Resources to support the management of diabetes in children and adolescents at school
Dear Colleagues,
Children and adolescents spend a considerable amount of time at school, generally over 30 hours a week. The need to inject insulin and doing fingerpicks to check blood glucose levels, can cause embarrassment and stigma for the child or young adult with diabetes. This can contribute to missed school attendance, suboptimal diabetes management during school hours, and mental and physical health problems.
The International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 guidelines for the ‘Management and support of children and adolescents with type 1 diabetes in school’ strongly recommends that all children and adolescents with Type 1 diabetes (T1D) should attend school regularly, be safe, and receive optimal medical management while at school. They should have the opportunity to fully participate in all school activities. To achieve this, a cooperative, supportive and respectful relationships between all stakeholders (school, parents/child, medical team) is essential. All stakeholders should be aware of their responsibilities as outlined by ISPAD and highlighted in the Position Statement on Type 1 Diabetes in Schools, which was based on ISPAD guidelines and developed with input from less resourced countries:
The parent/guardian is ultimately responsible, and needs to give informed consent, for the medical decisions made on behalf of their child. They should work with the treating medical team to develop an individualised Diabetes Management Plan for their child.
The student’s treating medical team (doctor/diabetes nurse practitioner) is responsible for providing medical treatment and self-care recommendations for that student and outline these in detail in a Diabetes Management Plan.
The school is responsible for carrying out the parental and medical orders outlined in the student’s Diabetes Management Plan; and for facilitating the training of school staff, to ensure that they are competent to follow the management and action plan (see examples below).
Every child and adolescent needs to have a ‘Diabetes Management Plan’ in place before they commence school.
The management plan should be reviewed regularly.
Regardless of their age, children and youth cannot be expected to be wholly responsible for their diabetes management at school and need encouragement, supervision, and support throughout their school years. It is therefore crucial that teachers and school staff have the necessary knowledge about diabetes and are aware of their responsibilities to ensure that the child/adolescent is safe and can achieve optimal blood glucose levels while at school. Likewise, educating class mates/pupils about diabetes can help to reduce stigma.
Leading international diabetes organisations have developed best practice school education and training programs and resources, including online training modules for teachers and school staff, educational video, diabetes management plan templates and much more.
The following resources can be adapted to your local context and language, some are available in several languages:
ISPAD - IDF Kids and Diabetes in School (KiDS) program
The ISPAD – International Diabetes Federation (IDF) KiDS project is an educational program that is designed for teachers (grades 1-9), school nurses and staff, students (aged 6-14 years), parents, policymakers, and government officials.
The education program has been updated in 2021 and includes a KiDS information pack, divided into section 1 which focuses on type 1 diabetes and includes guidelines for the management of children with T1D and a sample diabetes management plan; section 2 focuses on guidelines for a healthy lifestyle to prevent and manage type 2 diabetes. Resources are available in 13 languages (Arabic, Chinese, English, French, Greek, Hindi, Portuguese, Russian, Spanish, Hungarian, Polish, Urdu and Japanese). Adaptations to Brazilian Portuguese, Argentinian Spanish and Indian English are also online.
Below is the direct link to the KiDS resources in English and a list of available languages for each resource:
KiDS Tool Kit to inform on diabetes in schools – this is a wonderful low literacy manual for teachers, kids and parents, including story telling about Tom’s life with diabetes, illustrated with cartoon characters. It is available in English, French, Spanish, Portuguese, Russian, Urdu, Sindhi, Marathi, Arabic, Farsi and others
KiDS Nutriquiz (English, French, Spanish, Portuguese, Russian and others)
KiDS Advocacy tool - provides information and tips to help encourage local or national decisionmakers to bring diabetes education to schools (English, French, Spanish)
KiDS Virtual Implementation Leaflet - This guide has been developed to facilitate the virtual implementation of the KiDS programme in 10 steps (English)
Animation for younger kids/student to learn about type 1 diabetes - both educational and entertaining: exciting journey through the human body with Professor Bumblebee and Cara.
