Students with diabetes may require a range of equipment at school, such as blood glucose monitors, syringes, insulin pens and insulin pumps. They may also be snacking at times when others are not. This may leave them open to curiosity from other students. It may also mean that if teachers are not aware of the need for such equipment it may be confused with more sinister objectives and confiscated. Sometimes, well – meaning teachers or peers leave them out of class parties or don’t know what to do when birthday cake is being handed around. Students with diabetes have stories about being given detention for having lollies or being called ‘druggies’ by peers. They feel singled out or as though they are under constant surveillance.
If a student is to self- manage his/ her diabetes successfully, he/she requires an understanding environment and it is often the case that they are the ones who have to initiate it by teaching their peers and their teachers about their self- management needs. Self- management means being able to monitor blood glucose level, administer insulin and eat when necessary even it is in the middle of school activities. A student with diabetes needs to be assertive; this may be difficult, given that many young people do not want to draw attention to themselves. A student with diabetes must practise self- assertion, while continuing a punishing daily routine of health care, sometimes feeling unwell and emotionally stressed. However, without a level of assertion, students are likely to lose the impetus to maintain a routine and this will mean that their health will suffer. More frequent “hypos” may lead to more frequent episodes of embarrassment and school absences.
Effects on those close to the child / young person
Parents of children and young people with diabetes report the gamut of feelings experienced by all parents. However, their feelings of joy, frustration and pride in their children are tempered by the need to ensure their children are safe and to assist their children to grow into self-managers of their own health. Fear of how a child will cope in the rough and tumble environment of school means that parents also need to learn constructive assertion techniques to advocate on behalf of younger children and to be effective role models for older children.
The school visiting program of Juvenile Diabetes Research Foundation (JDRF), Melbourne Chapter recommends that parents spend time educating the staff at their child’s school. Basic information about Type 1 Diabetes should be provided to all staff including office and grounds staff. Staff must know appropriate emergency care and parents need to know that school staff may think they are well- informed but can be, in fact, sometimes complacent. The JDRF program suggests that parents provide the school with printed information, an action/emergency plan and a photo of the child, so that casual and replacement staff have some means to identify the student. If a problem arises, no matter how trivial, a parent should make an appointment to speak with the classroom teacher to explore mutually satisfactory solutions.
“In their shoes” – stories from children / young people with the condition ‘
…I knew I’d have to go on the injections eventually. Even then I thought it would only be one or two needles a day, when I went in there one day the doctor said to me,” You need four injections a day starting today.” It was devastating. I knew it was coming but it was so hard…’
… At first they gave me a long needle but I cut up a bit. It freaks you out. It’s not difficult but at first it’s very painful. Sometimes just pushing the needle in hurts the most. You think to yourself, this hurts so why am I doing it? It’s like punishing yourself because you’re hurting yourself.
… In a way it’s just an inconvenience now. For instance I have to eat certain foods at certain times, which is pretty hard to get used to. I’m not scared any more but I do get sick of it. Sometimes I think, bugger it, I can’t be bothered. But you just do it, you get angry with it, then you get over it. The injections still hurt sometimes but it’s just something I have to do.
… In a way things are getting back to normal. I hated school before the diagnosis mainly because my self- motivation wasn’t there. Then I got the diabetes and I got really depressed and I just couldn’t get myself to school. Now I am more energetic bit I missed so much school that they said I would have to repeat year 9, so I refused and left. I’m going to study at the Gordon Institute of TAFE next year instead…’ Ross (15) Extract from Different but the Same 1998, Ed Heather Cameron, Lothian Books Victoria, Australia.
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