A new state law allows diabetic students more freedom to manage their condition on their own at school and to seek care from certain staff members other than nurses.
Parents should review and plan for their children's diabetes management needs at school in light of the changes, according to American Diabetes Association representatives.
Type 1 diabetes
Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. Only 5 percent of people with diabetes have this form of the disease.
In type 1 diabetes, the body does not produce insulin. Insulin is a hormone needed to convert sugar, starches and other food into energy needed for daily life. With the help of insulin therapy and other treatments, even young children can learn to manage their condition and live long, healthy lives.
Source: American Diabetes Association
"This (legislation) is something the American Diabetes Association has been working several years on to get passed in all the states we can," said Connie Fetters, advocacy chairperson for the association's Arkansas chapter.
House Bill 1395 passed with overwhelming support from the Legislature and was signed into law by Gov. Asa Hutchinson in March. It allows children with diabetes who are capable of administering their own insulin to do so anywhere and at any time it is necessary. They also may carry medical supplies with them on school campuses and to school-related activities.
For students who cannot administer their own insulin, non-medical school staff members may volunteer to be trained to do so when a school nurse is not available. Prior to this year, trained volunteers were authorized only to administer glucagon to diabetic children. Glucagon is used only in extreme situations when a person's blood sugar level has dropped to a dangerously low level.
Supporters call House Bill 1395 the "Safe at School" law. Similar legislation has been passed in 33 other states, according to Fetters, a Bella Vista resident.
An estimated 208,000 Americans under age 20 -- about 0.25 percent of that population -- have been diagnosed with diabetes, according to the American Diabetes Association. A little more than 1,000 public-school students in Arkansas are estimated to have the disease, Fetters said.
Type 1 diabetes -- also known as juvenile diabetes -- must be managed around the clock, including those hours spent at school, on field trips and during extracurricular activities.
If a young child needs an injection of insulin or glucagon, it's no sure thing a nurse will be available to help.
For one thing, Fetters said, not every school has its own nurse. During the 2013-14 school year there were 1,148 public schools and 622 school nurses, she said.
Children with diabetes are covered under the American Disabilities Act. Fetters said parents of diabetic children should contact their school's administrators to complete a 504 Plan, which spells out the modifications and accommodations disabled students need to perform at the same level as their peers
It's the parents' or guardians' responsibility to get that plan in place and to request a staff member be trained to administer glucagon or insulin.
Kat Lynch, 10, is entering the fifth grade at Bentonville's Bright Field Middle School. She was diagnosed as a type 1 diabetic a few years ago. Her condition requires at least four insulin shots per day, according to her parents, Jeff and Veronica Lynch.
The new law is crucial, Veronica Lynch said.
"I can't describe the worry we have as parents every time she leaves the house," she said.
Jeff Lynch said he's "thrilled" by the new law.
"It's unfortunate every school doesn't have a nurse," he said. "When a child needs insulin or glucagon, they need it. Teachers are trained in CPR; why not this?"
The Lynches hope the legislation will lead to greater awareness about diabetes in general. When signs of the disease first began to show in Kat -- she was unusually hungry and thirsty, was suffering from nausea and losing weight -- it took a while to figure out what was affecting her, they said. One doctor they took her to misdiagnosed her as having the flu.
Only after buying a home blood testing kit did they find Kat's blood sugar level was extraordinarily high.
Kat said her diabetes has caused her to spend as much as half a school day in the nurse's office. She worries about missing class time.
"If I miss class, I may miss an assignment," she said.
Students are able to take care of the injections they need by themselves by the time they reach junior high school, Fetters said. The need for trained volunteers really is relevant at the elementary and middle school levels. The association has training materials and can work with schools in need of such volunteers, she said.
The Arkansas School Nurses Association opposed House Bill 1395. A request for comment made this week through the association's website was not returned. The association, however, published a list of talking points on the website about the bill.
"Insulin administration in the school setting should be a nursing task not a task performed by an unlicensed volunteer," the website states.
Helping students with diabetes manage their care requires ongoing assessment through blood sugar monitoring, assessing the trends of these readings and providing care based on the doctor's orders, the association's website states.
"All children with healthcare needs should have the services of a full-time school nurse," the website states. "Anything less is dangerous for the student, the employee and the school district. The best solution for providing safe and effective health care needs of school children is to have a nurse on every campus all day every day."
Fetters has heard the nurses association's concerns, but she believes they're unfounded.
"It is much more unsafe to have some kid in school who needs help with his insulin and there's nobody around to help him," she said. "A nurse in every school would be great, but I don't think that's going to happen. In the states where this has been implemented we have found no real safety concerns."
Kathy Launder, nurse coordinator for the Springdale School District, did not support House Bill 1395. Diabetes management is a complex thing, she said.
"We can't just train someone for a couple of hours and expect them to know everything," she said, adding the district will follow the law.
She estimated Springdale, the second-largest district in the state, has between 50 and 60 diabetic students at any one time. There are nurses in each of the schools, and when diabetic children go on field trips, a nurse goes with them, Launder said.
Parents interested in learning more on this subject should call the American Diabetes Association at 1-800-342-2387 and ask for a legal advocacy staff person. The Northwest Arkansas office also may provide assistance and can be reached at 479-464-4121.
NW News on 08/03/2015