Increased appetite
Sudden weight loss
Fruity, sweet, or wine-like odor or breath
Heavy, labored breathing
Stupor, unconsciousness

Type 2 Diabetes

Type 2 diabetes is a disease where the body cannot make enough, or can't properly use, insulin. Although this form of diabetes usually occurs most often in adults, it is becoming more common in youth. The average age of diagnosis of type 2 diabetes in youth is 12-14 years. It is more common among girls than boys. The number of children with newly diagnosed type 2 diabetes has risen since 1994.

Warning Signs of Type 2 Diabetes (Youth with type 2 diabetes can have some or all of the following signs and symptoms. Some youth with type 2 diabetes will have no symptoms.):
Frequent urination
Unusual thirst
Extreme hunger
Extreme tiredness
Irritability
Slow healing of wounds or sores
Tingling or numbness in hands or feet
Itching
Blurred vision
Acanthosis nigricans (dark, velvety patches on the skin around the neck or in the armpits)
High blood pressure
Treating Diabetes in Children
There is no cure for diabetes but it can be controlled. Family support, daily care and treatment help control diabetes so that a child can lead a healthy, active, and fun-filled life. Keeping blood sugar levels in a target range means balancing insulin, food, and exercise. Food raises blood sugar levels, while insulin and exercise lower them. Children and families should work with their diabetes medical team to find a plan that is best for them.

Websites for Information about Diabetes and Children
Juvenile Diabetes Research Foundation
American Diabetes Association
Children with Diabetes
Schools and Children with Diabetes
Schools have the legal responsibility to provide diabetic students with a medically safe environment as well as equal access to the same opportunities and activities enjoyed by other students. Trained school staff, access to necessary equipment and supplies, and a Health Care Plan developed by a student's personal health care team are all important to meet the student's specific medical needs.

Federal laws that protect children with diabetes include Section 504 of the Rehabilitation Act of 1973 , the Individuals with Disabilities Education Act of 1991, and the Americans with Disabilities Act of 1992.

Under federal law diabetes is 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 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 disruption to the school's and the child's routines as possible and should allow the child full participation in all school activities. Federal law requires an individualized assessment of any child with diabetes.

Both parents and the healthcare team must work together to be sure that schools and day care workers have the information and training they need to help children with diabetes to participate fully and safely in school and other activities.

At the beginning of a school year or upon diagnosis, the family of a student with diabetes should meet with the school administrator, the school nurse, other trained school staff, and the teacher who has primary responsibility for the student. The purpose of this meeting is to discuss the student's Health Care Plan (HCP) and to develop a 504, IEP or other educational plan. The student with diabetes should also attend the meeting when appropriate.
School Staff Responsibility
All members of the school community should:
Learn to recognize signs and symptoms of low blood sugar and high blood sugar, and respond to student's HCP.
Provide a supportive environment at school where students with diabetes are treated like other students except to meet their medical needs; and
Respect students' privacy about their diabetes
Tools for Schools
The National Diabetes Education Program's "Helping the Student with Diabetes Succeed: A Guide for School Personnel" is an excellent resource for schools.

The American Diabetes Association has a position statement on Care of Children with Diabetes in the School and Day Care Setting.

P.E.D.S. School Staff Action Tools, including the Individualized Healthcare Plan, procedures, resources and school staff action tools.

American School Health Association

National Association of School Nurses