By Julie Burger

As the eyes of Illinoisans (and the world) turn to the impeachment trial in Springfield, it might be tempting to overlook other necessary legislative activity.  Last year, the Care of Students with Diabetes Act was passed in the House, but died in the Senate.  This important legislation would have helped to ensure the safety of children with diabetes at school and clarified the rights and responsibilities of healthcare workers, schools, parents, and the children themselves.

According to data released by the NIH, there are nearly 186,300 children under the age of 20 in the U.S. with diagnosed diabetes.  Type I diabetes occurs in one in every 400 to 600 children within this age group.  Each year, more than 15,000 youth are diagnosed with type I diabetes.  Rates of type II diabetes are also on the rise in children under the age of 20.

Diabetes is a disease that affects the body’s production or use of insulin, a hormone produced in the pancreas that is necessary for glucose (sugar) to get from the bloodstream to cells.  If a person with diabetes does not get enough insulin, the glucose builds up in the blood, creating high levels of sugar in the blood which over time will damage the eyes, kidneys, nerves and heart.  People with diabetes are also at risk of hypoglycemia, which occurs when blood sugar levels drop too low to provide enough energy for the body’s activities.  The symptoms include dizziness, sleepiness, and confusion, and it can lead to loss of consciousness, seizures or even death. 

Diabetes is a disease that must be managed 24 hours a day, seven days a week.  Diabetes-related care does not stop just because children need to go to school.  But many schools do not have nurses and instead rely on parents to come to the school to administer insulin to young children.  Other schools have rules that prevent students from keeping their blood testing equipment with them and require them to go to the nurse’s office to test their blood sugar, eat snacks, or give themselves insulin.  This means students are missing a significant portion of class time.  Some schools have forbidden students with diabetes from riding the school bus and from participating in afterschool activities.  But still other schools have excellent policies that educate administrators and staff about diabetes and what to do in the event of a low blood sugar emergency.  Policies are not uniform across Illinois.

One of the policies that is most hotly contested is who can administer insulin to students who are too young to do it themselves.  Leading groups, such as the American Diabetes Association, and government organizations, such as the U.S. Department of Health and Human Services, have come to the conclusion that lay people readily can be trained to safely monitor children with diabetes and administer insulin if necessary.  These groups conclude that teachers and other school employees who volunteer to help children should be allowed to do so and schools should offer appropriate training.  The Care of Students with Diabetes Act (the “Care Act”) would have clarified this right. 

But in Illinois, the Nurse Practice Act stands as a potential impediment to training volunteers.  During the legislative session when the Care Act was introduced, the Nurse Practice Act was amended to state that nurses cannot delegate “nursing activities,” (i.e. work that requires specialized knowledge gained from nursing programs) to unlicensed people, “including medication administration.”  Some schools have expressed concern that the Illinois Nurse Practice Act prevents them from allowing trained volunteers such as teachers or staff from assisting children with diabetes.  However, administering insulin, while requiring training, does not require specialized knowledge only learned in nursing school.  Parents, siblings, babysitters, and the children themselves can be trained to administer insulin. 

In Illinois, approximately 4,000-5,000 of school age students have diabetes.  While having nurses at schools to care for all the children at a school is a laudable goal, relying on nurses to care for children with diabetes is not feasible due to budget constraints and nursing shortages.  This year the Care Act will once again be introduced in Springfield.  As busy as Illinois Senators and Representatives are currently, we can only ask that when their attention turns once again to business as usual that they act to protect the safety of students with diabetes in Illinois schools.