Laura Syron, president and CEO of Diabetes Canada is urging for consistent diabetes care standards in schools.
“Even though children have been living with diabetes –– and attending school ––– since the discovery of insulin more than a century ago, most Canadian provinces still do not have standardized policies in place to support students with diabetes,” she wrote in a news article published Nov. 14–– World Diabetes Day.
Approximately one in 300 children in Canada has type 1 diabetes and it is probable that every Canadian school has one student with diabetes. According to Syron, most Canadian provinces and territories have not developed a mandatory standard of care for managing diabetes in schools.
Locally, Scott Hill, Evergreen School Division superintendent, said they support a small number of students with diabetes and that each student has an individualized plan outlining their daily care, monitoring routines, and emergency procedures which staff closely follow.
“All students with diabetes have an Individualized Health Care Plan developed in collaboration with a URIS (Unified Referral and Intake System) nurse. These plans guide each school’s response and ensure consistency in care across the division. Schools also provide private spaces for testing and medical needs,” he explained.
Annually, ESD staff receive URIS training to support students with varying medical needs, diabetes included. URIS nurses also provide additional training throughout the year if a plan is updated or if a new staff begins to support the specific students. He noted staff can also access specialized virtual sessions offered through the Diabetes Education Resource for Children and Adolescents if required.
At this point, the division has not received any concerns from parents regarding the level of care. “Principals and Student Services Teachers work closely and proactively with families to ensure students’ needs are met and any questions or concerns are addressed promptly,” Hill added.
While each URIS plan is individualized, he said the standards of care remain equal among the students due to the reliability of the standardized URIS plans. He also said that because ESD is a smaller division, URIS nurses are able to provide the comprehensive training to all staff limiting the barriers associated with lack of training and care.
Hill welcomes any provincial effort that enhances clarity and consistency for students and families but is comfortable with the detailed and individualized guidance that URIS plans already provide.
“All schools follow the procedures outlined in each student’s health care plan. Typically, this includes administering fast-acting carbohydrates to raise blood sugar and monitoring the student closely. If symptoms do not improve or if the situation becomes urgent, staff contact emergency services and the student’s family immediately,” he added.
Syron said this level of care is not commonly found in other schools or divisions.
“It is well past time for provincial and territorial governments to mandate standards of care that align with Diabetes Canada guidelines to ensure that no child’s safety or education is jeopardized because of where they attend school,” she said. “All of them deserve consistent, safe and equitable care.”
So far, only British Columbia, Nova Scotia and Prince Edward Island have care standards that align with Diabetes Canada Guidelines, with most schools in other provinces and territories creating care plans based on divisional or school board discretion.
Syron noted that managing diabetes is a complex condition for adults to manage, let alone children.
“Well-managed diabetes is important for children’s health. Blood glucose levels that are too low can lead to life-threatening emergencies. Blood glucose levels that are left too high can overtime increase the risk of developing serious complications. Off-target levels can also lead students to feel unwell and unable to concentrate, negatively impacting their ability to participate and learn,” she added.
While some students are able to check their glucose levels or administer insulin independently, some students still need assistance from trained staff members and, “without a clear province/territory-wide standard of care outlining the roles and responsibilities of students, families and school staff, students are left vulnerable,” Pyron said.
She is requesting that provinces and territories should have a mandated standard of care based off the following criteria:
• Schools, parents and healthcare professionals to work together to develop an individual care plan for the student with diabetes that addresses both daily management as well as emergency response.
• Education for staff and school personnel on emergency prevention of low blood glucose events.
• Safe spaces to monitor blood glucose and for safe access to physical education, sports, field trips and other extracurricular activities
• Permission to students with diabetes to carry a cellphone or smartwatch if they receive diabetes-related data from their medical devices.
“It is time for provinces and territories to catch up and implement a mandatory standard of care aligned with Diabetes Canada guidelines to ensure that all students with diabetes receive the support they need,” she added. “Children and families in Canada have waited long enough.”
