This post has been on my mind for well over a year now but I struggled with how to put my thoughts down. After reading a recent post made by a 16yr old girl in a Diabetes support group I am in about an experience she had with a teacher, I knew it was time!
To start out with, I am not a doctor, I do not pretend to be a doctor. I cannot and am not giving medical advice here. This post is based off of my knowledge as a type 1 diabetic and my experiences.
Without further ado.....
When I was 10yrs old I was diagnosed with type 1 diabetes. Type 1 diabetes is an autoimmune disease and there is no cure (despite what some companies would like you to think). Type 1 diabetes is not caused by eating too much sugar. This disease was not caused by something I did or chose to do. Basically, my body decided my pancreas was the enemy and my immune system attacked and destroyed cells in my body that were there to produce insulin. There is not anything known that can be done to prevent type 1 diabetes and there is not anything that can be done to cure it (at this time). At this time scientists do not know what causes this disease but generally it is believed to be caused by environmentally factors and genetics (3 of my 4 siblings also have type 1 diabetes).
Diabetics in school are painfully aware that they live a different life than their peers. Decisions made by a diabetic can be the difference between life and death. One must be aware at all times of what their blood sugar levels are. Levels too low can cause loss of consciousness, seizures, and death. Levels too high can cause DKA - diabetic ketoacidosis which could lead to a coma (and death), and often involves a trip to the hospital. Along with being aware of blood sugar, diabetics must watch what they eat carefully. I keep track of every carbohydrate I put into my mouth. Dosages are different for everyone but for me I know that I need 1unit of insulin for every 10grams of carbohydrates I eat. The little diabetic students you see every day have to worry about these things too - as do their caregivers. Keeping track of these things is tough!
One struggle I had when I was in school (mainly middle and high school - when I had more independence than elementary where a nurse checked in on me constantly) was balancing my diabetes with schoolwork. Standing up in high school biology during a test - a test where the teacher threatened to fail any student who spoke - to tell the teacher I needed to eat a snack was so hard for me. I was once called out in a history class for rummaging in my purse during a lecture - I was actually checking my blood sugar at the time but was too shy to say anything.
So in order to try to help diabetic students in school today here are some teacher tips for those who teach students with diabetes:
Reach out to your diabetic student(s) day 1! If you can, keep some juice boxes, candy or other sugar item in a special spot. Let the student(s) know that at any time, no matter what - during a test, exam, lecture, etc they have permission to stand up, go to that spot and help themselves. Likewise, let them know you will not interfere in their diabetic life. Let them snack, drink, stop and mess with diabetes tools at any time during class. You may also ask them what they will do if they need to notify you of a need. Maybe they raise their hand and nod twice to let you know they are going to the nurse. Make sure they are aware you support them and they will not get in trouble for taking care of their business!
Ignore beeps and other sounds coming from your diabetic student(s). Many of the devices used today to manage diabetes are like cell phones. They beep, vibrate, play sounds, etc. Some diabetics even use their cell phones to monitor their sugars (cool right?!?) A rule following student who knows you do not allow cell phones to be used in class and often confiscate devices will be terrified of what will happen when their diabetic devices make noise. So if you hear sounds or noises, know that your student(s) devices are doing their jobs!
Do not treat diabetic students differently in regards to rewards and treats you share with your students. If a diabetic student does not want candy, that should be their choice - not yours. Don't offer a treat to every student in your class BUT the diabetic student. Diabetics feel different enough without you pointing out their disease. Personally I eat candy and treats when want. I just make sure to give myself extra insulin to cover the treat.
Know signs of low blood sugar -- your student, their parent and/or the school nurse should be able to tell you what they are. Signs are different for every diabetic. Be aware of when your student may be in trouble. Personally when my blood is low I get dizzy, have slurred speech, am irritable and sometimes visibly shake. When I was a freshman in high school I once showed all of those symptoms at once. My teacher assumed I was tired (a common high school student ailment) and ignored me putting my head in my hands and falling asleep on my desk. Luckily, the student sitting behind me noticed I was shaking, notified the teacher and a few minutes later I woke up laying on a stretcher in my classroom with my teacher and several paramedics there in my face. That teacher was my biggest supporter from that day on and kept snacks in a cupboard behind my desk from that day on. I did not experience even 1 low blood sugar in her class the remainder of the year thanks to her diligence.
Know signs of high blood sugar -- your student, their parent and/or the school nurse should be able to tell you what they are. Signs are different for every diabetic. When blood sugar levels get too high the body often starts to produce ketones. High ketone levels experienced by a type 1 diabetic is extremely uncomfortable. Frequent urination, thirst, nausea and headaches are common symptoms. So if your diabetic student asks to go to the restroom more than usual - please let them! Drinking lots of water and using the restroom helps flush ketones out.
While type 1 diabetes is not as prevalent as type 2 diabetes (which is the kind of diabetes TV commercials go on and on about) it is still a major disease that affects many people, including close to 200,000 school aged children in the United States. JDRF.COM shares these statistics:
1.25M Americans are living with T1D (type 1 diabetes) including about 200,000 youth (less than 20 years old) and over a million adults (20 years old and older)
40,000 people are diagnosed each year in the U.S.
5 million people in the U.S. are expected to have T1D by 2050, including nearly 600,000 youth.
Between 2001 and 2009 there was a 21% increase in the prevalence of T1D in people under age 20.
$14B T1D-associated annual healthcare costs in the U.S.
Less than one-third of people with T1D in the U.S. are achieving target blood glucose control levels
T1D is associated with an estimated loss of life-expectancy of up to 13 years (http://www.jdrf.org/about/fact-sheets/type-1-diabetes-facts/)
Type 1 diabetics *usually* take insulin daily. What we do is manage our diabetes. We are not curing it, we are managing it so that we can stay alive. Management looks different for each individual. Some diabetics rely on multiple finger pricks a day, along with injections. I myself (and thousands of other diabetics) use a device called an insulin pump. The pump is used to deliver insulin. Those of us who are lucky use an insulin pump coupled with a device called a CGM (continuous glucose monitor).
As mentioned previously in this post devices used to manage diabetes can be confused for cell phones, and other personal devices that may be banned in school. Here are some pictures of the equipment I use to manage my diabetes -- there are many different kinds of equipment, but this is what I choose to use!
I truly hope this post has given you ideas on how to teach a diabetic student (or students). If you have any questions or comments please leave them here! Again, I am not a doctor. I cannot and am not giving medical advice here. This post is based off of my knowledge as a type 1 diabetic and my personal experiences. Every diabetic is different so make sure to take the time to learn about the ones you have in your classroom and school.