The DataAccording to the CDC's survey in 2005, 21 million people (about 7% of the total US population) have Diabetes, and almost 200,000 of them are under age 20. One in every 400-600 students under age 20 will have diabetes. In some cases a diabetic student will appear tired in class due to diabetes-related fatigue, and require frequent bathroom and water breaks. In some cases a teacher needs to be vigilant about changes in mood, energy and irritiability because these may signal a blood-sugar crisis that could potentially lead to coma or death.
TYPE 1 diabetes (juvenile onset) is the most likely to appear in students as it develops in children. Type 1 involves the body attacking its own pancreatic beta cells that are supposed to create insulin: the hormone that controls the blood's glucose levels. As a result, people with Type 1 Diabetes need to take insulin by shot or pump. In some cases, if insulin isn't delivered in an appropriate dosage or at an appropriate time a student may experience hypoglycemia (low blood sugar), or ketoacidosis which can be life threatening.
Diabetes in the Classroom
Teachers need to be aware of their students' prevention and management plans, and need to develop a level of awareness about the student's danger clues. Especially in middle school, the desire to fit in with peers may cause a student to forget or neglect a step in their treatment, or may cause them to wait before getting an adult's attention when they feel their blood sugar is falling or rising dangerously. Someone in the school building may need to be able to administer an insulin or glucagon shot in an emergency situation. In schools that don't have a school nurse on the premisis at all times, it may be necessary for the teacher to be trained to give injections.
Even though middle school students should be aware enough of their bodies to follow appropriate steps when they notice a crisis coming on, the social implications of being seen as different and vulnerable or out of control of their bodies can make it hard for a student with Diabetes to ask for the help in the classroom they need. Not onlly is it logical that a teacher be aware of treatments and warning signs because they are the adult in the room, it may be imperative for young children who might not self-monitor enough to notice their own warning signs, and for middle school students who may realize, but not want to admit their warning signs. This is why teachers need to be involved in creating a plan for treatment, maintenance and checking in with students regularly.
Creating a Plan
Having a plan in place allows teachers to treat the student like all others without neglecting their health concerns. The student can then operate safely in the classroom without stigma or extra attention. In some cases it is appropriate to file an IEP or 504 plan for special seating arrangements and/or water and bathroom breaks (and even snack breaks) for students with diabetes especially during testing situations. The more a teacher knows about a student's personal plan for prevention of crisis, and their treatment in crisis the safer and more normal a child will feel in the classroom. For example, a lot of people know that diabetic people often avoid sugar as part of their treatment, but when a student is having a hypoglycemic episode it is appropriate and necessary to give them sugar. Conversely, there are situations where extra sugar can be dangerous. Unlike a disease like Asthma where there is one treatment no matter what the symptoms (always an inhaler or nebulizer) a teacher needs to have background on the symptoms and treatments to be aware of for their students in order to be able to assist them in crisis.
Some teachers have been successful pairing a student with diabetes with a "buddy" who watches out for them. In some schools, the stringent rules for no eating in class must be bent for students with Diabetes to avoid an emergency. Some students may need to test themselves using a finger-prick test a few times a day. Schools need to have a plan for where and when this can take place so that it is safe and private for the student (if the student wishes it be private), not disruptive to other students, and can be done accurately. Younger students may need supervision for this, and their peers will certainly need a respectful and accurate explanation.
The classroom culture in a class with a student with diabetes must be one of acceptance, helpfulness and respect so that the student can manage their health without fear of stigma, ignorance or incompetence on the part of adults around them, or misunderstandings surrounding their special accomodations. Bathroom, water and snack breaks are something every student wants more of, but many schools strictly limit. For a student with Diabetes, they can be life savers, but can also mean social suicide if their accomodations are not appropriately rationalized for their classmates.
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posted by Rachael Gabriel