While having Type 1 diabetes does not affect a person’s ability to learn in the classroom, lack of knowledge, improper care, and inflexibility by school personnel with regards to Type 1 diabetes could potentially affect a child’s success in the classroom.

While on the outside most children with Type 1 diabetes look and act exactly the same as everyone else in their class. They learn the same, the play the same, and most likely, they get in trouble the same. But one main difference between a child with Type 1 diabetes and a child without Type 1 diabetes is their blood sugar. A child without diabetes does not need to think about their sugar level before, during an after a test or activity. A child with Type 1 diabetes has no choice but to check and monitor their sugar before, during and after a test because it could mean the difference between an A or an F.

I saw this first hand when my son was on MDIs (multiple daily injections/shots). He was recently diagnosed and in preschool three days a week. The only thing he knew how to read at the time was his name. Having a name with 8 letters really helped him because he was able to pick it out of most of the names in his class because the other names were shorter. So, I got to the school and asked him to grab his work off of the table that his teacher would lay out at the end of each day.

My son could not find his paper. There were only 9 papers on the table. He looked at me and said, “I can’t tell which one is mine, could you get it?” I grabbed the paper that was covered on the entire top half with his 8 letter name. Immediately upon getting to our car I tested my son, his number was in the high 400s. Too high, yes. So high that he was unable to focus enough to pick out his own name. If this had been the SATs in Junior Year of high school, well, we all know where that would have ended, and it wouldn’t have been good.

All children with Type 1 diabetes have to have a 504 Plan or a Diabetes Medical Management Plan (DMMP) that stipulates, among other items, when a child is supposed to test their sugar, and in what range their number fall in order to perform at their absolute best.

This plan is something that needs to be discussed with all people involved with the education of children with Type 1 diabetes. While some teachers may think it is smart teaching to surprise the class with a ‘pop’ quiz, that teacher still needs to allow for time for the child to test their sugar and provide treatment if necessary in order for the child to do their best on the ‘pop’ quiz.

People with Type 1 diabetes are at their best when their numbers are in range. The only way to tell if their numbers are in range is to test, test and test some more. School districts need to follow these plans in order to keep the playing field level for all kids. In some states, the schools provide breakfast the day of a big test to make sure everyone is thinking at their best. This is the same for a child with Type 1 diabetes, they test to make sure they are at their best. That’s all anyone wants for their child, that they are able to perform at their best. Children with Type 1 diabetes can’t do it alone, they need the support of school personnel to understand, learn, and respect how knowing one’s blood sugar can be the difference between an A or an F.

It is essential that the patients who are suffering from diabetes should invariably consult a registered dietitian to get an effective diet plan enabling to fight the disease in controlling blood sugar. The diet plan drafted by the dietitian should be matching to the diabetic patient and his body type considering various factors. The list of foods a diabetic can eat should exhaustively be self containing with respect to the ingredients of the food items. It is not advisable that some diabetics do not consult a qualified dietitian in formulating the right diet plan. It is highly to include many risks if they try to fix a blind list of foods suggested by someone close to them. It is a blunder that the patient chooses to follow a diabetic diet menu which does not contain right foods for a diabetic. Such foods recommended by an unqualified dietitian can do more harm with diabetes complications than anything good.?

Here is the importance of why the advice and consultation of a qualified dietitian should be sought without fail by a diabetic patient. When a dietician formulates the food list for diabetics, he takes into consideration the body type and lifestyle patterns of the diabetic and includes those foods that can really help the patient. Such foods can serve as optimum energy resources for a diabetic according to the activity levels. Some patients have dormant and sedate lifestyle while some others are in general frenzied with active lifestyle. Hence, it is important that a food chart for diabetics is obtained from a dietician after a clinical diagnosis. The diabetes food chart thus formulated would also describe the bad foods that should be totally avoided by the diabetics. A dietitian alone can show competency in choosing the right foods, good and bad, fitting the body parameters of the diabetics.????

There is a list of diabetic diet foods that can be judicially followed by the diabetic patients under different health conditions. A good knowledge of right foods to eat and the quantum of intake can help a diabetic to maintain health in a balanced condition. In this context, the help of a dietitian can help a lot to fix good diabetic foods that a diabetic can eat without fear. One more thing to keep in mind is that the dietitian can suggest the intake of foods with different options of combination of food items. So, the patient need not be bored and reluctant with the same diabetic foods to follow for months together.

If the patient consults the dietitian and explains his diabetic condition clearly as he feels, it can help the dietitian in fixing balanced and good diabetic foods that a diabetic can eat without fear. The risks and complications related to the disease can be avoided, and life threatening situations of the supposed dreadful disease can be overcome. It is also advisable that the patient cares to follow these diet foods to control the diabetic condition combined with exercise routine.

As diabetes becomes more and more prevalent in our society, Diabetics may find that fitness professionals may be included in their health care plans. There is no “best” physical activity to do with diabetics, like with the rest of us, the best is the one that you will do, stick with, and enjoy the most. As long as it is a program that helps to lower glucose levels, reduce body fat, improve disease risk factors, which all in turn will help to keep the diabetic motivated, then it is the best plan for them.

Blood sugar may be compromised up to 24 hours after workouts. This effect after the workout is sometimes known as the lag effect of exercise. Blood glucose must be monitored closely before and after working out as well as throughout the day to avoid hypoglycemia.

Blood glucose levels that are less than 100 mg per dl (5.56 mmol per L) immediately after physical activity should practice the following so that this is not a common occurrence:

• Increased carbohydrate consumption before physical activity.
• Decreasing the dose of insulin for the next exercise session.
• Possibly decreasing the insulin dosage after physical activity.
• Proper hydration throughout the day
• If sugar levels by bedtime are not 100 mg per dl (5.56 mmol per L), then consume an evening snack and make sure it contains a mixture of carbohydrates with a protein

The goal is to prevent hypoglycemia (low blood sugar) as a result of physical activity. Exercise and sound nutrition are two very important cornerstones to a diabetic program to help with maintenance of blood glucose levels and prevention of any long-term complications.

“As with other people, physical activity results in cardiovascular disease prevention for those with diabetes mellitus. Because they have a greater risk, exercise is especially important for people with diabetes. Hy helps decrease risk of cardiovascular disease by reducing lipid levels, decreasing blood pressure, and maintaining or decreasing body weight.” (Horton, 1998)

Diabetes mellitus type 1 is a type of diabetes that is caused by a total lack of insulin as a result of a marked inability of the pancreas to secrete insulin because of auto-immune destruction of the B cells in the pancreas. {the body begins attack and destroy its own pancreas cells} The insulin deficiency in the body leads to reduced uptake of glucose into the body cells causing a state of hyperglycemia {increased blood glucose levels}. This leads to constant exposure of the cells of the body to excess glucose, gradually leading to different kinds of organ damage.

It occurs mainly in children with a fairly abrupt onset, but there is less common type known as adult form of type 1 diabetes called the “Latent autoimmune diabetes of the adult”{LADA}.

The main feature of type 1 diabetes mellitus is that it causes total dependency on use of insulin as the only treatment option. If taken off insulin type 1 diabetics quickly develop diabetes complication called ketosis.

Causes

The real cause of type 1 diabetes is not known, most often it has a genetic tendency. The disease sometimes follows a viral infection such as mumps, rubella, cytomegalovirus, measles, influenza, encephalitis, polio or Epstein Barr virus. Certain people are more genetically prone to this. There are other autoimmune diseases that may be associated with type 1 diabetes mellitus for example diseases of the thyroid gland.

Type 1 diabetes tends to have less tendency to have other family members affected with diabetes than Type 2 diabetes. In a large family study done in the US less than 4% of parents and 6% of siblings of a person with diabetes also had diabetes.

In studies with identical twins, less than 50% of the siblings of a person with diabetes mellitus also had diabetes versus almost100% of siblings with Type 2 diabetes. Children of Type 1 diabetes fathers are more likely to develop Type 1 auto immune diabetes than children of Type 1 diabetic mothers. White people seem to be more affected with Type 1 diabetes than blacks. The male to female ratio is about 1:1

Treatment

Insulin therapy is the only form of treatment of diabetes type 1. When insulin was first discovered, there was only one type of fast acting insulin that was available and this required several injections in a day, however today there are a variety of insulins that can be chosen and or combined to best manage diabetes.

The current program of insulin therapy for type 1 diabetes combines intermediate and long acting insulin{taken once or twice daily}with fast or rapid acting insulin taken at mealtimes. This approach mimics closely the activity of a normal pancreas, which produces a slow steady of insulin around the clock and surge of insulin after meals.

For effective management of Type1 diabetes, parents and young diabetic education is very important. The parent and the young diabetic must be educated very well on treatment modalities and home monitoring because a major part of treatment and adjustments will be done by them.

-As children grow their appetite activity levels change, their need for insulin also changes. The parents does not need to wait for a regular appointment to respond to these changes. To make insulin adjustments on their own, parents and the affected youngsters must:

a}Be confident that blood glucose checks are correct and meal plans are adhered to strictly {ie. no secret snacking}

b}Know the child’s blood glucose target range.

c}Understand the actions of the insulin the child is using.

d}Understand what each blood sugar check means.

e}Know when they should contact the health care team.

-Twice a day or more or minimum of once a day blood check is very important.

-There is really no diet restriction up to the age of 6 years, but calorie count and food replacement must be commenced from the age of 7 years.

-Exercise should be encouraged and the school of the child must be informed.

-Interpretation of child’s A1C {glycosylated hemoglobin levels}:

a}levels between 6-7% are considered as excellent

b}levels between7-8%are very good

c}levels between8-9%suggest a need for extra effort to improve control

d}levels above 10%means there needs to be a joint and concentrated effort by the child’s family and medical team to achieve control.

Every child should have his/her A1C measured once in every 3 months