Schools pushed to improve diabetics' care

Policies against food, sharps in class can jeopardize vulnerable young patients.

By Victoria Stagg Elliott, AMNews staff. May 20, 2002.

Shannon Oates, MD, an endocrinologist with Arnett Clinic in Lafayette, Ind., has met with school boards and written letters to teachers and principals in order to get permission for her patients with diabetes to test their blood sugar in the classroom. She has also fought for their right to have glucose tablets and food in their desk so they can deal with low blood sugar quickly.

"You've got to be a pit bull for your patients," said Dr. Oates. "My worst case was this kid who had to walk all the way across campus with low blood sugar -- about to pass out -- to get tested by the secretary.... That is not good enough."

Physicians are increasingly having to deal with how school policies affect diabetics because of the convergence of two trends: a shift in philosophy in how type 1 diabetes is cared for and an increase in the number of young people with type 2.

For those with type 1, treatment regimens have shifted to an emphasis on tight control. Many school-age patients now find themselves having to figure out ways to receive a dose of insulin midday. In addition, there is the challenge of having to check blood sugar more frequently.

"We're having to be more aggressive now because in the past insulin shots weren't traditionally given at lunch time," said Andy Muir, MD, associate professor in pediatric endocrinology at the University of Florida in Gainesville. "With the push towards intensive control, there's a lot of people who want to give insulin and check blood sugars and really do intensive treatment for the five or six hours a day they're at school." Dr. Muir presented a workshop on the issue at the May annual meeting of the American Association of Clinical Endocrinologists in Chicago. [...]