By: Pamela Egan, FNP-C CDE
Schools need to be aware of childhood diabetes
With the childhood obesity epidemic and the onset of diabetes in children, new issues are emerging for children and youth faced with diabetes.
For children at risk of developing diabetes, schools must recognize the role they need to play in preventing instead of contributing to the emerging epidemic of Type 2 Diabetes in the pediatric population. The health crisis in youth has mirrored the rise of childhood obesity. Up to 20 percent of America’s teens age 12 – 18 are overweight, amounting to more than 6 million children in our country. Diabetes occurs in those who are genetically susceptible when 1) they over-consume calories, particularly in the form of saturated fat, simple sugar and carbohydrates, and 2) they are physically inactive.
Unfortunately, schools are now in the business of selling sugar- containing soft drinks, candy and fast food to our children. In addition, the nutritional value of the federal school lunch program is less than optimal. The sharp rise in computer game playing and TV watching combined with the trend of schools abandoning their physical education programs, often due to budget cuts, means that fewer children are participating in sports or any form of physical activity. Schools need to focus on increasing children’s physical activity and improving their nutrition. Schools must re-institute vigorous physical eduction programs designed to help optimize the health of all children in all grades. Nutrition counseling needs to be available in schools to teach children the importance of healthy eating. The selling of candy and sugar-containing drinks and fast foods loaded with calories and fat must meet a minimum nutritional requirement that will insure that it is good for children. We must put the welfare of our children above the financial benefits accrued by selling junk food.
Like all children, children with diabetes spend an enormous amount of time in school and must be allowed to achieve the same level of diabetes management in school as they do the rest of the day. First, they must have access to the tools of diabetes management- blood glucose testing equipment, insulin delivery systems and oral diabetic medications, oral fast-acting carbohydrates, sufficient time to adhere to the nutrition plan and physical activity. Second, they need the support of school personnel who are knowledgeable about diabetes and able to assist as needed.
There are many schools where the child with diabetes is fully supported. Unfortunately, there are also many schools where good diabetes management is obstructed. In these settings, it is not easy for children to test their blood glucose level, take insulin, attend to hypo- or hyperglycemia, or receive an emergency injection of glucagon (glucose) during school. Young children who cannot perform their own glucose testing or own insulin injections often end up doing without. This forces parents to come into school to support these procedures. When children are not permitted to do their blood glucose testing in the classroom, which is common, they may have to cross the campus to the health office, missing major portions of instruction each day. If an extra test is required to confirm suspected hypoglycemia (low blood sugar), they have to leave class again-to try to make it to the health office before disaster hits. Many schools ban children from carrying, seeking or consuming oral glucose products where and when they need it. In short, youngsters with diabetes are often excluded, and their rights protected by a number of federal laws (section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, and the Individuals with Disabilities Education Act) are compromised.
The American Diabetes Association is dedicated to improving the outcomes for children with diabetes and those at risk for developing this dreaded disease. There is a role for each of us in advocating that schools do their part to turn back the rising tide of Type 2 Diabetes in children and youth.