Returning to school can heighten concerns for children with type 1 diabetes and their families due to the condition’s demands. This autoimmune disorder, where the pancreas fails to produce insulin, requires vigilant monitoring to maintain normal blood sugar levels, posing unique challenges for students and caregivers alike.
Ciara Stevens, a registered nurse and certified diabetes educator in Nova Scotia, works with people of all ages living with the condition and understands from personal experience the challenges that come with the diagnosis for school-aged kids. She was diagnosed with type 1 diabetes when she was 11.
She says of tackling the learning curve and later adopting technology devices and new insulin formulations as they advanced, “I took it and ran with it.” Living with the condition also influenced her career as a health-care provider.
Managing Type 1 Diabetes at School
Stevens emphasizes that diabetes affects people differently and the management required also changes over time. “There are many factors that influence glucose [blood sugar], not just what we eat, but our medications and how much we move. We say there’s like 42-plus factors,” she explains.
For success at school, Stevens recommends developing an individual care plan (ICP) for students that outlines daily management — blood glucose checks, insulin, meals, activity — and emergency procedures, following Diabetes Canada’s national guidelines. The plan of care for returning to school or perhaps even going to school for the first time if they received a diagnosis over Christmas break or summer break, it really does look individual based on the child or teen.
Stevens notes that not every child will be on the same system or regimen, but the advent of remote monitoring has been very nice, too. So if a parent does want to take a peek at what glucose levels are while their child is away from them at any time, if they are able to use a sensor, they can do that.
Watching for Signs of Low and High Blood Sugar
Teachers should be on the lookout for any changes where the student is less chatty or more chatty than usual or they’re not partaking when they typically would or if their friends say that they’re not acting like themselves, Stevens advises. This is because hyperglycemia or hypoglycemia, high and low blood sugar levels, influence those behaviours and can be problematic.
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Knowing what to do in these situations is important. The ICP will outline intervention, Stevens explains. In some cases at school, there’s one insulin injection per day that can be overseen or given by a particular individual.
Students typically carry a belt bag or backpack with a “diabetes kit” containing fast-acting glucose like apple juice or glucose tablets and supplies may be stored at school as well. Some students may carry intranasal glucagon, which can be given in the event of severe hypoglycemia, such as unconsciousness. Another factor is planning around physical activity that uses more energy and generally lowers blood sugar.
Stevens notes that schools are working hard to better support students with diabetes and welcome parents’ input. Generally, parents and caregivers are concerned about the response to glucose levels that are below target and troubleshooting technology. There’s also the emotional and social impact of what Stevens labels as “shame, blame and stigma,” where kids are treated differently because of their diabetes.
Some children are quite open about talking about their diabetes and if they are, parents can encourage them to talk to their teacher about having them share about it at school to their peers in a class presentation. Stevens encourages parents to also talk with kids about experiencing comments that are not accurate and to let them know that that’s something they can chat with them about when they get home.
Breakthrough T1D has virtual sessions to connect people and Diabetes Canada offers D-Camps in summer across the country for kids to connect and make friends. Stevens has worked at some of the D-Camps and is an advocate for participation. One of the biggest takeaways is that community experience and feeling like you’re not the only one, she says of the distress and stigma that results in people not accessing health care when they need it.
Community Support
Breakthrough T1D and Diabetes Canada offer programs to connect kids with type 1 diabetes. These programs help kids feel less alone and more supported in managing their condition. Stevens has seen the positive impact of these programs firsthand.
