Author: Tammy Lane • First Posted: Tuesday, January 03, 2012

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Type I diabetes is a chronic disease that currently affects about 130 children throughout Fayette County Public Schools. On average, one or two more diabetics join the population each month.

“There’s a lot that goes into managing diabetes in schools,” said Michelle Marra, who coordinates some of the nurses tending to the district’s nearly 40,000 students. “A lot of times in the school setting, the focus is on nutrition and P.E. But what we deal with on a daily basis is all these other health issues and health conditions. We empower kids to manage these chronic illnesses that they’ll have forever.”

Type I diabetes, in which the body produces no insulin, generally strikes children. With Type II diabetes, in which the insulin does not function properly, obesity is the primary cause.

Managing a student’s condition takes a joint effort, partly because a school nurse might not always be on hand. Teachers and paraeducators in the classroom, office staff and nutritionists in the cafeteria are among the trained support system. The nurses also prepare bus drivers for emergencies and even show hesitant parents how to care for their child.

“The purpose is to get a handful of people who all know what’s going on so anyone can step in and help a kid,” said Jan Bright, the nurse at Sandersville Elementary.

It’s crucial that everyone recognize the signs and symptoms that require attention because diabetes can also affect classroom performance. “When a child is high or low, their ability to learn and absorb and retain information can be impacted,” Bright noted.

Diabetics gradually become more in tune with their bodies. Younger children might not yet realize that an all-day headache means their blood sugar level is low. Older students, however, may know they feel sluggish when their counts are down and hyper when their sugar is high.

While the level of care depends on a child’s age and cognitive abilities, the aim is for each student to count their carbohydrates, check their sugar and administer their own insulin either by injection or pump.

In elementary school, the nurses do a lot of hand-holding and coaxing the kids to take their shots. Adults also must keep track of the carbs they eat because that number, along with their sugar, determines their insulin dosage.

“With a newly diagnosed student, there’s a window when they’re just getting comfortable poking their finger and reading their monitor, not fully grasping what that number means,” as Bright explained.

By middle school, most diabetics carry a small kit with an insulin pen, which dials up the correct amount.

“They’re very savvy in they’re able to add up what they ate, look at their blood sugar and come up with their dose,” Bright said of young teens.

At Paul Laurence Dunbar High School, nurse Marydale Coleman said most of her dozen diabetics are self-sufficient, but she still sees each of them at least once a week. Sometimes they simply need an extra snack to get through the day.

Coleman created a grid with her diabetics’ names, pictures and typical reactions, along with individualized suggestions to help everyone keep track of students’ various needs. She also uses juniors and seniors as role models for incoming students, who might be thrown off by the added effects of hormones and other stresses.

“A new diabetic in a high school, you’ll be working with the cafeteria, the teachers and the staff to get the students as independent as you can. The goal is to take their insulin shots and check their blood sugar when they need to. We nurses deal with the crisis management – the lows and highs,” she said, adding, “You never know what you’ll get on a day-to-day basis.”

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