Problems in diabetes managment in school setting in children and adolescents with type 1 diabetes in Serbia
Abstract
Background/Aim. Children with type 1 diabetes typically spend one-third of the day in school and they should achieve the same level of diabetes management there as they do outside the school environment. The aim of this study was to identify problems in diabetes management in children with type 1 diabetes at school according to the perceptions reported by children and parents. Methods. This cross-sectional survey was carried out at nine public hospitals in Serbia with a cohort of 6–18-year old children/adolescents. The parents were personally informed about the objectives of the survey and the necessity to involve their children. The self-reporting questionnaire included demographic information as well as some questions that helped to evaluate the general situation of children with type 1 diabetes at school. Results. The obtained results show that not all children test blood glucose levels at school (50% of children in the 6–10-year-old age group and 67.3% in the age group over 11 years) and that not all children receive insulin at school (81.1% vs 18.9%, and 57.7% vs 42.3%, respectively). The frequency of severe hypoglycemia was 2.7% in children and 3.3% in adolescents. A high proportion of teachers did not have diabetes training. Conclusion. This brief report about problems in children and adolescents with type 1 diabetes at school in Serbia indicates what happens in the school setting and suggests how to improve control of this disease and facilitate the complete integration of children with diabetes at school.
Key words:
diabetes mellitus, type 1; child; serbia; schools; questionnaires; preventive health services.References
American Association of Diabetes Educators. Management of children with diabetes in the school setting. Diabetes Educ 2014; 40(1): 116−21.
Chiang JL, Kirkman MS, Laffel LM, Peters AL. Type 1 Diabetes Sourcebook Authors. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care 2014; 37(7): 2034−54.
Pinelli L, Zaffani S, Cappa M, Carboniero V, Cerutti F, Cherubini V, et al. The ALBA project: an evaluation of needs, manage-ment, fears of Italian young patients with type 1 diabetes in a school setting and an evaluation of parents' and teachers' per-ceptions. Pediatr Diabetes 2011; 12(5): 485−93.
Amillategui B, Calle JR, Alvarez MA, Cardiel MA, Barrio R. Identifying the special needs of children with Type 1 diabetes in the school setting. An overview of parents' perceptions. Diabet Med 2007; 24(10): 1073−9.
Amillategui B, Mora E, Calle JR, Giralt P. Special needs of children with type 1 diabetes at primary school: perceptions from parents, children, and teachers. Pediatr Diabetes 2009; 10(1): 67−73.
Wagner J, Heapy A, James A, Abbott G. Brief report: glycemic control, quality of life, and school experiences among students with diabetes. J Pediatr Psychol 2006; 31(8): 764−9.
Hayes-Bohn R, Neumark-Sztainer D, Mellin A, Patterson J. Adolescent and parent assessments of diabetes mellitus management at school. J Sch Health 2004; 74(5): 166−9.
Klingensmith G, Kaufman F, Schatz D, Clarke W. Diabetes care in the school and day care setting. Diabetes Care 2004; 27(Suppl1): S122−8.
Hellems MA, Clarke WL. Safe at school: a Virginia experience. Diabetes Care 2007; 30(6): 1396−8.