Doctors urge provinces to support students with diabetes

OTTAWA—Two paediatric groups are calling on provincial and territorial governments to develop comprehensive policies that ensure in-school support for students with type 1 diabetes.

In a statement released today, the Canadian Paediatric Society (CPS) and the Canadian Pediatric Endocrine Group (CPEG) expressed concern at the inconsistent and inequitable support for students with type 1 diabetes, saying the absence of policy could have short- and long-term health consequences.

“There are discrepancies in resources and policy across the country, even among schools in the same jurisdiction,” said Dr. Sarah Lawrence, a paediatric endocrinologist in Ottawa and lead author of the statement. “Diabetes is not a static condition, so it’s critical that school personnel be educated, equipped and available to support students with this disease.”

About 1 in 300 children have type 1 diabetes, a chronic disease where the pancreas no longer produces insulin. They need frequent blood sugar checks each day, and regular administration of insulin, either via injections or through a pump. Physical activity and diet must be closely monitored. Depending on their age and ability, many children need an adult to either do or supervise these daily tasks.

“Blood sugars can change from minute to minute,” said Dr. Lawrence. “Over time, both high and low blood sugars can affect learning, so it’s important to do everything we can to keep students’ glucose levels in their target range.”

Currently, only four provinces have policies to address diabetes in the school setting, leaving thousands of families across Canada to piece together a plan each school year. The CPS and CPEG recommend that:

• Each school develops an Individual Care Plan for a student with type 1 diabetes, and ensures that at least two school personnel are trained to provide support;
• Personnel are trained to help check blood sugar or administer insulin, especially for younger children;
• Personnel are trained to recognize and treat low blood sugar (hypoglycemia), which, if left untreated, can lead to loss of consciousness or seizure;
• Meals and snacks are supervised, to ensure they are eaten in full and on time;
• Students have extra time for exams or tests, in the event of an episode of low blood sugar;
• Students are able to check their blood sugar anytime, anywhere, and are able to eat as needed (whether in class, in the gym, or elsewhere).
• Incentive policies for school attendance should not apply to students with type 1 diabetes, who are absent to attend required  medical appointments.

The recommendations in the statement are consistent with the Canadian Diabetes Association’s Guidelines for the Care of Students Living with Diabetes at School, which were released in September.

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About the Canadian Paediatric Society

The Canadian Paediatric Society is a national advocacy association that promotes the health needs of children and youth. Founded in 1922, the CPS represents more than 3,300 paediatricians, paediatric subspecialists and other child health professionals across Canada.