Care of children with type 1 diabetes mellitus in school – An interventional study
-
Umamaheswari Gurunathan
, Hemchand Krishna Prasad , Sherline White , Bala Prasanna and Thangavelu Sangaralingam
Abstract
Objectives
Paucity of data from India on care of children with Type 1 diabetes in schools. Aims: To study assess the knowledge, attitude, practices and fear of Type 1 diabetes in school teachers and to assess the impact of an educational model on the fear of teachers and care of children in Type 1 DM at school hours.
Methods
A community based study, involving school teachers and the intervention being educating them about diabetes conducted. Data pertaining to basic demography, attitude of teachers towards diabetic children, Hypoglycemia fear factor survey- parent version with worries domain and preparedness of school was collected. An education program was conducted on diabetes care in children. Immediately and after three months, the proforma details and HFSP-W scores reassessed.
Results
Forty two teachers (mean age: 38.7±5.4; M:F ratio 2:40) participated in the study. Post intervention, a higher willingness to have the diabetic child in class (100 vs. 57.1%; p>0.05), better support in daily care (100 vs. 92%; p>0.05), participation in sports activities (100 vs. 7.1%; p<0.05) observed. HFSP-W scores were 38.8±4.5 (pre-intervention), 22.5±4.3 (immediate post intervention) and 29.5±3.2 (at 3months) (p<0.05). To study the determinants of improvement in HFSP-W a regression analysis was performed: presence of glucometer the most likely determining factor (T=1.999, p=0.05).
Conclusion
There is a significant element of fear in the minds of teachers towards hypoglycemia which improves with a structured education program.
Acknowledgment
We would like to thank Prof Nedunchelian Krishnamoorthy for reviewing this manuscript.
Research funding: None.
Author contribution: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
References
1. Aguiree, F, Brown, A, Cho, NH, Dahlquist, G, Dodd, S, Dunning, T, et al. IDF Diabetes Atlas, 6th ed. Brussels, Belgium: International Diabetes Federation; 2013.Search in Google Scholar
2. Ramachandran, A, Snehalatha, C, Krishnaswamy, CV. Incidence of IDDM in children in urban population in southern India. Madras IDDM registry Group Madras, South India. Diabetes Res Clin Pract 1996;34:79–82. https://doi.org/10.1016/s0168-8227(96)01338-1.Search in Google Scholar
3. Pinelli, L, Zaffani, S, Cappa, M, Carboniero, V, Cerutti, F, Cherubini, V, et al. The ALBA project: an evaluation of needs, management, fears of Italian young patients with type 1 diabetes in a school setting and an evaluation of parents’ and teachers’ perceptions. Pediatr Diabetes 2011;12:485–93. https://doi.org/10.1111/j.1399-5448.2010.00722.x.Search in Google Scholar PubMed
4. American Diabetes Association, et al. Diabetes care in the school and day care setting. Diabetes Care 2012;35:S76–80.10.2337/dc12-s076Search in Google Scholar PubMed PubMed Central
5. Jackson, CC, Albanese-O’Neill, A, Butler, KL, Chiang, JL, Deeb, LC, Hathaway, K, et al. Diabetes care in the school setting: a position statement of the American Diabetes Association. Diabetes Care 2015;38:1958–63. https://doi.org/10.2337/dc15-1418.Search in Google Scholar PubMed
6. Bratina, N, Forsander, G, Annan, F, Wysocki, T, Pierce, J, Calliari, LE, et al. ISPAD Clinical Practice Consensus Guidelines 2018: management and support of children and adolescents with type 1 diabetes in school. Pediatr Diabetes 2018;19:287–301. https://doi.org/10.1111/pedi.12743.Search in Google Scholar PubMed
7. Boden, S, Lloyd, CE, Gosden, C, Macdougall, C, Brown, N, Matyka, K. The concerns of school staff in caring for children with diabetes in primary school. Pediatr Diabetes 2012;13:e6–e13. https://doi.org/10.1111/j.1399-5448.2011.00780.x.Search in Google Scholar PubMed
8. Jacquez, F, Stout, S, Alvarez-Salvat, R, Fernandez, M, Villa, M, Sanchez, J, et al. Parent perspectives of diabetes management in schools. Diabetes Educat 2008;34:996–1003. https://doi.org/10.1177/0145721708325155.Search in Google Scholar PubMed PubMed Central
9. 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;24:1073–9. https://doi.org/10.1111/j.1464-5491.2007.02250.x.Search in Google Scholar PubMed
10. Särnblad, S, Åkesson, K, Fernström, L, Ilvered, R, Forsander, G. Improved diabetes management in Swedish schools: results from two national surveys. Pediatr Diabetes 2017;18:463–9. https://doi.org/10.1111/pedi.12418.Search in Google Scholar PubMed
11. Olson, AL, Seidler, AB, Goodman, D, Gaelic, S, Nordgren, R. School professionals’ perceptions about the impact of chronic illness in the classroom. Arch Pediatr Adolesc Med 2004;158:53–8. https://doi.org/10.1001/archpedi.158.1.53.Search in Google Scholar PubMed
12. Wang, YL, Brown, SA, Horner, SD. The school-based lived experiences of adolescents with type 1 diabetes. J Nurs Res 2013;21:235–43. https://doi.org/10.1097/jnr.0000000000000003.Search in Google Scholar
13. Haugstvedt, A, Wentzel-Larsen, T, Aarflot, M, Rokne, B, Graue, M. Assessing fear of hypoglycemia in a population-based study among parents of children with type 1 diabetes - psychometric properties of the hypoglycemia fear survey - parent version. BMC Endocr Disord 2015;15:2. https://doi.org/10.1186/1472-6823-15-2.Search in Google Scholar
14. Teachers – primary ,upper primary, high school and higher secondary; 2012. Available from: www.ssa.tn.nic.in/docu/genedustat.pdf. 1012 p.Search in Google Scholar
15. Distribution of Population, Decadal growth rate, sex-ratio and population density.Available from: censusindia.gov.in/2011-prov…/3.Tamil%20Nadu_PPT_2011-BOOK%20FINAL.pdf; 2012. 15 p.Search in Google Scholar
16. Wagner, J, James, A. A pilot study of school counselor’s preparedness to serve students with diabetes: relationship to self-reported diabetes training. J Sch Health 2006;76:387–92. https://doi.org/10.1111/j.1746-1561.2006.00130.x.Search in Google Scholar
17. Warne, J. Diabetes in school: a study of teachers’ knowledge and information sources. Practical Diabetes International 2005;5:210–4. https://doi.org/10.1002/pdi.1960050507.Search in Google Scholar
18. Aycan, Z, Önder, A, Çetinkaya, S, Bilgili, H, Yıldırım, N, Baş, V, et al. Assessment of the knowledge of diabetes mellitus among school teachers within the scope of the managing diabetes at school program. J Clin Res Pediatr Endocrinol 2012;4:199–203. https://doi.org/10.4274/jcrpe.756.Search in Google Scholar
19. Gómez Manchón, M, Gómez Carrasco, JA, Ramírez Fernández, J, Díez Fernández, T, García de Frías, E. Special needs of schoolchildren with diabetes mellitus. Point of view of parents and teachers. An Pediatr 2009;70:45–52. https://doi.org/10.1016/j.anpedi.2008.07.004.Search in Google Scholar
20. Edwards, D, Noyes, J, Lowes, L, Haf Spencer, L, Gregory, JW. An ongoing struggle: a mixed-method systematic review of interventions, barriers and facilitators to achieving optimal self-care by children and young people with type 1 diabetes in educational settings. BMC Pediatr 2014;14:228. https://doi.org/10.1186/1471-2431-14-228.Search in Google Scholar
21. Norris, SL, Nichols, PJ, Caspersen, CJ, Glasgow, R, Engelgau, M, Jackjr, L, et al. Increasing diabetes self-management education in community settings. A systematic review. Am J Prev Med 2002;22:39–66. https://doi.org/10.1016/s0749-3797(02)00424-5.Search in Google Scholar
22. Pansier, B, Schulz, PJ. School-based diabetes interventions and their outcomes: a systematic literature review. J Publ Health Res 2015;4:467. https://doi.org/10.4081/jphr.2015.467.Search in Google Scholar PubMed PubMed Central
23. Cox, DJ, Irvine, A, Gonder-Frederick, L, Nowacek, G, Butterfield, J. Fear of hypoglycemia: quantification, validation, and utilization. Diabetes Care 1987;10:617–21. https://doi.org/10.2337/diacare.10.5.617.Search in Google Scholar PubMed
24. Erie, C, Van Name, MA, Weyman, K, Weinzimer, S A, Finnegan, J, Sikes, K, et al. Schooling diabetes: use of continuous glucose monitoring and remote monitors in the home and school settings. Pediatr Diabetes 2018;19:92–7. https://doi.org/10.1111/pedi.12518.Search in Google Scholar PubMed PubMed Central
25. Liberatore, RJr, Perlman, K, Buccino, R, Artiles-Sisk, A, Daneman, D. Continuous Subcutaneous insulin infusion pump treatment in children with type 1 diabetes mellitus. J Pediatr Endocrinol Metab 2004;17:223–6. https://doi.org/10.1515/jpem.2004.17.2.223.Search in Google Scholar PubMed
© 2020 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Frontmatter
- Review Article
- The current review of adolescent obesity: the role of genetic factors
- Original Articles
- Trends in abdominal obesity among Chinese children and adolescents, 1993–2015
- Association of childhood obesity with retinal microvasculature and corneal endothelial cell morphology
- Communication frequency between visits is associated with improved glycemic control in pediatric diabetes
- Increased length of stay and hospital charges in adolescents with type 1 diabetes and psychiatric illness
- Distance from the endocrinology clinic and diabetes control in a rural pediatric population
- Care of children with type 1 diabetes mellitus in school – An interventional study
- Treatment and long-term follow-up of patients diagnosed with type 1 diabetes mellitus before age 5
- Diabetes distress in Indian children with type 1 diabetes mellitus and their mothers
- Impact of lockdown for COVID-19 pandemic in Indian children and youth with type 1 diabetes from different socio-economic classes
- First report on the nationwide prevalence of paediatric type 1 diabetes in Serbia and temporal trends of diabetes ketoacidosis at diagnosis—a multicentre study
- Factors affecting thyroid volume in adolescent students attending a rural middle school in East Hangzhou, China
- Impact of maternal thyroid disease on neonatal thyroid status
- Impact of growth hormone treatment on scoliosis development and progression: analysis of 1128 patients with idiopathic short stature
- Short Communication
- Are we ignoring coexisting rhabdomyolysis as an important aggravating factor for acute kidney injury among childhood diabetic ketoacidosis?
- Case Reports
- Microdeletion in the IGF-1 receptor gene of a patient with short stature and obesity: a case report
- SLC25A19 deficiency and bilateral striatal necrosis with polyneuropathy: a new case and review of the literature
- Familial neonatal nonautoimmune hyperthyroidism due to a gain-of-function (D619G) thyrotropin-receptor mutation
- Transient neonatal diabetes due to a disease causing novel variant in the ATP-binding cassette subfamily C member 8 (ABCC8) gene unmasks maturity-onset diabetes of the young (MODY) diabetes cases within a family
Articles in the same Issue
- Frontmatter
- Review Article
- The current review of adolescent obesity: the role of genetic factors
- Original Articles
- Trends in abdominal obesity among Chinese children and adolescents, 1993–2015
- Association of childhood obesity with retinal microvasculature and corneal endothelial cell morphology
- Communication frequency between visits is associated with improved glycemic control in pediatric diabetes
- Increased length of stay and hospital charges in adolescents with type 1 diabetes and psychiatric illness
- Distance from the endocrinology clinic and diabetes control in a rural pediatric population
- Care of children with type 1 diabetes mellitus in school – An interventional study
- Treatment and long-term follow-up of patients diagnosed with type 1 diabetes mellitus before age 5
- Diabetes distress in Indian children with type 1 diabetes mellitus and their mothers
- Impact of lockdown for COVID-19 pandemic in Indian children and youth with type 1 diabetes from different socio-economic classes
- First report on the nationwide prevalence of paediatric type 1 diabetes in Serbia and temporal trends of diabetes ketoacidosis at diagnosis—a multicentre study
- Factors affecting thyroid volume in adolescent students attending a rural middle school in East Hangzhou, China
- Impact of maternal thyroid disease on neonatal thyroid status
- Impact of growth hormone treatment on scoliosis development and progression: analysis of 1128 patients with idiopathic short stature
- Short Communication
- Are we ignoring coexisting rhabdomyolysis as an important aggravating factor for acute kidney injury among childhood diabetic ketoacidosis?
- Case Reports
- Microdeletion in the IGF-1 receptor gene of a patient with short stature and obesity: a case report
- SLC25A19 deficiency and bilateral striatal necrosis with polyneuropathy: a new case and review of the literature
- Familial neonatal nonautoimmune hyperthyroidism due to a gain-of-function (D619G) thyrotropin-receptor mutation
- Transient neonatal diabetes due to a disease causing novel variant in the ATP-binding cassette subfamily C member 8 (ABCC8) gene unmasks maturity-onset diabetes of the young (MODY) diabetes cases within a family