As a parent, it is only natural to worry when your child has diabetes. How to make sure that your child's diabetes is well managed at school? Here are some pointers to help you put your child's school days and cafeteria visits into perspective.

The development of type 1 diabetes (T1D) in children

T1D is a chronic autoimmune disease. The affected person's immune system "attacks" the pancreas cells responsible for producing insulin. The result is a lack of insulin, which causes blood sugar levels to rise. Hyperglycemia is the cause of diabetes symptoms and complications.

T1D Often appears in childhood (between the ages of 4 and 10), adolescence or young adulthood. A later diagnosis in adulthood is possible, but rarer. To date, there is no cure or prevention for this disease.

 

How do you manage diabetes at school?

As a parent, the best way to manage your child's diabetes at school is to begin by drawing up a personalized action plan (PAI) that defines the child's glycemic targets, insulin protocol and alert procedures. Next, inform school staff and ensure easy access to an emergency kit (glucometer, insulin, glucagon, snacks). Finally, keep a daily monitoring notebook and organize regular follow-ups with the care team.

Is diabetes considered a handicap at school?

Type 1 diabetes is not officially recognized as a handicap by the Ministère de l'Éducation du Québec. However, every student benefits from accommodations and preventive support, without stigmatization. The Personalized Action Plan (PAI) is part of the legal framework for accessibility and equity at school.

What rights do diabetic children have at school?

In the early 2000s, the Politique de l'adaptation scolaire une école adapté à tous ses élèves (Special education policy a school adapted to all its students) introduced the notion of at-risk students and abolished the declaration of students in difficulty, to ensure that any student encountering certain difficulties in their educational pathway would receive special attention. Consequently, the school your child attends must have access to services adapted to their daily needs.

 

What are the risks associated with T1D?

Even today, T1D can be life-threatening. Diabetic ketoacidosis is the leading cause of morbidity and mortality in children with diabetes, and prevention is imperative.

It occurs when insulin levels are insufficient to meet basic needs. Its symptoms include nausea, vomiting and abdominal pain. It can also lead to cerebral edema and coma, which can be fatal.

A major challenge in managing T1D is recognizing and managing episodes of hypoglycemia (low blood sugar). This can lead to symptoms that can compromise a child's health, well-being and performance, such as low energy, weakness, headaches, dizziness, drowsiness, difficulty concentrating or speaking, blurred vision and so on.

 

How do you explain type 1 diabetes to your child?

Managing diabetes requires a great deal of autonomy on the part of your child. What's more, they will want to fit in with the other students without being seen as different. As a parent, it is important to prepare your child for the many challenges of the disease, so that they can successfully overcome them!

In order for your child to organize themselves properly at school, they need to understand their disease and why insulin is so important. They must be familiar with, and comfortable with, the following aspects:

• Glycemic targets;
• Using their administration device;
• Measuring blood sugar and ketone levels;
• Adjusting the dosage;
• Treatment when they are sick;
• Preventing diabetic ketoacidosis;
• Recognizing and managing hypoglycemic episodes;
• Food plan procedures;
• Adjusting their treatment in case of physical activity.

What is Diabetes School?

Diabetes School is an educational program, often offered by CISSS/CIUSSS or certain private clinics, that trains:

• Children and their families in the day-to-day management of T1D.
• Teachers and school staff to safely intervene.
• Children's peers to promote inclusion and reduce stigmatization.

Practical workshops (4 to 6 hours divided into sessions) simulate real-life situations (recess, cafeteria, sports activities).

 

Teaching and daycare staff involvement

Informing school staff about your child's condition is absolutely necessary. Ideally, arrange a meeting with the people responsible for your child's well-being at school (teacher, lunch supervisor, daycare worker, nurse, etc.).

For reasons of safety, the families of the child's friends, and anyone else who may have temporary responsibility for the child, should also be made aware of the illness and the important aspects outlined above.

 

Tips for managing your child's diabetes at school

Here are a few additional tips:

• If your child eats lunch at school, make sure they eat enough to avoid glycemic imbalance. Pack healthy lunches and snacks.
• Check regularly to see if the insulin's expiry date has passed.
• Prepare a document (action plan) containing all the important information, and distribute it to everyone concerned.
• Encourage your child and the school staff to contact you if they have the slightest doubt or if anything is not quite right. Include your cell phone or office phone number on the action plan and in any other useful location. Ideally, your child should know your numbers by heart.
• Listen to and support your child. Above all, applaud their efforts to manage their diabetes!

Together, you now have all the keys you need to support your child and make diabetes at school a challenge to be met with peace of mind. Your vigilance, the personalized action plan and the cooperation of the entire educational team will ensure that your child grows, learns and flourishes in complete safety.

Feel free to ask your healthcare professionals and your Jean Coutu pharmacist to help you improve your children's day-to-day school life.