Unsafe At School Advocacy Group

October 22, 2011

We are writing this letter of advocacy on behalf of our children, who have Type 1 Diabetes (T1D) and attend public school in B.C.  As concerned parents, we are directing this letter to your jurisdiction because the current care plan model for T1D students at school does not meet the basic medical needs required to keep them safe. We are asking you to consider the following proposal.

Type 1 Diabetes is a chronic, life-threatening illness that affects children of all ages. It is treated with insulin and has no cure. To manage this illness, children who suffer from T1D have specific treatment regimens that require blood glucose (sugar) tests and insulin injections so they can live.  However, since blood sugar levels are variable, T1D students require frequent monitoring to prevent life-threatening hypoglycemic or hyperglycemic (low or high blood sugar) reactions. Due to the intensive nature of treatment required, Type 1 diabetics are labeled as “disabled” by both Federal and Provincial Governments. Care plans are in place to help diabetics at school, but these plans have severe limitations as they do not fully accommodate for the disability and ultimately prevent T1D students from reaching their full potential. It is also possible that current plans could ultimately cause these students harm.

·       They are inadequate for many children, especially young children that cannot yet self-manage their blood glucose testing, insulin injections, and insulin pump boluses. Current care   plan models have not kept pace with advances in diabetes treatment options, such as the insulin pump and multiple daily insulin injections.  They are limited to blood glucose testing and treating low blood sugar, with no provision in these plans to effectively correct for high blood sugars (hyperglycemia).

·       Educational Aides cannot administer insulin to help their T1D students.

·       Educational aides are not permitted to inject Glucagon –a lifesaving medication used to treat severe low blood sugar.

Research shows that both hypoglycemia and hyperglycemia adversely affect cognitive development in children with T1D. Current care plan models ensure school aides treat moderate low blood sugar, but they are not permitted to assist a child with insulin administration to correct hyperglycemia.  When left untreated, hyperglycemia is detrimental to learning.  These students will struggle with concentration, memory work, behavioral control and will find even known tasks more challenging. When compounding this with the devastating chronic health complications of hyperglycemia (heart attack, stroke, kidney failure, blindness and amputation), it is merited to ask you to consider changing current care plan practices.

At the moment, five independent care plan agreements have been arranged in different school districts in B.C. and are operating successfully. These care plans provide for an aide to administer insulin injections and pump boluses for children too young to self-manage and were made in consultation with the child’s Endocrinologist (diabetes specialist). The help these plans provide to students is invaluable and addresses the problems of hyperglycemia.

However, many families who want better glycemic control for the health and learning of their diabetic students are being forced to have one parent quit gainful employment in order to come to school every day to administer insulin. Families who cannot afford to have one parent quit work, are often forced to choose sub-optimal care regimes, that ultimately may be deleterious to their child’s long-term health, learning outcomes and emotional development.

Respectfully, we would like to ask you to change care plan policy to allow education assistants to administer insulin, operate insulin pumps, as well as give glucagon injections.  Until this occurs, diabetic children will not be adequately cared for in B.C. schools.

Thank you,

Unsafe At School:  Advocating for Children with Type 1 Diabetes

cc) The Ministry of Health, The Ministry of Child and Family Development, The Premier’s Office