Evaluating Type 1 Diabetes Management in an Elementary School Setting

Abstract

Type 1 diabetes (T1D) is a chronic disease that affects 208,000 youth and children in the United States (American Diabetes Association, [ADA], 2014). Managing the disease requires intermittent monitoring throughout the day, including checking blood glucose levels, insulin administration, and counting carbohydrates. Depending on a child’s ability to self-manage T1D, some must rely on school nurses and staff to aid in this management, especially elementary students. The ADA has established key aspects of successful diabetes management in an elementary school. This project was implemented in several elementary schools in a North Carolina county that had 62 children diagnosed with T1D. T1D management practices of school nurses and other staff were compared with the ADA guidelines. Objectives of the project were (1) to complete an assessment of diabetes management in the county elementary schools by reviewing care plans, education materials, school health policies, and meeting with key informants to discuss their involvement with disease management, and (2) to make 2-3 recommendations, based on findings, to the county school nurses. The overall project goal was to facilitate the delivery of best practice diabetes care to support positive student learning experiences. Diabetes management processes were identified and compared to ADA guidelines, and roles were discussed with key informants such as the school nurses, nursing coordinator and school staff. Findings were presented to key informants and recommendations provided. Recommendations included a need to conduct a county-wide evaluation of T1D management, modification of staff diabetes education including incorporation of various forms of media, use of the county’s standardized case management program, and development of diabetes peer support groups to provide a therapeutic environment in which students may discuss concerns related to managing T1D.