Monday, November 25, 2024
How understanding the condition can improve life for our students
Since you were in school, and maybe even since you started working in schools, the face of Diabetes care has changed quite a bit as our understanding of the condition has grown. We spoke with Louise Wilson, the DPI’s statewide School Nurse Consultant about what’s new and what all educators and staff should know to help keep kids with Diabetes healthy.
Clearing up Myths and Misunderstandings about Diabetes
- Diabetes is now considered an autoimmune disorder, and we need to shift mindsets.
- Exercise does not necessarily lower people’s blood sugars. It all depends on the person!
- Students with Diabetes need to plan for snacks and treats and have insulin. Students should not be denied participation in class food activities, but rather, those should be planned for.
- We must change the language we use around Diabetes and its care. Generally, it’s best to refer to “students with Diabetes” and not use the outdated term “Diabetic.” This person-first language also extends to describing the condition and its treatment. “We are not controlling blood sugars– we manage blood sugars,” Wilson says. “There’s no such thing as good or bad blood sugars. It’s a number,” again, emphasizing reducing stigma.
- Mental health and stressors can affect and be affected by Diabetes. Diabetes is a lifetime disease and it can affect many different systems in the body. “Blood sugar can affect emotions, concentration, and worry about blood sugar can also cause stress,” says Wilson. “We need more understanding about the impacts of Diabetes on folks who have it.”
- Students and families may or may not have enough support at home, and that can impact the care they receive in school. A student might be essentially managing Diabetes alone; or they may have helicopter parents who can deter student confidence.
- There are lots more resources available especially to students with Diabetes than there have been ever before, including summer diabetes camps! Students usually find out about these things from a school nurse, school counselor, or even an educator or paraeducator. Louise Wilson’s school nurse newsletters are a great source of information for these opportunities.
Technology and Diabetes Management Changes
Diabetes has always been a condition that requires vigilant, precision care, and that has not changed. Generally, it is a condition that is best managed in schools by a school nurse, who is trained in the management of Diabetes. However, not all school districts or schools have a school nurse. This means that care may be delegated to someone without a medical background, like an administrator, an educator, or an aide.
Nurses understand the importance of timely glucose checks and calculating the proper dose of insulin.The risk of miscalculating the insulin dose or not checking at correct intervals– too early, too late, or skipping a check at all– can all have grave consequences and can even be deadly, depending on the student and the situation.
Most of us are familiar with a basic understanding of Diabetes care: Monitoring glucose by using a pinprick of blood on a test strip and then administering an appropriate amount of insulin via injection. Technology is just one way the face of Diabetes care has changed in the past decade or so. Continuous glucose monitors and insulin pumps have become a more common way of automating glucose monitoring and insulin dosage.
Yet many students still rely on the older technologies for managing their care. This creates a wider range of treatment modalities that school nurses or a care team must be familiar with.
It Takes a Village
The American Diabetes Association has worked hard to make sure that students with Diabetes are not discriminated against in schools due to their condition. Every school nurse should have a care plan for each student with Diabetes they serve, and this should be made in consultation with the student’s family and their medical team. Additionally, parents or guardians may request a 504 plan as an additional lever of accountability to make sure a student’s health needs are being addressed.
Louise Wilson, the DPI’s School Nurse Consultant, underscores the need for collaboration between nurses, diabetes caregivers, a student, their family, and the student’s medical team so that there is consistency in care. “It takes collaboration, it takes a village,” Wilson says. She estimates that for every student newly diagnosed with Diabetes, or even just transferring into a district requires at least 10 hours of work time in a week to meet a parent, the child, consult the student’s physician or clinic, make plan, and work with and train people who are going to be around the student and possibly responsible for implementation of part or whole of the care plan.
To help school districts, school nurses, and other designated Diabetes caregivers in schools, Wilson, along with her colleagues at the University of Wisconsin School of Medicine and Public Health Department of Pediatrics founded a program called DISH (Diabetes in School Health). DISH is a monthly school diabetes health teleconferencing program for school nurses and school personnel who care for students with diabetes. Each ECHO session consists of a 10-15 minute talk by a pediatric diabetes expert, followed by 45-50 minute discussion of de-identified cases and questions to promote collaborative learning between school personnel in communities across the state.
The program started in Wisconsin in 2019 to great success, and has expanded to Washington, Colorado, New Mexico, and Oklahoma, connecting practitioners in each state.
We Can Improve the Experiences of Students with Diabetes
A huge amount of a student’s life is spent in school. We know that school nurses have a lot on their plates and must rely on their school “village” to help out. During this national Diabetes Awareness Month, we salute all of those who continue to learn and grow their practice– whether they be school food service managers, classroom teachers and subs, paraeducators, administrators, and of course school nurses! Together, we make a difference.
For more information about Diabetes management in schools, visit the school nurse chronic disease diabetes page.