Original Article

Parental Perspectives of Diabetes Management in Alabama Public Schools

Authors: Jason P. Skelley, BS, David R. Luthin, PhD, Jessica W. Skelley, PharmD, Edmond K. Kabagambe, DVM, PhD, Ambika P. Ashraf, MD, Joycelyn A. Atchison, MD

Abstract

Objectives: The purpose of this study was to assess parental perceptions of the current state of care for children with diabetes in the Alabama public school system, identify existing disparities, and determine what resources would most improve diabetes management in this setting. There is a significant need for such information because of the paucity of published data on the current state of diabetes care in Alabama public schools.


Methods: We based our survey on the American Diabetes Association guidelines and collected responses on the Internet via SurveyMonkey and by paper surveys. We distributed surveys to parents of children with diabetes through the Children’s Hospital endocrinology clinic, a diabetes camp, and through the Alabama Association of School Nurses e-mail listserv.


Results: A majority of children had type 1 diabetes mellitus. Students who could conveniently check their blood glucose levels (BGLs) at school were significantly more likely to participate in all school activities and their parents were significantly more likely to be satisfied with their child’s diabetes care at school. Compared with minority students (defined as all races other than white), white students were more likely to be able to conveniently check their BGLs at school.


Conclusions: The accommodation and care for children with diabetes is highly variable within much of the Alabama public school system. The ability to conveniently check BGLs at school is key for participation in all school activities and for parental satisfaction with diabetes care at school. Institution of a uniform, statewide diabetes training protocol for school personnel could improve care and parental satisfaction.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. National Institute of Diabetes and Digestive and Kidney Diseases. National diabetes fact sheet, 2007. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf. Published 2008. Accessed July 8, 2010.
 
2. US Census Bureau. State intercensal estimates (2000–2010). http://www.census.gov/popest/data/intercensal/state/state2010.html. Accessed July 8, 2010.
 
3. Lewis DW, Powers PA, Goodenough MF, et al. Inadequacy of in-school support for diabetic children.Diabetes Technol Ther 2003; 5: 45–56.
 
4. Diabetes Control and Complications Trial Research Group. The effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J Pediatr 1994; 125: 177–188.
 
5. National Diabetes Education Program. Helping the Student with Diabetes Succeed: A Guide for School Personnel. NIH Publication No. 03-5127. Bethesda, MD: National Institutes of Health; 2003.
 
6. Gormanous M, Hunt A, Pope J, et al. Lack of knowledge of diabetes among Arkansas public elementary teachers: implications for dietitians. J Am Diet Assoc 2002; 102: 1136–1138.
 
7. Collins PH. Diabetes awareness, training, and action program: North Carolina’s response to the care of school children with diabetes law [abstract]. http://www.cdc.gov/pcd/issues/2005/apr/04_0142cc.htm. Published April 2005. Accessed July 14, 2010.
 
8. Bannon MJ, Ross EM. Administration of medicines in school: who is responsible? BMJ 1998; 316: 1591–1593.
 
9. Tolbert R. Managing type 1 diabetes at school: an integrative review. J Sch Nurs 2009; 25: 55–61.
 
10. Nabors L, Lehmkuhl H, Christos N, et al. Children with diabetes: perceptions of supports for self-management at school. J Sch Health 2003; 73: 216–221.
 
11. Jacquez F, Stout S, Alvarez-Salvat R, et al. Parent perspectives of diabees management in schools. Diabetes Educ 2008; 34: 996–1003.
 
12. Nimsgern A, Camponeschi J. Implementing a new diabetes resource for Wisconsin schools and families. Prev Chronic Dis 2005; 2 (Spec no.): A11.
 
13. American Diabetes Association. Diabetes care in the school and day care setting. Diabetes Care 2009; 32: S68–S72.
 
14. Centers for Disease Control and Prevention. National Diabetes Surveillance System. http://www.cdc.gov/diabetes/statistics. Accessed September 1, 2012.
 
15. Alabama Rural Health Association. Rural versus urban Alabama comparisons. http://www.arhaonline.org/rururbcomp.htm. Published June 2010. Accessed July 25, 2010.
 
16. US Census Bureau, Small Area Estimates Branch. Small area income and poverty estimates. Median household income for Alabama counties, 2008. http://www.census.gov/did/www/saipe/data/interactive/#. Published November 2009. Accessed July 10, 2010.
 
17. Mayer-Davis EJ. Type 2 diabetes in youth: epidemiology and current research toward prevention and treatment. J Am Diet Assoc 2008; 108: S45–S51.
 
18. Joshi A, Komlodi A, Arora M. School nurses’ perceived barriers to diabetes knowledge, communication and management in children with type 1 diabetes. School Nurse News 2008; 25: 24–29.
 
19. Curriculum to Teach Unlicensed School Personnel How to Assist With Medications in the School Setting. Montgomery: Alabama State Board of Education/Alabama Board of Nursing; 2007.
 
20. Salem MA, Aboelasrar MA, Elbarbary NS, et al. Is exercise a therapeutic tool for improvement of cardiovascular risk factors in adolescents with type 1 diabetes mellitus? A randomised controlled trial.Diabetol Metab Syndr 2010; 2: 47.
 
21. Ciangura C. Physical activity in type 2 diabetes. Rev Prat 2010; 60: 490–494.
 
22. US Census Bureau. 2010 Census interactive population search. http://www.census.gov/2010census/popmap/ipmtext.php?fl=01. Accessed January 13, 2012.
 
23. Rehabilitation Act of 1973. Pub L no. 93-112, § 504, 87 Stat. 394 (1973).
 
24. Americans with Disabilities Act of 1990. Pub L no. 101-336, § 2, 104 Stat. 328 (1991).