By Tim Welch

Many kids with diabetes are having serious problems at school when it comes to potential emergency situations.  One of the issues that children and adults with diabetes face is the risk of severe hypoglycemia.  Severe hypoglycemia occurs when the body's blood sugar level gets too low.  It is an extremely dangerous and life-threatening condition, in which the body begins to shut down.  Without immediate treatment, the hypoglycemic person will lose consciousness and stop breathing.  If left untreated, the condition will lead to coma, brain damage, and death.

In a severe hypoglycemic emergency, the person may not be capable of swallowing food or liquids and cannot eat food or drink beverages to raise their blood sugar.  But fortunately there is a life-saving treatment.  Glucagon, a hormone that causes the liver to release glucose into the blood stream, can be administered to help the person who is suffering from hypoglycemia.  It is crucial that glucagon be administered immediately in order to save the hypoglycemic person's life.  Administering glucagon is also relatively low-risk, since it is safe to inject even if the person with diabetes is not suffering from hypoglycemia, but some other condition with similar symptoms.

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by Keith Syverson

Surveys have shown that the vast majority of teachers know of at least one student in their school with a chronic illness.  Several studies have investigated the administration of medication in schools from the perspectives of principals or of school nurses, but few studies exist on how students and parents feel about this issue.  A 2008 study in the Journal of School Nursing went directly to the source, interviewing students with diabetes, asthma, and ADHD in order to determine the "types of problems and mistakes [they] experience with their medicines at school."  The group of researchers included pharmacologists and a professor of nursing.  They reached conclusions that surprised them but correspond to modern recommendations for diabetes care.

The researchers initially assumed that the higher the level of responsibility a student has for his or her medication administration, the greater the child's "risk factor index" and the greater the chance of medication error.  The authors state that this index is a combination of risk factors previously identified in the literature and "the collective clinical experiences of the authors."  These included whether the child: transports his or her own medication to school, stores his or her own medication within reach, and whether the child self-administers his or her own medication.  The researchers found that students with diabetes have the highest degree of self-responsibility and thus, as a group, have the highest risk factor index.  Contrary to the initial assumption that a high degree of self-responsibility put the student at a high risk for medication errors, the researchers found that diabetic students had the lowest prevalence of medication error. In contrast, a higher prevalence of errors was reported among children with ADHD who had the least amount of self care responsibility.

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By Sarah Blenner, JD, MPH

As Clifton Hassam, a Florida 16 year old junior in high school, sat in class, his blood sugar began to reach dangerous levels.  His monitor, which is attached to his hip, began beeping to inform him of this.  Hassam reached down to turn off the beeping noise and take care of his blood sugar levels.  However, the substitute teacher, believing that Hassam had a cell phone, the use of which during the school day is forbidden, reached down and grabbed the device, pulling out the tubing from Hassam's waist and disconnecting the insulin pump.  It took several days before Hassam's blood sugar reached normal levels again.

Hassam was diagnosed with diabetes when he was six years old.  Like many other individuals with type-1 diabetes, Hassam manages his diabetes in part by wearing an insulin pump, a device that is designed to notify Hassam when his blood sugar reaches unhealthy levels.  According to Hassam, the pump is “my whole life on my side.” The device is about the size of a pager and has a tube (or catheter) that runs under the skin and into the blood stream.  The pump not only monitors blood glucose levels, but it also releases fast acting insulin directly into the blood stream just as a pancreas in a body with normal pancreas function would release insulin into the blood stream.

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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.

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