- After a New Diagnosis and Extended Absence
- Typical Reactions of Classmates
- Typical Reactions of Students
- Availability of Diabetes Re-entry Programs
- Ways to Ease the Return
Teachers should expect several missed school days when a student is first diagnosed with type 1 diabetes. In-patient hospitalization of two, three, or four days is common upon first diagnosis. Understandably, this can also be a traumatic time for everyone involved as news about a life-long illness has been conveyed, and training about a host of dietary, treatment, and life-style changes has followed.
It is intuitively obvious that some classmates react with fear and apprehension when a student develops diabetes. Other classmates react with confusion or indifference, and a few may ridicule or bully the student. A recent study found that one in three classmates (age 11-16 years) voiced a wish for more information about diabetes if they were a friend of the student with the disease. Many students in the study wanted more information to allay their fears about diabetes or to help support their classmate in his or her disease management.
It appears that many students are apprehensive about the potential for negative peer reactions if they disclose their diagnosis. For example, over one-half of children and adolescents in one study did not talk about their diabetes with peers and over one-third believed they would be liked less if peers knew they had diabetes. These findings, however, date to the 1980s. It is unknown whether the information-rich contemporary world has resulted in less apprehension and personal concern about sharing diabetes information. More positively, a 2009 study found that students with type 1 diabetes strongly value peer and teacher support.
Although some large centers (such as Children’s Hospitals) practice school-reintegration to support their students, most of these practices do not appear in the form of programs with manuals and specific guidance for how to implement the program. This thus leads schools and small medical practices to adopt their own programs for re-entry. Nonetheless, we encourage educators to contact their students’ health care team about the availability of this option.
Although few formal diabetes school re-entry programs appear to exist, students do appear to learn some things about their classmate’s diabetes. One study of children (average age 12 years) in 2006 found that 56% of classmates received some type of diabetes training—usually informal presentations by a parent or school nurse. Topics covered included general diabetes information, the importance of effective self-care, as well as recognizing and treating hypoglycemia.
Resources do exist to share information with classmates about a student with diabetes (elementary and junior high age-range). The Children with Diabetes website suggests sharing information about low blood sugar and prompting classmates to respond appropriately if an insulin reaction occurs. In addition, the website suggests providing information to dispell the myths about the causes of type 1 diabetes. A modifiable letter to tell parents about the presence of a student with diabetes and to inform them that their son or daughter has been provided with diabetes-related facts can also be found on the website. We know of no research that yet supports the use of this apparently helpful program, although other research documents the value of instilling diabetes training among classmates. Some emerging research (from 2009) confirms that students with diabetes believe that their re-integration in school would be aided by the dissemination of diabetes information. Thus, unless students prefer otherwise, sharing basic facts about diabetes seems advisable.