Diabetes

Diabetes

The National Diabetes Information Clearinghouse (NDIC) of the National Institutes of Health (NIH) notes that in 2010, the number of young people under age 20 years with type 1 or type 2 diabetes was about 0.26 percent of all people in this age group (NDIC, 2010). New data on diabetes prevalence from 5 centers in the United States as well as data from selected American Indian reservations shows that there has been a sizable increase in diabetes among children between 2001 and 2009. The prevalence for type 1 diabetes is currently 1.93/1000 showing a 21.1 percent increase over 8 years from 2001 to 2009. In this same time period, there was a 30.5 percent overall increase in type 2 diabetes with a current prevalence of 0.24/1000 (Dabelea et al., 2014).

While the number of children with type 1 and type 2 diabetes is small, schools must be prepared to prevent, recognize, and react to emergency medical involving students with type 1 diabetes. Children and adolescents with diabetes are at risk for low and high blood sugars, which if left untreated, can lead to insulin shock or diabetic ketoacidosis. Severe low blood sugar or insulin shock is treated with an injection of Glucagon or concentrated sugar on the oral mucous membrane. In diabetic ketoacidosis, high levels of ketones build up when blood sugars are too high or when the student with diabetes is getting sick. Treatment for diabetic ketoacidosis involves the administration of insulin to lower blood sugar levels. Very high levels of ketones can cause loss of consciousness.

See the National Association of School Nurses Position Statement Diabetes Management in the School Setting (2019) for a description and guidance on the role of school nurses in managing diabetes.

Resources

• American Diabetes Association
• Emergency Action Plan - Department of Health Services
• Diabetes Medical Management Plan
• eSchoolCare, an evidence-based online resource for school nurses is available by subscription. Content on chronic illnesses including asthma, allergies, and diabetes is presented by experts.
• School Nurse Summer Institute 2016—Managing Diabetes Safely in the School Setting: A framework for collaborative care
  • FAQ
  • Summer Institute 2016 Presentations
  • White Paper

• Diabetes in School Health (DiSH) - UW School of Medicine and Public Health Department of Pediatrics

  • DiSH ECHO is a monthly school diabetes health teleconferencing program for school nurses and school personnel who care for students with diabetes. Presentations are recorded and archived along with other resources on the website.

Training Resources

• American Diabetes Association Training Resources for School Staff

Forms

• Template for a 504 Accommodation Plan for students using injections
• Individual Health Care Plan for Diabetes Management
• Emergency Action Plan for Kenosha
• Checklist for students with diabetes

Policy

• Sample diabetes policy from Madison Metropolitan School District

References

National Diabetes Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health. (2011). National Diabetes Statistics: Diagnosed Diabetes among People Younger than 20 Years of Age, United States. Accessed at http://diabetes.niddk.nih.gov/dm/pubs/statistics/#ddY20

Dabelea, D., Mayer-Davis, E. J., Saydah, S., & Imperatore, G. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA, 311(17), 1778-1786. Accessed at http://jama.jamanetwork.com/article.aspx?articleid=1866098