Considerations for the Management of Hypoglycemia and Diabetes in Schools - Episode 3
A certified diabetes educator comments on the some of the available resources for patients, their families, and school staff surrounding the management of diabetes in a school setting.
Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDCES: There are many places that individual school staff and school nurses can obtain resources to get them prepared for the student coming in with diabetes. There are 4 major places I tend to recommend. Of course, the CDC has a great website on some school-based training, education, and literature for someone to read. The American Diabetes Association [ADA] is usually my go-to because it has one of the best booklets that can be downloaded by anyone, and it’s called Helping the Student With Diabetes Succeed. That was done in conjunction with the National Diabetes Education Program. We also have the Juvenile Diabetes Research Foundation, which also has a webpage that’s dedicated to school and diabetes. Then finally the diabetes educator group, the Association for Diabetes Care and Education Specialists, also has a website that has some nice handouts that can be downloaded and used for the schools. One other thing that I forgot to mention about the ADA is that there are videos and modules that school staff can watch to gain their annual competency. Now, I wish I could say that all 4 of these particular resources are something that’s very common knowledge, but they’re not. I do strongly encourage that anyone who’s working with children with diabetes, that you’re shouting about them from the rooftops, because these are some great resources that can be really useful, especially if the schools do not have access to in-person or virtual training.
The Safe at School state laws dictate that any student with diabetes is allowed to have staff on site all the time who can help them to stay safe at school. [It could be] a school nurse, which we would love to have a school nurse on staff on an ongoing basis, but there are some schools that don’t have that luxury, where the school nurse is kind of spread thin over several schools. So one or multiple staff members need to understand and be able to handle the emergency types of situations that can come with diabetes. In the event that someone needs to take insulin or needs to be given glucagon, someone has to be on site at all times who knows how to do that, whether it’s a nurse or not. That is what the state laws have stipulated, and that’s federal. So again, we want to make sure that there’s someone who can do that. If we can have a school nurse on staff all the time, I would love that greatly, but we know that may not be possible.
One thing we also have to have in place in all of these schools is something called a diabetes medical management plan. It’s basically the nuts and bolts of what that child with diabetes has to do throughout the day. It stipulates where the glucose levels need to be, when they need to take medicines, how much they need to take, and that should be done and signed off by the prescriber on an annual basis. That should also be disseminated to the school staff as well, specifically what kind of symptoms does this child have when it comes to hypoglycemia, how does their insulin affect them, and will that impact the school day at any particular time they’re in the classroom.
Transcript edited for clarity