Managing diabetic children in class

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"As always, forearmed is forewarned," says Jacquie van Viegen, a diabetes educator at Novo Nordisk (SA), local division of the world's leading diabetes healthcare company. "Each school should have a formal process for obtaining information about special-needs children and all teachers should be notified if there are children with diabetes or other chronic conditions at the school.

"This enables them to be alert to any changes in the child's behaviour or to any signs of distress. It also gives individual teachers the opportunity to educate classmates about the condition in general at the beginning of the school year."

Written instructions and guidelines from parents can be especially helpful and these can be pinned up in an accessible place in the classroom, so that both teachers and fellow learners can refer to them if necessary. Educating classmates about their friend's condition will also help to eliminate fear and empower them to act if necessary.

"It's always helpful to include information and discussion on special-needs classmates during the welcoming process at the start of the year. This is important in order to dispel myths about diabetes and other chronic conditions."

Children may, for instance, need to reassured that diabetes is not contagious and be enabled with the necessary knowledge to help their friend out should the need arise. Knowing about diabetes will also help them to recognise that, when a classmate's behaviour is unusual, this may be a sign that they need assistance.

On an everyday level, teachers of younger children in particular should keep a watchful eye over the situation without giving the impression that the child is receiving preferential treatment.

They should ensure that children with diabetes have a healthy snack before undertaking strenuous exercise, either in the gym or on the sports field. Exercise, like insulin, lowers blood glucose levels, and can lead to low blood sugar or hypoglycaemia. As this, in turn, can lead to convulsions, loss of consciousness or even coma, it is important to monitor the child's carbohydrate intake before gym or other physical activities.

Emergency care

Similarly, teachers should ensure that children with diabetes always have access to an emergency source of glucose in order to counteract a hypoglycaemic episode should this occur. A ready supply of glucose sweets is always advisable, and a small carton of fruit juice can be a lifesaver in an emergency.

"It's also important for teachers to understand that children with diabetes need to have regular snacks throughout the day and they should allow them to eat a small yoghurt or another suitable snack in class if necessary. Some children may also need to use the bathroom more frequently than others and this should be taken into account too."

Moreover, it is essential for teachers to be able to identify the early warning signs of a hypoglycaemic episode. In general, these include irritability, sleepiness and erratic responses to questions. The child who appears not to be paying attention may be getting low on all-important glucose.

"In terms of first-response treatment, glucose sweets or fruit juice usually does the trick but if the child doesn't show signs of improvement almost immediately, it's important to seek medical help."

Informed and caring teachers can make all the difference to a child living with diabetes or any other chronic condition. They can help to teach them how to live normal, active lives outside the home, and can ensure that they are well integrated with their peers.

"The lessons they teach them about coping with the condition in everyday situations are likely to be of great value to them throughout their lives," she concludes.

For further information on diabetes and treatment options for people living with diabetes, go to www.novonodisk.com.