Laura Tzunun

MED 6085
NATURE OF THE PROBLEM

Maintaining type one diabetes (T1D) is like trying to navigate through a labyrinth, which

can only be solved by a team of expert maze runners, maps, and tools. “T1D is a complex,

disease, requiring frequent self-monitoring of blood glucose levels and adjustment of insulin

dose, diet and exercise” (Wang & Volker, 2012). Trying to manage T1D is so complicated, that

one day the diabetic may think they have solved the maze only to realize the next day the maze

has completely changed, with new traps and barriers that have been added. Obstacles like stress,

hormone changes, diet, exercise, sleep, sickness, and other unknown factors can affect a person

with T1D’s blood glucose (BG) levels (Smith et al., 2012).

A team of doctors, nurses, parents or guardians, and school personnel should help

children with T1D manage the complex disease (Wang & Volker, 2012). T1D is so complicated

that many adults struggle to manage their own T1D even if they have had the disease their whole

lives. Managing diabetes is not something that becomes second nature for most adults. T1D is

something that constantly needs to be cared for and adjusted (Lawrence, Cummings & Pacaud,

2015). Children do not have the cognitive maturity to understand what diabetes is and how to

take care of T1D. They are often afraid to poke themselves to check BG or to inject themselves

with insulin on their own; this must be done by an adult. Children often have a hard time

noticing symptoms of hypoglycemia to the extent that they may become too confused to treat

themselves (Kise, Hopkins & Burke, 2017).

Parents or guardians of a child with T1D must become the expert to help their child

manage their diabetes. Because children are not always with their parents, other community

members must take over the responsibility to help the child manage their T1D. This is not
something that is just expected; it is the law. T1D is the most common disease in children. About

one in every 400 school age children have T1D (Herbert et al., 2014). Children spend about one

third of their day in school. School personal need to be trained how to manage students T1D.

Unfortunately, school personnel may not know how to properly monitor T1D (Smith et

al., 2012). Teachers who are uneducated or simply naïve have been known to not let students

suffering from low BG (hypoglycemia) eat in class because of class rules. These students have

had to suffer through class not being able to understand what is going on until they get help.

Sadly this has escalated to the point where students have had seizures in class because of their

severely low BG. Some teachers have been known to be too afraid to help students with high

BG (hyperglycemia) because they fear the effects of hyperglycemia (Smith et al., 2012). These

students with high average BG are enduring permanent damage to their body as well as reduced

cognitive function (Warren & Frier, 2004). People with medical disabilities, including diabetes,

are protected by the law to receive equal opportunities for education (American Diabetes

Association). When they are not being properly cared for, they are not receiving such

opportunities.

PURPOSE

T1D is one of the most prevalent chronic childhood illnesses, effecting one in every 400-

600 American Children (Herbert et al., 2014). Serious short-term and long-term conditions can

develop if the condition is not properly cared for, such as hypoglycemia which can lead to

seizures, and loss of consciousness. It also causes hyperglycemia which can lead to a diabetic

coma, heart disease, neuropathy, loss of limbs, kidney failure, and retinopathy (Smith, et al.,

2012). Children with diabetes manage their condition by visiting a doctor on a regular basses,

taking medication, closely monitoring their diet and exercise, and checking blood glucose.
 Children lack the ability to effectively manage their diabetes on their own. Children have

a difficult time recognizing symptoms of hypoglycemia, which puts them at high risk seizures

and loss of consciousness. In order to determine the correct amount of insulin to be given

complicated math equations must be used. If even a small error in the problem occurs, the child

could suffer drastic consequences (American Diabetes Association). Children spend one third of

their day at school, therefore school personnel should be trained in diabetes managing and be

able to recognize the signs and symptoms of hypoglycemia. Unfortunately, most school

personnel are not properly trained in diabetes management (Smith, et al., 2012).

The purpose of this quantitative study is to explore the effects of educating school

administrators, staff, and teachers (school personnel) from grades kindergarten to ninth grade

about T1D. Specifically, the research will answer the following questions:

1. To what extent does educating school personnel about T1D improve their ability to

recognize the signs and symptoms of Hypoglycemia?

2. How does educating school personnel about hypoglycemia help increase their

understanding of the effects hypoglycemia has on cognition?

3. In what ways does educating school personnel help improve their confidence in

diabetic care, and help them feel more prepared for a diabetic emergency?

4. To what extent does demographic factors impact knowledge of diabetes?

5. How can previous experience with T1D affect prior knowledge?