A Student with Diabetes Is in My Class
Rosenthal-Malek, Andrea, Greenspan, Jan, Teaching Exceptional Children
This article addresses areas of concern for teachers who have a student with diabetes in their classrooms. Teachers need to understand how diabetes affects a student's ability to function successfully in the classroom. We discuss misconceptions about the effects of the disease, how the disease may affect the student in the classroom, and strategies and accommodations that teachers can use to help meet the student's needs. In addition, we discuss how students with diabetes feel about their disease.
What Is Diabetes?
Diabetes is an autoimmune illness, similar to rheumatoid arthritis or multiple sclerosis. Autoimmunity is a problem where the body's white blood cells, which normally fight infection, turn on a part of the body. In diabetes, the white blood cells target the cells that produce insulin. After a certain amount of time, there is a lack of insulin and one of two forms of diabetes, noninsulin-dependent diabetes, the more common form, and insulin-dependent diabetes, better known as juvenile diabetes, eventually develops (Norbury-Glaser, 1997).
Although there are no actual figures on the exact number of diabetics in this country, estimates range from 8 to 14 million persons, of which about 800,000 to 2 million are insulin-dependent. At least 100,000 of those afflicted are children 19 years and younger (1993 estimates) (Klatt, 1997; Norbury-Glaser, 1997). The figures vary for a number of reasons including the fact that many diabetics go undiagnosed and because there is no national registry and estimates are developed from various regional sources (Klatt; Norbury-Glaser). Juvenile diabetes can occur as early as age 6 months and at every age through adulthood (Bates, 1984).
Although juvenile diabetes is categorized under the Individuals with Disabilities Education Act (IDEA) and Americans with Disabilities Act (ADA) as a chronic health impairment because it requires continued medical treatment (Frieman & Settel, 1994), unless otherwise disabled, students with this disease are routinely placed into general education classrooms. Because the disease may accompany other disabilities, however, these students could be placed into any special education classroom. Considering the number of students with diabetes, special education teachers will at some point probably work with one or more of these students.
The parent, administrator, or the school nurse should inform you if a student with diabetes is to be placed into your classroom. This knowledge, however, is not a guarantee that you will know what to do when a specific incident revolving around the diabetes arises, especially because some situations that arise may need specific accommodations or modifications to the student's daily routines.
Understanding Is the Key
To meet the physical and psychological needs as well as the federal mandates for students with diabetes, teachers need to know the basic elements of the disease, the general aspects of the medical management of the disease, the best way to work with parents, and the best approach for including the child into the classroom routines (Frieman & Settel, 1994). In other words, if teachers understand diabetes, they are better prepared to provide appropriate accommodations for the student.
If a teacher is unprepared, he or she may actually cause either bodily or psychological harm to the student. To clarify your understanding of the disease, the following is a brief explanation of juvenile diabetes.
Juvenile diabetes is a chronic disease that impairs the body's ability to use glucose (the form of sugar that serves as an energy source for the body's cells) properly. The hormone insulin must be present for cells to absorb glucose (sugar) and convert it to energy for the cells. In the insulin-dependent diabetic, the pancreas produces little or no insulin. Because the sugar in the blood cannot be used, it builds up in the bloodstream as fat even while the body is literally starving for energy. …