Diabetes
The American Diabetes Association notes that in 2019 the prevalence of diabetes was 11.3% of the population. Nearly 1.9 million Americans have type 1 diabetes, including about 244,000 children and adolescents. In 2014-15 the annual incidence of youth diagnosed with diabetes was estimated at 18,200 for type 1 diabetes and 5,800 youth and adolescents with type 2 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.
Students living with type 1 diabetes miss an average of nine more days of school a year compared to those without the condition according to a study published in Diabetes Care (Robert French et al, Educational Attainment and Childhood-Onset Type 1 Diabetes, Diabetes Care (2022). DOI: 10.2337/dc21-0693). Schools must be prepared to prevent, recognize, and react to emergency medical situations involving students with type 1 diabetes. School nurses help both students with type 1 and type 2 diabetes manage their diabetes in school and attend safely and successfully.
DPI’s 2016 white paper on Managing Diabetes Safely in the School Setting: a framework for collaborative care defines roles and priorities in providing care to students with diabetes. DPI recognizes that the science of diabetes care and management is constantly changing and suggest school nurses seek out current resources when developing care plans. Similarly, current resources are recommended when developing school policies and protocols.
Resources
- American Diabetes Association
- Emergency Action Plan - Department of Health Services
- ADA Diabetes Medical Management Plan
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Diabetes in School Health (DiSH) - UW School of Medicine and Public Health Department of Pediatrics
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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.
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NASN - School Nursing Evidence-Based Clinical Practice Guideline Students with Type 1 Diabetes
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Continuous Glucose Monitoring in Schools Guidance- American Diabetes Association