The Centers for Disease Control 2005 survey reports that 21 million individuals or 7% of the total U.S. population have Diabetes. Furthermore, it is reported that one in every four to six-hundred students under the age of 20 years will have diabetes. (Belson, 2010) Diabetes is a "chronic metabolic disorder that results from failure of the pancreas to produce insulin (Type 1) or from insulin resistance with inadequate insulin secretion to sustain normal metabolism (Type 2)." (American Diabetes Association 2003; Centers for Disease Control, 2002 in: Getch, Bhukanwala, and Neuharth-Pritchett, 2007, p.1)
Characteristics of Diabetes
Children with diabetes have two problems that teachers must understand:
(1) Hypoglycemia; and (2) Hyperglycemia. (Children With Diabetes.com, 2010)
Hypoglycemia is low blood sugar and hyperglycemia is high blood sugar. Children with low blood sugar are known to have erratic behavior or alternatively act tired and to be hungry and shaky quite often. (Children With Diabetes.com, 2010) Children with high blood sugar also may be sleepy and thirsty and have a need to go to the restroom frequently. (Children With Diabetes.com, 2010)
I. Diabetes in the Classroom
Students with diabetes sometimes present in class tired due to diabetes-related fatigue and as well, students with diabetes need frequent breaks to visit the restroom and drink water. Type I Diabetes is also known as 'juvenile diabetes' or 'insulin dependent diabetes' and is an autoimmune disease that results in the body destroying "insulin-producing beta cells in the pancreas." (Centers for Disease Control, 2010) Insulin is needed by the body to utilize glucose and without insulin, the body starves. Individuals with type 1 diabetes must inject insulin to live.
Young children with diabetes tend to have higher rates of absenteeism than older children with diabetes and contributing factors include such as: (1) overprotection by parents; (2) philosophy of parents regarding academics; (3) the quality of communication between teachers and parents of children with diabetes; and (4) lack of information for schools on managing diabetes. (Getch, Bhukanwala, and Neuharth-Pritchett, 2007, p.1)
Extended absences from school for children with diabetes is not typical however, students miss valuable time in class when they spend part of the day with the school nurse of managing their diabetes. The teacher in the classroom must necessarily be sensitive to factors that contribute to the child with diabetes falling behind in class.
II. Psychosocial Challenges Impacting Teachers
Psychosocial challenges are known to impact teachers of children with diabetes because children with diabetes tend to: (1) Experience more school-related difficulties and this is especially true if they have adjustment problems; (2) Become belligerent and moody; (3) Have poor self-confidence and achievement motivation from frequent absenteeism; and (4) Experience more anxiety and depression than their peers as a result of the poor fit between their health needs and school environments. (Getch, Bhukanwala, and Neuharth-Pritchett, 2007, p.1)
III. Findings in Survey of Elementary and Middle School Teachers
A survey of elementary school and middle school teachers, Neuharth-Pritchett and Getch (2001) states findings that "relatively few teachers have had any formal coursework or in-service training in assisting children with chronic medical conditions." (Getch, Bhukanwala, and Neuharth-Pritchett, 2007, p.1) Stated to be areas of concern that impact participation in working with a child with diabetes if likely to include: (1) Teacher anxiety; (2) Lack of appropriate preparation of teachers and other school staff; (3) Lack of clarity about school policies and the roles and responsibilities of school staff in providing services; and (4) The need for improved communication among families, schools, and healthcare providers. (Getch, Bhukanwala, and Neuharth-Pritchett, 2007, p.1)
IV. Needs of Children with Diabetes
Children with diabetes need to have the following:
(1) access to the tools for diabetes management (blood glucose testing equipment; insulin delivery systems; and oral, fast-acting carbohydrates and glucagons);
(2) sufficient time to adhere to their nutrition plan; and (3) access to personnel who are knowledgeable about diabetes and are able to assist when needed (ADA, 2002a; ADA, 2003, NIH, 2003 in: Getch, Bhukanwala, and Neuharth-Pritchett, 2007, p.1).
V. Protection for Children with Diabetes
Protection for children with diabetes falls under section 5004 of the Rehabilitation Act (1973), Individuals with Disabilities Education Act (1990) and the Americans with Disabilities Act (1990). Under these two laws, "diabetes has been determined to be a disability, making it illegal for public schools to discriminate against children with diabetes (ADA, 2003; NIH, 2003; Vennum, 1995). A diabetes healthcare plan is a…