Children with diabetes in school: autonomy begins with the teacher

Key words: Type 1 diabetes, School setting, Management, Teachers

The management of insulin-dependent diabetes in young children is challenging and, despite the availability of technological devices, these children need assistance or supervision by an adult to perform blood monitoring and insulin administration at school. Currently in Italy the educational assistance is not standardized. This could imply problems in proper management of therapy with potential risk of acute and chronic complications, the need for intervention of outside personnel to administer insulin, sometimes limiting participation in school activities, although there are laws that protect the rights of young children to prevent discrimination. The project for school autonomy proposed in the Health Districts of Ravenna and Cesena, which provides for the direct involvement of teachers in the assistance, seems to have proved useful to encourage children autonomy, obtaining positive effects in social life and diabetes management, without a significant economic cost by optimizing existing resources. The project was realized thanks to the fundamental contribution of Community Pediatrics, an institution that represents a sort of link between hospital and community and that provided medical and nursing team for the training of child care staff. This approach could be exportable to other situations. Even in the absence of Community Pediatrics other trained health personnel or primary care paediatricians could be involved.