Abstract

Objective: The Commonwealth of Virginia passed legislation in 1999 requiring non-medical school personnel to assist students with the management of their T1DM when school nurses were unavailable. This study was designed to determine which school personnel in Virginia currently assist students with T1DM with insulin administration and management of hypoglycemia and to determine if these students are being cared for in a safe manner.

Research Design and Methods: Parents of children with T1DM who attended public school in Virginia during the previous year and who were receiving their diabetes care at the University of Virginia Diabetes Clinics were asked to participate in an anonymous survey. The survey asked parents which school personnel were responsible for their child's diabetes care while at school and which persons helped with specific care tasks including blood glucose monitoring, insulin administration and assistance with treatment of hypoglycemia. Questions were asked regarding the occurrence and treatment of hypoglycemia and any adverse effects of such treatment.

Results: 185 parents whose children attended 153 different schools responded. 69% reported that a full time school nurse was assigned to their child's school. In other schools, teachers, administrators, coaches and cafeteria workers supplemented part-time nurses in assisting students with diabetes management tasks. Although hypoglycemia was not a rare event (75% of students experienced a median of 5 episodes per year), only one severe event requiring the use of glucagon was reported. In that case glucagon was administered appropriately by a part-time school nurse and the student experienced no adverse effects related to the treatment.

Conclusions: Students with T1DM can be cared for safely during the school day by a variety of trained medical and non-medical personnel. The occurrence of 1 severe hypoglycemic event among the 185 students suggests that as many as 3% of students could experience severe hypoglycemia in a given school year. Legislation which permits non-medical school personnel to assist students with their diabetes management could make the child's school day safer and improve their overall glucose control.