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November is diabetes month

In 1922, Canadian scientists discovered insulin and forever changed the lives of millions of diabetics around the world. Yet over 80 years later, it is Canadian school children with diabetes who are going without insulin and effective diabetes management. With a growing epidemic of insulin dependent (Type 1)  diabetes, Canadian children are at greater risk of developing diabetes, and at a younger and more vulnerable age. Diabetes is a disease in which the body loses the ability to process carbohydrates, the complex sugars that make up much of a normal diet.

With overlapping Provincial and Federal jurisdictions, Canada lacks the laws and standards to protect school children with diabetes and other disabilities from discrimination and ensure appropriate care during school hours. School children with diabetes lack national guarantees for equal standards of care, which according to American and International Diabetes organizations, includes insulin injections, and in rare emergency situations, injection of glucagon, a drug similar to the adrenalin injected to treat life threatening allergic reactions.

In the United States, children are guaranteed freedom from discrimination and access to medically necessary support while in school by the Individuals with Disabilities Education Act  (IDEA). Backed by the strength of Federal laws, the American Diabetes Association published the "Safe at School" statement of principles, which has been endorsed by the American Academy of Pediatrics, and other associations including the Juvenile Diabetes Research Foundation. To date, no other Canadian diabetes organizations have endorsed the principles of "Safe at School", although the Canadian Diabetes Association continues to lobby at the Provincial and Territorial levels for legislative change.

We believe the principles of "Safe at School" are universally important and that it is Canadian laws and advocacy that need to rise to world standards. Until then, Canadian children with diabetes and other medical disabilities must be presumed to be Unsafe at School. Unsafe at School has been formed by concerned parents to advance the rights of school children with disabilities, with a focus on diabetes.

While many children with diabetes are capable of self managing their care, which includes injecting insulin - very young school children can not, and should not be expected to bear the burden of their care. Without support from schools, parents have to juggle busy work schedules to coordinate care themselves, or leave children untreated during school hours, exposing them to the risks of hyperglycemia, which studies show cause reductions in verbal IQ  and cognitive function[1], among other health consequences.

According to researchers, by 2020, the incidence of Type 1 diabetes is expected to double in children under five years old. Canada has the 4th highest incidence of Type 1 diabetes[2], ranking ahead of Norway, the United Kingdom and the USA. Based on 2007 figures, Type 1 diabetes affects at least 440,000 children under the age of 14 and millions of adults, with 70,000 children newly diagnosed each year. Between 1992 and 2002, the incidence of Type 1 diabetes in Ontario increased by 48%[3]. While Type 1 diabetes is thought to have environmental triggers ranging from viruses to vitamin D deficiency, diet and exercise are some of the main factors in Type 2 diabetes, typically viewed as a disease of adulthood, is rising alarmingly in Canadian children, youth.

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Advocacy
www.unsafeatschool.ca
www.jdrf.ca
www.diabetes.ca


Sources

American Diabetes Association - Safe at School
http://www.diabetes.org/living-with-diabetes/parents-and-kids/diabetes-care-at-school/safe-at-school/safe-at-school-statement-of.html

UK Diabetes - Diabetes Care in Schools
http://www.diabetes.org.uk/Professionals/Shared_Practice/Care_Topics/Diabetes-Care-in-Schools

International Diabetes Federation - The Rights of the Child with Diabetes in the School
http://www.idf.org/Position_statementsrights_of_children

The Type 1 Diabetes Epidemic
http://www.medscape.com/viewarticle/703479
http://www.canada.com/health/family-child/Type+diabetes+double+European+kids+under+five/1639081/story.html

Impact on IQ and Cognitive Function
[1] Effects of prior hypoglycemia and hyperglycemia on cognition in children with type 1 diabetes mellitus 
Cognitive Function Is Disrupted by Both Hypo- and Hyperglycemia in School-AgedChildren With Type 1 Diabetes: A Field Study http://care.diabetesjournals.org/content/32/6/1001.long

Canadian Diabetes Statistics
[2] Brook C, Clayton P, Brown R. DiaMond study. In: Brook's Clinical Pediatric Endocrinology, 5th Edition. Malden Massachusetts, Blackwell Publishing; 2005:441

[3] http://www.diabetes.ca/files/for-professionals/DiabetesandSociety-cjd-dec-08.pdf
Hux JE, Booth, GL, Slughter PM, et al.(eds.) Diabetes in Ontario: An Ices Practice Atlas: Institute for Clinical Evaluative Sciences. 2003.