PEAD-SA – Should children with diabetes go back to school?

The Paediatric & Adolescent Endocrinology & Diabetes Society – South Africa (PEAD-SA) share their position statement on children with Type 1 diabetes mellitus returning to school.


All children should return to school in accordance with government guidelines. Type 1 diabetes mellitus (T1DM) does not seem to increase the risk of acquiring infection or of having COVID-19 severe disease in children and adolescents. Our position as PEAD-SA is that children and adolescents with T1DM should not be prevented from returning to school.

Background

The pandemic of infection with coronavirus (SARS-Cov-2), which has caused corona virus disease since 2019 (COVID-19) has affected all aspects of life throughout the world.

South Africa has not been spared and we are now in the early stages of this epidemic. The carefully considered and courageous decision by government to call for a lockdown was timely and necessary as is the easing to the different levels.

As part of this change, it has been recommended that children and adolescents begin returning to school. Considering concerns raised by numerous people, PAEDS-SA is presenting our position on this aspect of the epidemic.

What does PEAD-SA know about children and infection with SARS-Cov-2?

What we do know comes from very limited information from other countries and from limited local experience.

  1. Children (under 20 years) do get infection with SARS-Cov-2. In most countries, children make up a small fraction of all the people with infection. Thus, it seems that children and young people don’t contract COVID-19 at the same rate as adults. In China and Italy, children less than 10 years were only 1% of all cases, and those between 10 and 19 years were 1,2% of all cases. In the USA, children and adolescents (under 18 years of age) were 1,7% of all cases reported1,2,3.
  2. Children do not seem to get severe infection very commonly. This may be the reason why children make up such a small fraction of people with infection, because in most countries, people are only tested when they are ill. It is thought that most children get infected but do not have symptoms. Children rarely require hospitalisation or have severe disease4. (1,1% of cases are critical, 2,2% of cases are severe)5(5,7% of children hospitalised US)3
  3. Very few children have been seriously ill or have died from this condition. To date, it is thought that 30 children have died from COVID-19.
  4. Children do not seem to be responsible for the major spread of infection to others. Most children are infected by adults rather than from each other.
  5. It is not clear that children have the same risk factors as adults for serious illness e.g. hypertension, lung disease, Type 2 diabetes, etc. Reports from colleagues suggest that children with T1DM do not contract Corona virus infection more frequently than other children2 and do not have more severe forms of COVID-19 disease than other children. In China and Italy, no-one under 25 with T1DM landed up in hospital or with severe disease (needing ICU).2
  6. In South Africa, we are starting to see a few children with COVID-19 disease and the pattern does not seem to have changed from the rest of the world.
  7. We are seeing increasing numbers of children with stress, anxiety and other psychological, social and emotional issues because of the lockdown.

Conclusion

PEAD-SA, therefore, have taken the position that children and adolescents with T1DM should not be treated any differently from other children in terms of going back to school.

All usual advice for the care of children and young people with T1DM remains valid:

  • Better control means better health, particularly in winter when everyone gets sick.
  • Children with T1DM should have a flu vaccine.
  • Any illness will affect glucose control, which then needs extra attention.
  • If children are ill, they or their caregivers should not delay in contacting their healthcare provider because they are afraid of COVID; unmanaged DKA is far more dangerous.
  • Hypoglycaemia remains the most urgent problem that must be treated immediately, including at school.

PEAD-SA will continue to monitor reports from international organizations (WHO, ISPAD, ADA), colleagues and from across the world and update this statement promptly as new information becomes available.

Click on the video below to hear The International Society for Paediatric and Adolescent Diabetes (ISPAD)  statement on COVID-19 and children with diabetes.

REFERENCES: 

  1. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in ChinaSummary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention Zunyou Wu, MD, PhD; Jennifer M. McGoogan, PhD JAMA. 2020;323(13):1239-1242. doi:10.1001/jama.2020.2648
  2. Summary of recommendations regarding COVID‐19 in children with diabetes: Keep Calm and Mind your Diabetes Care and Public Health Advice | International Society of Pediatric and Adolescent Diabetes (ISPAD) | Ped diab 2020;21(3):413-414 doi.org/10.1111/pedi.13013
  3. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. 422 MMWR / April 10, 2020 / Vol. 69 / No. 14. CDC COVID-19 Response Team 
  4. SARS-CoV-2 Infection in Children Xiaoxia LuLiqiong ZhangHui Duet alNEJM 18 Mar 2020
  5. Clinical Manifestations of Children with COVID-19: a Systematic Review Tiago H. de Souzaa, MD, PhD; José A. Nadala, MD, MSc; Roberto J. N. Nogueiraa et al
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Lunch ideas for home or school during lockdown

Mommy, what are we eating for lunch? A question that most mommies have heard a lot during the lockdown period. Donna Van Zyl, a dietitian, shares a few lunch ideas for the family


School-going children generally have a routine and other activities that makes diabetes management a bit easier than children at home during lockdown. They may be sleeping late at night, waking late morning, and eating at irregular times. The lack of routine may contribute to irregular blood glucose levels.

In addition, we find ourselves walking far more to the cupboard or refrigerator due to boredom and we catch ourselves snacking slightly more. Boredom eating is one of the bigger challenges in lockdown and therefore routine should also be established like the school day at home with breakfast; school work; snack and lunch time. However, eating at home or school; a diabetic lunch is no different to a healthy lunch that every child should eat.

A healthy balanced lunch will ensure that your child gets the right amount of nutrients and energy they need to concentrate or perform optimally. A balanced lunch consists of a wholegrain/unrefined low-GI carbs, protein, fats, fruit, salads and vegetables.

 Tips for lunch or lunch boxes

  • For those who are carb-counting, a good tip is to write down the total amount of carbohydrates on a sticky note, paste inside the lunch box so that it is easier for your child, or the school nurse, to count carbs at school. Preparing portioned foods can also aid your child at school, or at home, when carb counting.
  • Prepare or pack a healthy lunch you know your child will eat. Otherwise your child may enjoy swopping his or her food with friends or end up not eating. It is important to switch up the foods regularly. Let your children try new foods over the weekend or at night, so that you know whether you can prepare or pack the food in for them.
  • Allow your child to help you prepare the lunch or pack the lunch box. At the same time, you can teach your child how to do the carb counting or even some culinary skills. Often children who take responsibility for preparing the meal establish healthy and good eating habits.
  • Always provide a low-carb option, such as a protein or fat snack. See options listed below.
  • Always have a snack available to pick up a low blood glucose level; longer life options, such as a packet of raisins, can be kept close by just in case.
  • Prepare food in advance and freeze or prepare more portions the evening before so that leftovers can be used for lunch the next day

Use leftovers

How to use leftovers the next day; and if there are no leftovers what can you serve for lunch tomorrow?

When leftovers are available:

Chicken Chicken mayonnaise whole-wheat wraps, whole-wheat rolls with added salad preserves

Pesto quinoa/durum wheat pasta chicken salad with added rosa tomatoes and feta

Pineapple and pineapple mixed salad

Chicken, feta and bean salad including salad preserves

For the lower carb: Chicken salad with a honey mustard dressing

Steak Steak Prego whole-wheat roll with added salad preserves

Stir-fry and steak vegetable wrap

Steak strips served with baby potato salad and salad/veg on the side

For the lower carb: Steak salad with a balsamic & olive oil or Blue Cheese dressing

Mince Mince and cheese toasted whole-wheat or rye sandwich (can even be topped with a fried egg)

Cheese, mince and corn whole-wheat wrap (Toasted)

Mince, guacamole, corn and diced tomato tacos

Prepared Soup Chicken and noodle soup

Hearty beef and barley soup

Vegetable and lentil soup

When no leftovers are available:

Eggs Lean bacon, cheese and egg toasted whole-wheat sandwich

Scrambled egg muffins/omelette (bacon, mushroom and cheese or spinach and feta) served with a whole-wheat or rye toast

Tuna Apple and tuna salad mixed with salad preserves and mayonnaise

Tuna pasta salad

Salmon and tuna fishcakes (prepared) served with roasted vegetables or mixed assorted salad

For the lower carb: Tuna, cucumber, tomato and chickpea salad dressed with mayonnaise

 

Snack items

For those children heading off to school, a lunch box can include a few more snacky items; especially when lunch is generally served at home. You can include the following:

  • Proteins

Scrambled egg muffins; or lean meat, such as beef strips, chicken breasts strips, sosaties (mini), biltong, salami slices/sticks, meatballs (chicken or beef), cheese: wedges, blocks of cheddar cheese, cottage cheese or cream cheese, yoghurt, smoothies.

  • Starchy food

Whole-wheat/rye bread, whole-grain Provitas, wraps, brown rice, quinoa, barley, baby boiled potatoes/sweet potato with the skin, and durum wheat pasta.

  • A good helping of salad, vegetables and fruit

Fresh fruit is easy to pack; or chopped fresh strawberries, pineapple fingers, apple slices, orange or naartjie wedges. Remember to count the fruit towards your carbs.

Raw veggies, such as carrot sticks, cherry/Rosa tomatoes, mini cucumber or sliced, gherkins, mini corn, corn on the cob, capsicum strips are all popular to add colour to the lunch box and can always be served with a dip: sour cream/hummus or guacamole.

Nuts and seeds or unsweetened nut butters can also be added as an additional treat.

The actual lunch box

  • Ensure it is a strong container that will protect the food from being squashed.
  • Have smaller containers available for dips, sauces or cut-up fruit.
  • When choosing a water bottle, make sure that it will be easy to clean. Some juice containers have a removable ice pack that you can use to keep the water cold. This is also great for milk or smoothies.
  • You can use a soft cooler bag for food that needs to be kept cool.
  • And remember to wash out the lunch box daily.

MEET THE EXPERT


Donna van Zyl is a private practicing dietitian for Nutritional Solutions, Bloemfontein. She is growing in the field of paediatrics and plays a key role in individualising nutritional therapy for Type 1 diabetics. Her special interests are optimising health, managing chronic lifestyle related diseases, and sports nutrition. She lectures part-time at the University of the Free State, which she enjoys thoroughly.


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Youth with Diabetes – How to decide if your child should go back to school

We hear Youth with Diabetes’ position statement on whether sending your child with diabetes back to school is a good idea.


Two large studies from England have just been released on COVID19 and diabetes. Because of this new information, Youth with Diabetes is adjusting our recommendations about going back to school. Please use this new advice to help you decide if you will be sending your child back to school.

The studies show that people with Type 1 diabetes are more at risk of dying from COVID-19 than those with Type 2 diabetes.

After taking into account age, sex, heart disease, socioeconomic status and race, people with Type 1 diabetes are almost three times more likely to die from COVID-19 than those without diabetes. (Hazard ratio of 2,86).

If your HbA1c is more than 10,0%, you are twice more likely to die than if your HbA1c was less than 7,5%. (Hazard ratio of 2,19).

It is important to note that age is the most important risk factor, even if you have diabetes. In these studies, no one with Type 1 diabetes under the age of 50 has died. Most of the COVID-19 deaths in Type 1 diabetes have been in the age group of over 70 years.

Other risk factors that contribute to increased risk of death for people with Type 1 diabetes are obesity and chronic kidney disease.

All this information means that you can reduce your risk by getting your blood glucose level under control and losing weight if you are obese.

Here are the links to read the full research articles:

https://www.england.nhs.uk/wp-content/uploads/2020/05/valabhji-COVID-19-and-Diabetes-Paper-1.pdf

https://www.england.nhs.uk/wp-content/uploads/2020/05/Valabhji-COVID-19-and-Diabetes-Paper-2-Full-Manuscript.pdf

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Esther Rodrigues – My hero calls me Mom

Esther Rodrigues, a T1D Mom, shares the joys of seeing her son, Mikyle, celebrate his 21st birthday.


Esther Rodrigues stays in Cape Town with her husband, Antonio, and  their three children, Kelsey, Mikyle and Jayden.

I am a T1D Mom, who is exceptionally proud of my son, Mikyle Rodrigues, who turned 21 on 20 May 2020.

Mikyle is a strong T1D Warrior who never gives up. In his quiet confidence, he has the strength of a lion, a will to survive and a burning desire to overcome all obstacles in his way.

Currently, my son’s life consists of studies, exercise, eating lots of food, playing PS4 and managing his Type 1 diabetes.

Our family and friends are supportive and assist us wherever possible. Two and a half years ago, Mikyle fell in love, and that gave him reason to live, reason to fight and unconditional love.

Diagnosis

Mikyle was diagnosed at the tender age of 10 in August 2009. I did not know anything about Type 1 diabetes. I was completely dumbfounded with the diagnosis. In the blink of an eye, without any warning, our lives changed forever. Nothing can prepare you for this…Google became my best friend.

As a T1D Mom, I did not know how I was going to do this. I felt as if there was a huge hole in the centre of the earth and I was being sucked in. It was only once we came home, with all the reading and research I did, that I realised what Type 1 diabetes was all about.

The first few years were fine until puberty struck and caused havoc in our lives. We pushed through as best we could but we were advised to look at an insulin pump. Pumps are very expensive and while trying to save towards one, Mikyle was gifted with his first insulin pump by another T1D Warrior, Rowena Carmyn Webb. Rowena gave it to Dr Tracy Janse Van Rensburg, Mikyle’s doctor at the time, to bless a child with it and Tracy chose Mikyle. Sadly, Rowena, an incredibly generous woman, passed away on 22 June.

Eating habits changed as a family

As a family, we love eating. We celebrate with food. Eating habits had to be altered, sugar was removed from our household and sugar-free drinks were bought. Xylitol was used for baking, because Mikyle has a sweet tooth.

I remember the highlight of his school camps were ending the day with hot chocolate topped with marshmallows. So, I searched high and low and made sure that I packed his sugar-free hot chocolate and sugar-free marshmallows when he went on school camps. I did everything in my power to convert the things he liked into sugar-free treats!

Insulin

Mikyle uses a Medtronic insulin pump and Humalog insulin. To test his glucose levels, he uses a Freestyle Optium Glucometer with Freestyle testing strips.

What Mikyle enjoys

Mikyle enjoys exercise, with his favourite being weight training and recently he started taking interest in cardio, specifically boxing.

Since he has joined the gym, he heals faster, and his immune system is much stronger. The blood glucose control is also much better.

Mikyle enjoys eating food. If you want to steal his heart then cook for him. He enjoys most foods, with emphasis on healthy foods. He is currently studying Dietetics (2ndyear) at Stellenbosch University so he knows the importance of consuming healthy foods.

Most of the time, he is playing games on his PlayStation, driving and spending time with his girlfriend, Tamia.

Lessons learnt

I was prepared to help my son grow into a strong, independent young man who could do anything he puts his mind to, but it turns out that he is stronger than I could ever have imagined. With many prayers and the grace of God, he celebrated his 21stbirthday with us as a family.

I believe that God gives his hardest battles to his strongest soldiers, and took some of the strongest women and made them T1D Moms.

My hero calls me mom.

Images by RE Photograghy.

20th Annual Al Bawasil Children’s Diabetes Camp

Sister Barbara Chinyerere and her son, Joshua (9), who has Type 1 diabetes give feedback after attending the 20th Annual Al Bawasil Children’s Diabetes Camp, in Doho, Qatar.


Invitation to 20th Annual Al Bawasil Children’s Diabetes Camp

Diabetes South Africa (DSA) was invited to attend the 20th Annual Al Bawasil Children’s Diabetes Camp, in Doho, Qatar. This took place from 21 to 26 December 2019. Sister Barbara Chinyerere and her son, Joshua (9), who has Type 1 diabetes, attended on behalf of DSA.

Sponsorship

Barbara and Joshua are active members of DSA’s T1 Youth Warriors committee, helping DSA to organise events and outreaches for youth with Type 1 diabetes.

The Qatar Diabetes Association sponsored mother and son to attend the annual camp for children aged 7 – 11 years with Type 1 diabetes.

Barbara’s feedback

Three words: it’s was awesome! We left on Sunday evening. The camp had started on Saturday but there was a delay with my visa. We arrived on Day 3, just in time to join the outing.

There were around 40 local children and another 30 or so children from other countries, like Tunisia, Iran, Sudan and South Africa. Joshua and myself were the first South Africans to attend. Most countries represented had a supervisor and two kids.

The programme started early with prayers. Medical teams were always available, in case any help was needed. These teams consisted of students, doctors, dietitians and nurses with a male volunteer leading each team.

All the children were placed in teams. The outings were all educational; we went to the beach where we spent the day playing games, riding camels and doing quizzes.

The next outing was to the museum where we learnt about Islamic history, the origins of the culture, and saw various statues and ornaments. We enjoyed lunch at the park that day.

KidZania

On the next day, we went to KidZania, a children’s amusement park. Kids can choose from more than 60 real-life fun activities, such as doctor, dentist, police officer, firefighter, actor and singer, etc., in a safe and secured kid-sized city. Designed by educators, for children aged 1-14, KidZania blends learning and reality with entertainment.

Here the group of children got to experience a range of different careers. Children must get involved, get tasks and experience. I must say this was Joshua’s favourite. We then went for a train rides around the area.

Evenings were loaded with diabetic-related board games and small workshops. Food would be delivered at the outings and the food was on point! Even back at the camp side we were stayed, which is a student res. It was impeccable!

Freestyle Libre machines

The Qatar Diabetes Association ensures that all children living with Type 1 diabetes has the best of care. The government sponsors Freestyle Libre machines for children under 12 to 15 years of age. They are very strict on carb-counting and their readings are not in mmol/L like in South Africa.

The last day all the children had to perform skits. They got certificates for attending and the winning team got medals. Families from around joined the closing ceremony. The Qatar Diabetes Association gave a gift to DSA. In their culture, visitors are presented with gifts.

Thank you to DSA for choosing Joshua and myself to experience this once in a lifetime opportunity. We learnt so much and had a blast.

How to help children deal with diabetes-related stress

Daniel Sher suggests four psychologically-informed strategies to help children cope with diabetes-related stress.


As a parent of a child with diabetes, it is fair to assume that you are no stranger to stress. We all know how detrimental chronic stress can be for any child’s mental and physical well-being. When it comes to diabetes care, stress can make it that much harder for children to cope.

The signs of stress in children

Stress is a physiological, mental, emotional or behavioural response to a difficult situation.

  • Physiological signs of stress include muscle tension, shallow breathing, restlessness, sweating and an elevated heart rate.
  • Mental manifestations of stress are thoughts which seem overwhelming and disproportionately negative. Examples include “I’ll never get this right”, “I’m losing control” or “My readings are never where I want them to be.”
  • Stress also manifests emotionally, leading to feelings of shame, anxiety, irritation, fear or anger.
  • Finally, stress can manifest behaviourally, in the form of anger outbursts, social withdrawal, forgetting to take one’s insulin or falsifying one’s blood-glucose results.

Stress and diabetes: a vicious cycle

Stress can affect diabetes directly, by increasing the level of cortisol and adrenaline (stress hormones) in the bloodstream. These chemicals make it harder for insulin to work properly, which can cause a spike in blood glucose levels.

Stress also affects diabetes indirectly. A stressed child, for example, may be more susceptible to eating sweet treats, avoiding testing or skipping on insulin doses. Adolescents may engage in denial and avoidance, whereby they choose to take a break and pretend that they don’t have diabetes for a period.

Four ways to help your child fight stress

It is important to tailor these strategies according to your child’s age and temperament.

  1. Empathise and reflect

Humans are biologically hard-wired to seek out social support. While there are many practical tools (such as meditation and exercise) that can be used to manage stress, arguably the best way to help children de-stress is to make them feel heard.

This involves temporarily brushing aside your own, personal concerns about the situation and truly putting yourself in your child’s shoes. Ask yourself what he/she is feeling and why? Try to imagine their actual emotional experience.

Establishing true empathy will make it that much easier to connect with your child in a way that promotes healing, on a neurobiological level.

Once you have a sense of what they are going through, ‘reflect’ this back to them. So, that they have an experience of being heard and supported. Examples of reflective statements include:

  • “It sounds like this is really tough for you.”
  • “I can see how angry you are.”
  • “It’s clear that you’re feeling overwhelmed.”
  1. Help them name their feelings

To support your child, help him/her develop a vocabulary with which to express emotion. Research has demonstrated again and again that translating emotions into language (or namingfeelings) helps people to regulate their emotions.

Start by asking your child to help you understand what they are feeling. If they don’t have the vocabulary to describe their emotions, help them by proposing possible labels, such as:

  • sad
  • scared
  • hurt
  • angry
  • helpless
  • hopeless

If it feels like these concepts are too abstract for your little one, you can start by focussing on where in the body their emotion is felt. Emotions often manifest physiologically. Is the feeling warm or cool? Radiating, pulsating, vibrating or static? Does their emotion have a colour? Have interactive conversations about emotions. Don’t forget to reward them as they learn to develop this vocabulary.

  1. Model healthy behaviours and attitudes

Modelling means leading by example. Sometimes, the best way to help your little ones’ cope is by showing them how we manage our own stressors. How can you model healthy stress management to your child?

Know the difference between healthy and unhealthy coping mechanisms. How do mom and dad manage when things get tough? Do they go get some endorphin-boosting exercise, take a dip in the ocean, or attend a yoga class?

Or are they more inclined to get snappy, binge eat on junk food or turn to alcohol? When mom and dad get stressed, are they able to verbalise and own their experience, or do they withdraw into themselves?

Modelling healthy stress-reduction mechanisms is vital. Not only does this teach your children adaptive skills and techniques for coping, it also helps them to feel more secure in themselves.

Children who believe that their parents know how to cope with stress are better equipped, on an emotional level, to feel competent in doing so themselves.

  1. Treats are okay

Food is a big deal. The dietary restrictions that a diabetes diagnosis brings can feel incredibly limiting. It is important to recognise that as they grow, they will become increasingly independent. This means that before long, you will have no say whatsoever as to whether they choose to cheat.

In her excellent book The Emotions of Children with Diabetes, Rosemary Flynn describes the difference between ‘cheating’ and ‘treating’. Cheating involves deception, while treating is a form of self-care. If your son has an occasional portion of his favourite ice cream for dessert and accommodates by increasing his insulin dose, this is not cheating, but treating. But, if he sneaks a chocolate bar behind your back and doesn’t accommodate for it, that is cheating.

If your child wants the occasional treat, don’t make them feel shamed or shunned. Support them in their choice to treat themselves occasionally, if they are taking appropriate measures to compensate with insulin or exercise.

At the end of the day, it is not our job as parents to dictate our children’s choices to them. But to support them in making safe and informed decisions for themselves.

When to seek professional help?

While stress and anxiety often go hand-in-hand, they are not the same thing. Anxiety disorders are mental health conditions that may be triggered by acute or chronic stress. If you think that your child may be developing an anxiety disorder, it is important to seek help from a licensed mental health professional.

Do your child’s stress levels feel out of control? Are they stressed-out for extended periods of time? Are they unable to cool-off and regulate their emotions? Is their stress significantly impacting on their grades, social lives, relationships or physical health?

If the answer to any of these questions is ‘yes’, your child may benefit from a consultation with a psychologist who can help them set up an anxiety treatment plan.

Taking back control

Stress is inevitable. Everyone experiences it. We know that stress can negatively affect mental and physical health, making it harder for children to effectively manage their diabetes.

However, stress in and of itself is not a bad thing! If we feel equipped to cope, small doses of stress can make us feel energised, focussed and motivated.

The answer, therefore, is not to try to completely eliminate stress from the lives of your kids. This is impossible. Rather, we need to support them in developing the tools and feelings of competency that they will be able to draw on to manage stress effectively.


References:

Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in psychiatric treatment, 11(5), 338-346.

Flynn, R. (2000). The emotions of children with diabetes. Creda Communications: JHB.

MEET THE EXPERT


Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital in Cape Town where he works with Type 1 and Type 2 diabetes to help them thrive. Visit danielshertherapy.com


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Back to school (with Type 1 diabetes)

Going back to school can be a stressful time for anyone. For people with Type 1 diabetes (T1D) this can be even more so, especially returning to school after a new diagnosis. It’s important that teachers are aware of T1D so they can ensure the wellbeing of their students.


Education

It’s so important that your school teachers are aware of your T1D and know what to do when you need assistance. If they are educated, they will be better prepared to help you.

It’s also advisable to keep a Glucagon kit at the school office, therefore it’s best to educate the school secretaries or the school nurse.

If you feel comfortable, it’s also great to make your friends aware. That way you can ask them for help too.

Educate your teachers on the symptoms of high and low blood glucose so that they can keep an eye out for you.

If you play sports, educate your coaches on how you may need to take breaks if your blood glucose drop and eat and rest until your blood glucose returns to a good level.

Know your rights

It’s important to educate your teachers that you need to eat during class. No excused from your teachers, you are the exception. If you write exams, make sure the teachers are aware of your T1D!

Be as open about your T1D as possible

The more open you are about your diabetes, the better. People are often very inquisitive and unfortunately T1D carries a lot of misconceptions so try to be as patient as possible

If you wear a medical device, wear it with pride

NEVER be ashamed of a CGM or pump being visible. People are more likely to ask you questions but use it as an opportunity to educate people and create a positive conversation about T1D.

Be prepared

Make sure you ALWAYS have glucose sweets or a juice box with you. Lows can happen at the most unexpected times. It’s also important if you leave the classroom to carry your ‘low’ treatments with you.

Drink plenty of water at school too. Pack your bag the night before; that way you are less likely to forget important things at home. Be prepared for more than one low a day and pack enough supplies.

Remember that your T1D doesn’t define you

Know that diabetes doesn’t make you different from everyone else 🙂

Click on the image to make use of a printable PDF from the JDRF which is a great resource to give to your teachers.

T1D

MEET OUR YOUTH WARRIOR


Sarah Gomm (16) has been living with Type 1 diabetes for nearly 13 years; diagnosed at age four.


Sarah’s story

My family knew something was wrong with me due to my symptoms of thirst and weight loss, etc. They took me to the doctor and I was immediately sent to the hospital where I was diagnosed with T1D. I spent a few nights in hospital where my family and I learnt all the ins and outs of T1D.

For the next eight years, I did insulin injections and finger pricks. My mom would come to my school during break to do my injections until I was able to do them myself.

The past five years, I’ve been fortunate enough to use a CGM and insulin pump, which I’ve found to assist in lowering my HbA1c and improve my overall control.

As I get older, I’m becoming a lot more responsible managing my diabetes and it’s made me a very independent person.

However challenging T1D can be, I still count it as a blessing. I have experienced so many amazing things I never would have, it’s made me mature and, most importantly, I’ve met so many amazing people.

T1D does not define me, though, it has made me the person I am today, and for that I am grateful!