With the new school-year well underway, provincial governments are implementing new health and safety policies, including classroom cellphone bans and requirements for automated external defibrillators and naloxone kits in schools.
Yet, a critical health and safety issue for thousands of students throughout Canada remains overlooked — most Canadian provinces and territories have not developed a mandatory standard of care for diabetes management 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. 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.
Approximately one in 300 children in Canada has type 1 diabetes and a growing number are being diagnosed with type 2, meaning that likely every school in Canada has at least one student with diabetes.
All of them deserve consistent, safe and equitable care. Unfortunately, this is not happening.
While British Columbia, Nova Scotia and Prince Edward Island have mandated standards aligned with Diabetes Canada guidelines, other provinces and territories fall short.
Across those provinces and territories — and even between schools in the same district — support is fragmented and unreliable, often left up to individual school boards, schools or teachers.
Diabetes is a complex condition that requires monitoring of blood glucose levels and balancing medication, food and activities every day.
This is taxing enough for an adult. For children, it is even more challenging as they must incorporate diabetes care into school routines that often requires adult support.
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.
Managing diabetes requires students to perform tasks multiple times during the school day, including checking blood glucose levels with a monitoring device or tests strips and using an insulin pump or insulin pen.
While most students can do these things independently with minimal support from school personnel, some students — especially younger ones — often cannot manage these tasks by themselves and need help from trained staff.
Without a clear province/territory-wide standard of care outlining the roles and responsibilities of students, families and school staff, students are left vulnerable.
Parents tell us that they are often left to navigate a patchwork system with no guarantees that their child will receive the necessary support. Many are forced to adopt a less favourable diabetes treatment plan for their child or step in and provide care during school hours. To provide this care, some are forced to quit their jobs or take part-time work — deeply impacting the family’s financial and mental well-being.
One parent cited multiple incidents where their child’s blood glucose level fell too low, but the school would not provide juice to raise it until staff talked to the parent, despite already having instructions on what to do.
Another parent was told by a school principal to keep their daughter home until “she can manage her diabetes on her own.”
Rather than excluding students or further burdening parents, schools need a uniform policy on how to support children with diabetes.
Students spend about 30 to 35 hours a week at school — more than half their waking weekday hours. It is incumbent upon all provincial and territorial governments to set clear and consistent mandatory standards of care and ensure that they are then implemented equitably across schools.
A provincial or territorial mandated standard of care should require:
- 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.
Children and families in Canada have waited long enough.
Photo courtesy of DepositPhotos
