More clarity around T1D in schools: IPSAD position statement

Dr Peter Goss

Dr Peter Goss

Clinicians have to step up to their roles and responsibilities regarding the optimal management of diabetes in school-aged children.

According to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Position Statement on Type 1 Diabetes in Schools, every student should have a written individual diabetes management plan.

Schools should have access to an identified member of the student’s medical team and be supported by the team ‘to establish processes to address issues and provide appropriate information regarding the use and handling of diabetes equipment including lancets, syringes/needles and used test strips.’

The position statement, issued in late 2018, is based on ISPAD’s 2018 guidelines for the management of type 1 diabetes in school.

It strongly supports compliance with legal protections for children and adolescents with type 1 diabetes to attend and be safe at school and to receive optimal medical management at school and in all associated activities.

Co-chair of the ISPAD Working Party Dr Peter Goss told the limbic that medical teams cannot say they are too busy to interact with schools and abrogate responsibility to someone else.

“The message for medical specialists is that this aspect of managing diabetes is very important and if they want the best results for their patient, they need to ensure that the child’s school time, which is the most variable time and it is quite a lot of their day, is managed to its optimum.”

“We are not trying to create a burden for schools, we are trying to create a path forward so you will see in the position statement again and again that it has reinforced that the medical team and the school and the family should have a tripartite supportive relationship.”

Dr Goss, a paediatrician in Geelong who specialises in allergy and diabetes, is co-chair of the Australian Paediatric Society Diabetes Committee and was an author on the ISPAD guidelines.

He said a local parent survey had found about 50-60% of parents of children with diabetes felt well-supported at school.

“So there are a lot of schools doing some good work but 40-50% aren’t – with Victoria being the worst state.”

He said the lack of support translated into issues such as discrimination, but also insulin regimens that were not consistent with international recommendations.

The position statement clarifies how treatment should be delivered in schools, what constitutes reasonable adjustments, the right of the child and the family, and the roles and responsibilities of the three main stakeholders – family, school and medical treating team.

Dr Goss said given very few schools have school nurses, other school personnel have to be trained to understand and manage children with diabetes.

An online e-learning platform to assist in the education and training of school staff is available to augment training providing by the treating team.

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