Special feature: Safe at school at last

“Unsafe at School: Advocating for Children with Type 1 Diabetes” was published in the June 2012 issue of the BC Medical Journal (BCMJ 2012;54:232-237).

The article describes how type 1 diabetes, unlike other common, life-threatening illnesses in school-aged children such as asthma, severe allergies, and epilepsy, is not fully accommodated in the BC school system and has had far-reaching negative effects for affected children and their families.

However, for the past few years an advocacy movement has been afoot in BC. On 22 October 2013, in response to increasing pressure from families and following the recommendations of an independent Child Health BC report, the BC government announced a new, standardized province-wide policy that will keep children with type 1 diabetes safe at school at last.

Changes were planned to start in January 2014, with full implementation scheduled for the start of the 2014–2015 school year.

One highly anticipated change will be tailoring the school care plans to the individual needs of the child—involving parents and the child’s diabetes doctor in decision making. For the first time school staff will be trained in glucagon administration for children of all ages, and will be better prepared should a hypoglycemic emergency occur. For students who are not independent in their care, staff will be trained to directly administer insulin, be it via insulin pump or using a syringe or pen.

This policy should have been in place years ago. As new intensive insulin therapies were made available, children should not have been required to stay on outdated regimens just to fit into a care model that did not keep pace. Parents should not have had to attend school to ensure their children had access to care.

The diabetic community in BC has demonstrated immense enthusiasm and relief for this new policy. Parents are experiencing peace of mind for their children’s safety and for the opportunity to rejoin the workforce to better provide for their families. Single parents no longer have to choose between their child’s health and their family’s financial security. One father whose school district was especially challenging stated, “It means that my wife and I will no longer be terrified when we drop our daughter off at school. It means the world to us.”

The diabetic community across Canada has been equally encouraged and is hoping all Canadian school systems follow suit. To date only Quebec and New Brunswick have achieved similar success.

Resources for physicians and families
Physicians can provide affected families with the BC Ministry of Health policy announcement letter,[1] as well as an independent report from Child Health BC on diabetes care in schools.[2] The policy announcement letter specifies the start dates for glucagon and insulin administration (January 2014 and September 2014, respectively). Prior to policy implementation in September 2014, families are encouraged to enter into agreements at the local level. The Unsafe at School website outlines the steps parents have taken to achieve independent (locally arranged) care plans,[3] along with examples of independent plans and other documents that may be of assistance to parents. Further details regarding the new policy will be posted on the Unsafe at School website as they are available.

References

1.    BC Ministry of Health. Policy announcement letter re: In-school support for students with type 1 diabetes. Accessed 4 February 2014. http://bit.ly/1dqQHwl.
2.    Child Health BC. Diabetes care in the school setting. Accessed 4 February 2014. www.childhealthbc.ca/guidelines/category/82-diabetes.
3.    Unsafe at School. Getting an independent care plan. Accessed 4 February 2014. www.unsafeatschool.ca/2012-telus-walk-to-cure-diabetes.

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Dr Yewchuk is a pediatric radiologist at BC Children’s Hospital in Vancouver and a clinical instructor in the Department of Radiology at the University of British Columbia.