Since managing type 1 diabetes is a full-time endeavor, the safety of schoolchildren with T1D is always an issue for parents and schools. In New York City, there are a growing number of kids with T1D in public schools—where school nurses usually have the responsibility of caring for children with special medical needs. Recently, Naomi Berrie Diabetes Center Pediatrician, Mary Pat Gallagher, MD, volunteered her time and expertise to the New York City Department of Education to train a group of nurse supervisors on the management and care of T1D. The supervisors are charged with educating the school nurses who actually care for the children with diabetes.
In New York City, schools that enroll 200 or more students are required to have a school nurse on campus, which most schools do. Still, Dr. Gallagher pointed out, “Just having a nurse in school is not enough. We need to ensure that school children with diabetes are cared for appropriately.” And there are all kinds of new technology and gadgets—like continuous glucose monitors—that nurses need to know about, if they don’t already. “Because the management of type 1 diabetes is much more intensive than it’s ever been, it can be challenging for schools to keep up,” she said.
For the last 7 years, Dr. Gallagher has volunteered her services to the New York City schools—last year she conducted a workshop for a network of district doctors, so school caregivers can keep up with all the advances and changes taking place in managing T1D. “I feel like we’re forging relationships that will continue to help students have the best access to care without sacrificing their academic achievement,” Dr. Gallagher said. Untrained nurses are just one of the challenges; many schools in the state of New York don’t even have school nurses or any other personnel trained in the current management of diabetes.
Dr. Gallagher’s work in schools is part of a larger effort by the American Diabetes Association’s “Safe at School” program. When we last wrote about diabetes in schools , the state of New York had just introduced the School Diabetes Care Bill, crafted by the ADA to try to improve the school environment for children with type 1 diabetes. Among other things, the bill would allow non-licensed personnel to be trained in the management and care of diabetes, which would take some of the responsibility off of school nurses, who also take care of all the other students with special medical needs in the classroom.
The bill, which is still in committees, would also allow children who self-manage their own diabetes to perform their own blood glucose checks, administer their own insulin through the pump and treat their mild hypoglycemia and hyperglycemia—without having to go to the nurse’s office. This is an ADA suggestion that is already happening in some New York City schools.
Said Dr. Gallagher: “The truth is, bright kids may be more informed than their nurses and teachers but they still need guidance and reminders. They may know more about the disease, the pump, their doses and counting carbohydrates than the adults around them, but they’re not ready to be completely independent, so it can be challenging.”
If you are a parent or guardian of a child who attends the Berrie Center, ask about our next workshop on "Taking Diabetes To School" and learn how to be your child’s best advocate.
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