It’s no surprise that diabetes management can be difficult–the activities of daily life that most people can do without a second thought, from eating to exercise, to sleeping and going to school, people–especially kids–who live with diabetes must carefully monitor a handful of variables to keep their health in balance.

In the past, type 1 diabetes was the most common type of diabetes affecting children. In type 1 diabetes, the body’s immune system attacks and destroys cells inside the pancreas called “islet” or “beta” cells–this is an autoimmune disorder. These cells are responsible for producing the hormone insulin, which allows the body to break down carbohydrates [sugar] into energy. Without insulin, blood sugar rises, and diabetic ketoacidosis can occur. Hallmark symptoms of diabetes include excessive thirst, frequent urination and tiredness. Type 1 diabetes is managed with frequent monitoring of levels of glucose [sugar] in the blood, giving insulin either via syringe, insulin pen, or insulin pump, through exercise, and dosing insulin in balance with the number of carbohydrates eaten.

Type 2 diabetes is also on the rise in kids–it is caused by genetics, but its onset may be triggered earlier in life by lifestyle choices that may negatively impact health–sedentary lifestyle and diet high in simple carbohydrates may cause people who are already predisposed to type 2 diabetes to develop the disease earlier than later. In type 2 diabetes, the pancreas is sometimes able to produce enough insulin, but the cells in the body are resistant to using this insulin–it requires more insulin to lower blood sugar than normal. Thus, the body cannot use glucose properly as an energy source, and glucose ends up building up in the blood. In other cases, insulin is still being produced, but not enough is made by the pancreas to keep blood sugar stable. The symptoms are the same as in type 1 diabetes, but are often of more gradual onset as the body loses sensitivity to the insulin it is producing and insulin production lessens–and stops. Type 2 diabetes can be managed with medications, exercise and lower carbohydrate diet, but may also require insulin if a) blood glucose levels keep rising despite lifestyle modification and medication or b) amount of insulin produced slows down too much or stops completely. People with type 2 diabetes often check their blood sugar levels, but typically not as frequently as those with type 1 unless they are taking insulin.

For most parents of kids with diabetes, and the children themselves, diabetes is a stressful condition that constantly requires attention to avoid blood sugars becoming too high, or too low. This stress can be magnified when a child attends school. To alleviate some of this stress:
Ensure communication is open between the child and school staff, and school staff and the parent. This includes teachers, teachers aides, office staff, and of course, the school or district nurse if available.
Keep extra medication, insulin and syringes and testing supplies at school, just in case–kids with diabetes should always have access to their supplies, and carry them with them if they are old enough.
Have a solid plan in place before sending a child off to school–check out the links below to some excellent resources for kids with type 1 and management at school.
Have glucose available at all times to treat low blood sugars. Though it varies by parent preference, most prefer that if a low blood sugar is suspected and the child cannot test his or her levels immediately, that 15 grams of quick acting carbohydrates are given (juice, glucose tablets or whatever the child’s preferred treatment is)
Ensure the child is as independent as possible with his or her diabetes management for their age, but that they know to ask for help if they need it.
I also highly recommend my friend Scott Benner’s series on Diabetes and School (I am in awe of the technology integration), as well as his downloadable copies of his daughter’s 504 Plan documents for how they manage her type 1 diabetes in school–a parent of a kid with diabetes knows way better than I ever will!

Special thanks to Bob Pedersen for reviewing the discussion in this article.

WRITTEN BY:  Kerri MacKay