Children and youth with type 1 diabetes in school

What is type 1 diabetes?

Type 1 diabetes is a chronic disease where the pancreas doesn't produce insulin - a hormone that allows the body to convert glucose (sugar) into energy. Without insulin, glucose levels in the blood become dangerously high. Untreated type 1 diabetes is life-threatening. The only treatment is daily injections or infusions (through a pump) of insulin.

About 1 in 300 children have type 1 diabetes. These children need frequent blood sugar checks each day and regular doses of insulin. Physical activity and diet must also be closely monitored. Depending on their age and ability, many children need an adult to either do or supervise these daily tasks.

How does type 1 diabetes impact a child in school?

Children spend up to 35 hours per week at school, so managing their diabetes while there is important for both short- and long-term health.

Blood sugars that are too high or too low can affect a child's ability to learn. And blood sugars can change quickly, so it's important that school staff are educated, equipped and available to support students.

Some families worry that their child won't have the proper support to deal with diabetes at school. Will a child be excluded from activities because there is no one to help with diabetes-related tasks? What happens when a teen has low blood sugar just before an exam? These are just some of the situations students with diabetes may face in school.

How is type 1 diabetes being managed in schools?

Support for students with type 1 diabetes in schools is inconsistent across Canada. Resources and policies are different across the country, even among schools in the same city or the same school board.

Currently, only five provinces (British Columbia, New Brunswick, Newfoundland and Labrador, Nova Scotia andQuebec) have policies or guidelines to provide for the care of students with diabetes.

Each province and territory needs to establish minimum standards for care so that schools create a safe and supportive environment for students with type 1 diabetes.

What are the responsibilities of a parent or guardian and the school?

Both the Canadian Paediatric Society and the Canadian Diabetes Association believe that effectively managing a child's diabetes in school should be a shared responsibility between families (including the child), schools, and, if needed, a healthcare provider.

Although parents or guardians should be responsible for the daily management decisions around their child's diabetes (e.g., medications and storage, frequency of blood sugar monitoring, carbohydrate counting, determining insulin doses), school staff should be equipped to provide the student with reliable hands-on support and supervision.

Each school year, parents (guided by their healthcare team) should develop a detailed Individual Care Plan (ICP) for their child, which should include a daily diabetes management plan and a diabetes emergency plan for school staff. The ICP should also outline roles and responsibilities of everyone involved in the child's wellbeing.

Parents should review and finalize their child's ICP with input from school staff. The school principal should then share it with all staff that will be in contact with the student on a regular basis.

10 things teachers should know

KidsInTheHouse.com: What school staff should know about diabetes (video)

National Diabetes Education Program (American): Helping the Student with Diabetes Succeed - A Guide for Personnel

Information for parents:

Canadian Diabetes Association: Children and type 1 diabetes

Diabetes Resource Centre, Hospital for Sick Children: Includes a fact sheet on Diabetes in the Classroom

The Hospital for Sick Children: Letter about diabetes for your child's teacher

Juvenile Diabetes Research Foundation (JDRF): School Advisory Toolkit for Families (Includes sample diabetes management plan)

Canadian MedicAlert Foundation: No Child Without - Free membership in MedicAlert (including bracelet, to children 4 to 14 years)

Children with Diabetes (American): Diabetes at School and Diabetes Management at School