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Ask Dr. Shore...

About Diabetes

Q.
Dear Dr. Shore,
A student who has diabetes recently entered my class. What do I need to know about a student with this condition?

A.
The first thing you need to know is that you do not have to be an expert in diabetes if you have a student with this condition. The school nurse should take the lead here. At the same time there is some key information you should know.

Diabetes is a chronic disease that impairs the body's ability to process sugar properly. It is not contagious and therefore cannot be passed from student to student. Although it can give rise to potentially significant physical complications, it can be managed effectively in school with close attention and monitoring, so teachers should not press the panic button if one of their students has diabetes. By following a few basic guidelines, some of which are described below, you should be able to handle almost any situation that arises in the classroom.

Develop a written plan with the parents and school nurse. Meet with the parents and school nurse before, or soon after, school begins to spell out in writing how the school will manage the child with diabetes. The child should also be encouraged to participate.

Make sure all school personnel working with the child are informed of her condition. Because the child can exhibit diabetes-related problems in various school settings, from the classroom to the ball field to the cafeteria, school staff who supervise the child will need to be apprised of her medical condition.

Help your other students understand diabetes. You or the school nurse might lead the discussion, or you might ask the parents or even the student with diabetes to talk to the class. The presentation, which should be brief, matter-of-fact, and allow for questions, will demystify diabetes and help classmates understand when the child with diabetes conducts a blood test, eats a snack, or refuses cake during a class party.

Adapt to the child's dietary needs. A child with diabetes will likely need to eat snacks in the morning and afternoon. It's important that she snack at the prescribed time to maintain proper blood-sugar balance. Holiday celebrations and parties in school might be especially difficult for the child with diabetes because certain food might be off-limits to her. Let the parents know about the party ahead of time so they can send in some special food for their child.

Monitor the impact of physical activity on the child. Children with diabetes generally can participate in all school activities as long as they adhere to their treatment program. That includes physical education class and sports. The child might need to have a snack just before strenuous exercise to compensate for the sugar that will be burned during the activity.

Be sympathetic without being overprotective. The child with diabetes might need more than the usual amount of support, understanding, and sympathy. At the same time, you don't want to shower her with excessive concern or attention, excuse her from the normal classroom responsibilities, or keep her from attending school functions. Children with diabetes, perhaps more than other children, must learn to become resourceful and independent.