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supporting students with diabetes at school: diabetes canada calls for a national standard of care
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advocates say that without mandatory guidelines for support and care at school, kids with type 1 diabetes are missing out.
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fitting in and making friends at school can be tough. it’s even more of a challenge for kids living with type 1 diabetes who have to be on alert about keeping their blood sugar in the normal range.
“imagine you’re in grade 3 and you can’t go on the field trip because there’s no one trained to help you if your blood sugar drops. or you’re sitting out of gym class, not because you can’t participate, but because the school doesn’t have a plan in place for what happens if you go low during activity,” says laura syron, president and ceo of diabetes canada.
“these kids want what every kid wants: to feel normal, to be included, to not have to explain themselves constantly.”
negative messaging about diabetes at school affects kids’ development
what can be the most challenging part of living with type 1 diabetes is the feeling of isolation and being singled out for being different. and when kids are not supported at school in their diabetes care, they’re internalizing the message that their health needs are a burden that makes them “too much” to accommodate, she says.
learning is affected. self-esteem and social development are affected. these are causes for serious concern that can have lasting consequences. about 0.3 per cent of kids and youth aged one to 19 in canada live with diagnosed diabetes.
diabetes canada, alongside family advocates, is calling for action by governments to give kids living with type 1 diabetes the support they need to have the same opportunity as others to learn and thrive at school. the national non-profit is advocating for provincial and territorial policymakers to introduce mandatory standards of care that are aligned with the diabetes canada guidelines for the care of students living with diabetes at school. the document outlines the unique needs of kids with type 1 diabetes so that school staff can be trained and supported by administrators to be aware of challenges and steps for care.
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the cognitive effects of high or low blood sugar levels can affect mood and behaviour, and lead to emergency situations if left untreated. these students learn and perform best when their blood sugar levels are within the target range outlined by their healthcare providers. as the guidelines outline, students with diabetes should be accommodated.
to demonstrate “their knowledge of a subject, including writing exams and performing other tasks for credit, blood sugar levels should be within their target range. if not, then an alternate time to redo or complete the activity should be provided.”
individual care plan for daily management and emergency action
an important key to the success of the guidelines is developing an individual care plan for each student, which includes information and instructions for school personnel on the student’s daily diabetes management tasks and diabetes emergency prevention and treatment.
“with the right supports—individualized care plans, trained staff, access to their devices—these kids can do everything their peers can do,” syron explains, adding that parents have become experts in a condition that is highly complex. “they’re doing the work. but they shouldn’t have to do it alone.”
the guidelines have become the foundation for mandatory standards in nova scotia, prince edward island and british columbia, but every other province and territory has a patchwork of guidelines and policies where kids are falling through the gaps, she notes.
“ultimately, what we’re hoping for is consistency and equity. a child in thunder bay should have the same access to safe diabetes care at school as a child in toronto or halifax or vancouver.”
type 1 diabetes can be life-threatening
syron talks about a recent incident where a child whose blood sugar dropped dangerously low during class (2.2 when it should have been 4.0). the child had juice in their backpack for this specific reason, the teacher had the care plan, and the signs were all there. but the school staff member wouldn’t give the child the juice until they reached the parent by phone first because they said they weren’t allowed to interpret the blood sugar reading.
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“so this child sat there, feeling shaky, confused, unable to concentrate, while staff tried to get a parent on the phone. that’s not just frightening, it’s dangerous. severe low blood sugar can lead to seizures, loss of consciousness, even death if not treated quickly.”
this staff member didn’t have the proper training or authority to act, whereas a trained staff member would have identified the emergency, given the juice immediately and then called the parent. the situation would have been resolved in minutes, and the child would have been safe instead of facing a crisis.
mandatory standards support educators, students and families
“that’s exactly why we need mandatory standards. when everyone understands the risks—when they know what low blood sugar looks like, what the numbers mean, and what immediate action to take—they can respond with confidence instead of fear.”
without mandatory standards in place, the health and quality of education of kids living with type 1 diabetes are at risk. parents are filling the care gap, syron notes, where they rush to their child’s school on their lunch break to administer insulin. some have to quit their jobs to make it all work, while others decide to move to another school board to get quality care.
“some are even pulling their kids out of the classroom entirely because they don’t feel their child is safe. that’s heartbreaking.”
she adds that educators want to help but are stuck because there is no provincial or territorial mandate. so, they don’t have the training, the authority, or the protection they need to safely support these students.
“no child should be denied safety or a fair shot at education because they live with diabetes. this is about basic equity, and it’s long overdue.”
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