Diabetes Care in the School Setting: A Position Statement of the American Diabetes Association

173

The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

“…Refer to the ADA position statements "Diabetes Care in the School Setting" (8) and "Care of Young Children With Diabetes in the Child Care Setting" (9) for additional details.…”

Section: School and Child Carementioning

confidence: 99%

12. Children and Adolescents: Standards of Medical Care in Diabetes—2018

2017

173

“…Nevertheless, the increased use of basal-bolus regimens, insulin pumps, frequent blood glucose monitoring, goal setting, and improved patient education in youth from infancy through adolescence have been associated with more children reaching the blood glucose targets set by the ADA (7,(22)(23)(24)(25) in those families in which both the parents and the child with diabetes participate jointly to perform the required diabetes-related tasks. Furthermore, studies documenting neurocognitive imaging differences related to hyperglycemia in children provide another compelling motivation for lowering glycemic targets (1).…”

Section: Glycemic Controlmentioning

confidence: 99%

“…Refer to the ADA position statements "Diabetes Care in the School Setting" (7) and "Care of Young Children With Diabetes in the Child Care Setting" (8) for additional details.…”

mentioning

confidence: 99%

11. Children and Adolescents

2015

TYPE 1 DIABETESThree-quarters of all cases of type 1 diabetes are diagnosed in individuals ,18 years of age. The provider must consider the unique aspects of care and management of children and adolescents with type 1 diabetes, such as changes in insulin sensitivity related to physical growth and sexual maturation, ability to provide self-care, supervision in the child care and school environment, and neurological vulnerability to hypoglycemia and hyperglycemia in young children, as well as possible adverse neurocognitive effects of diabetic ketoacidosis (1,2). Attention to family dynamics, developmental stages, and physiological differences related to sexual maturity are all essential in developing and implementing an optimal diabetes regimen (3). Due to the paucity of clinical research in children, the recommendations for children and adolescents are less likely to be based on clinical trial evidence. However, expert opinion and a review of available and relevant experimental data are summarized in the American Diabetes Association (ADA) position statement "Care of Children and Adolescents With Type 1 Diabetes" (4) and have been updated in the ADA position statement "Type 1 Diabetes Through the Life Span" (5).A multidisciplinary team of specialists trained in pediatric diabetes management and sensitive to the challenges of children and adolescents with type 1 diabetes and their families should provide care for this population. It is essential that diabetes self-management education (DSME) and support (DSMS), medical nutrition therapy, and psychosocial support be provided at diagnosis and regularly thereafter by individuals experienced with the educational, nutritional, behavioral, and emotional needs of the growing child and family. The appropriate balance between adult supervision and independent self-care should be defined at the first interaction and reevaluated at subsequent clinic visits. The balance between adult supervision and independent self-care will evolve as the adolescent gradually becomes an emerging young adult. Diabetes Self-management Education and SupportRecommendation c Youth with type 1 diabetes and parents/caregivers (for patients aged ,18 years) should receive culturally sensitive and developmentally appropriate individualized diabetes self-management education and support according to national standards at diagnosis and routinely thereafter. BNo matter how sound the medical regimen, it can only be effective if the family and/ or affected individuals are able to implement it. Family involvement is a vital component of optimal diabetes management throughout childhood and adolescence. Health care providers (the diabetes care team) who care for children and adolescents must be capable of evaluating the educational, behavioral, emotional, and psychosocial factors that impact implementation of a treatment plan and must work with the individual and family to overcome barriers or redefine goals as appropriate. DSME and DSMS require periodic reassessment, especially as the youth grows, develops,...

“…Partial list, with most recent publications appearing first Diabetes Care in the School Setting (1) First publication: 1998 (revised 2015) A sizeable portion of a child's day is spent in school, so close communication with and cooperation of school personnel are essential to optimize diabetes management, safety, and academic opportunities. See the ADA position statement "Diabetes Care in the School Setting" (http://care.diabetesjournals.org/content/38/10/ 1958.full.pdf1html).…”

Section: Advocacy Position Statementsmentioning

confidence: 99%

14. Diabetes Advocacy

2015

Managing the daily health demands of diabetes can be challenging. People living with diabetes should not have to face additional discrimination due to diabetes. By advocating for the rights of those with diabetes at all levels, the American Diabetes Association (ADA) can help to ensure that they live a healthy and productive life. A strategic goal of the ADA is that more children and adults with diabetes live free from the burden of discrimination.One tactic for achieving this goal is to implement the ADA's Standards of Medical Care through advocacy-oriented position statements. The ADA publishes evidence-based, peer-reviewed statements on topics such as diabetes and employment, diabetes and driving, and diabetes management in certain settings such as schools, child care programs, and correctional institutions. In addition to ADA's clinical position statements, these advocacy position statements are important tools in educating schools, employers, licensing agencies, policymakers, and others about the intersection of diabetes medicine and the law.