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Central European Annals of Clinical Research

(ISSN: 2668-7305) Open Access Journal
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Central European Annals of Clinical Research (CEACR) is no longer published on JAMS (the publishing platform provided by MDPI) as of 10.07.2021. The articles published until that date are archived at ceacr.archive.jams.pub by courtesy of JAMS.

Cent_Eur_Ann_Clin_Res 2020, 2(1), 31; doi:10.35995/ceacr2010031

Endoped Abstract
Diabetes in School—An Important Challenge
Gun Forsander 1,2
1
Department of Pediatrics, Institute for Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Box 426, 405 30 Gothenburg, Sweden; gun.forsander@vgregion.se
2
Region Västra Götaland, Sahlgrenska University Hospital, The Queen Silvia Children’s Hospital, Rondvägen 10, 416 50 Gothenburg, Sweden
How to cite: Forsander, G. Diabetes in School—An Important Challenge. Cent. Eur. Ann. Clin. Res. 2020, 2(1), 31; doi:10.35995/ceacr2010031.
Received: 4 November 2020 / Accepted: 14 November 2020 / Published: 17 November 2020
Keywords:
diabetes management plan; diabetes self-care; school; legislation; safety

Background and Aims

To handle diabetes self-care is a challenge for everyone but especially for children during the school day. School attendance is a prerequisite for a successful academic performance, but studies show that children with diabetes, at least historically, exhibit reduced performance in comparison to healthy children. This can be due to a lack of competent adult support in insulin treatment during the school day, resulting in a high glucose variability with hypo- and hyperglycaemia, affecting brain function. It can also be caused by parental fear of hypoglycemia, which can lead to less school attendance, i.e., during sport days.

Materials and Methods

A couple of studies have been performed in Sweden before and after a piece of legislation was implemented in 2009, stating that all children have a right to get adult support in their diabetes self-care during the school day [1]. The effect of this legislation has improved the situation for children with diabetes and made parents feel more confident to send their child to school [2]. ISPAD has published a new chapter 2018 on diabetes in school and soon thereafter as a complement, a strong position statement [3,4]. This paper states that “The principles of this ISPAD Position Statement on Type 1 Diabetes in Schools should be applicable globally. ISPAD strongly supports compliance with legal protections for children and adolescents with type 1 diabetes to attend school, to be safe at school, and to receive optimal medical management at school and in all school associated activities”. In this position statement, the diabetes education of all school personnel is mandatory but divided into three levels, depending on the individual, every-day responsibilities for the child.

Results

A guideline or even an international position statement has to be followed by legislation on a national level to have a true impact for the children in need of special support. In Sweden, it has been shown that such legislation has made a difference [5].

Conclusions

Children with diabetes have a brighter future than ever before if their need for extra support during the school day is ensured. A young child should put the energy and effort on the demanding learning process in school, without unnecessarily being troubled by thoughts of the glycaemic control. A teenage student with type 1 diabetes is often mature enough to solve problems with the diabetes self-care during a school day, even if the parental support at home still is essential for many years.

Funding

This research received no external funding.

Conflicts of Interest

The author declares no conflict of interest.

References

  1. Sarnblad, S.; Berg, L.; Detlofsson, I.; Jonsson, A.; Forsander, G. Diabetes management in Swedish schools: A national survey of attitudes of parents, children, and diabetes teams. Pediatr. Diabetes 2014, 15, 550–556. [Google Scholar] [CrossRef] [PubMed]
  2. Sarnblad, S.; Åkesson, K.; Fernström, L.; Ilvered, R.; Forsander, G. Improved diabetes management in Swedish schools: Results from two national surveys. Pediatr. Diabetes 2017, 18, 463–469. [Google Scholar] [CrossRef] [PubMed]
  3. Bratina, N.; Forsander, G.; Annan, F.; Wysocki, T.; Pierce, J.; Calliari, LE.; Pacaud, D.; Adolfsson, P.; Dovč, K.; Middlehurst, A.; et al. ISPAD Clinical Practice Consensus Guidelines. Management and support of children and adolescents with type 1 diabetes in school. Pediatr. Diabetes 2018, 19 (Suppl. 27), 287–301. [Google Scholar] [CrossRef] [PubMed]
  4. Goss, P.W.; Middlehurst, A.; Acerini, C.; Anderson, B.J.; Bratina, N.; Brink, S.; Calliari, L.; Forsander, G.; Goss, J.L.; Maahs, D.; et al. ISPAD Position Statement on Type 1 Diabetes in Schools. Pediatr. Diabetes 2018, 19, 1338–1341. [Google Scholar] [CrossRef] [PubMed]
  5. Forsander, G. Legislation can help children to receive the support they need to manage chronic health conditions like type 1 diabetes at school. Acta Paediatr. 2018. [Google Scholar] [CrossRef] [PubMed]