By Del Stover
06/28/05 -- As diseases go, diabetes gets an unusual amount of attention at Guillen Middle School in El Paso, Texas. The 990-student school is one of the few in the nation with its own diabetes education and prevention program.
Officials had good reason to launch such a narrowly focused initiative: The school serves a particularly high-risk population, says Carolyn E. Adams, principal investigator for the program.
“Our children have all the predisposing factors for type II diabetes,” she says. “They’re overweight. They’re mostly Mexican-Americans, whose ethnicity puts them at greater risk. They have sedentary lifestyles. And most are economically disadvantaged.”
Medical screenings add weight to educators’ concerns: 30 percent of the school’s sixth-graders have signs of a pre-diabetic condition, Adams says. “All of these things made us realize that we needed to get to these children early.”
Other school districts are likely to come to the same realization in the coming years. One out of every 400 to 500 students has diabetes, reports the American Diabetes Association, and the incidence of type 2 diabetes is growing, particularly among African-American, Hispanic, and Native-American children and adolescents.
“This is going to be a disease in which schools will need to be involved in its management, says Art Campfield, professor of food science and human nutrition at Colorado State University. “The schools are an ideal spot for intervention.”
Many schools already have some experience with the disease. At least 100,000 school-age children have diabetes, and school personnel already are helping these students with monitoring and treatment.
But some parents believe schools aren’t always doing a good enough job in coping with diabetic children’s medical challenges. Two years ago, for example, a Florida school system came under fire when an assistant principal confiscated an eighth-grader’s insulin pump.
Federal law, specifically the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act, requires schools to accommodate the needs of students with diabetes, as well as other disabilities.
But some states have gone a step further. A new Texas law, for example, requires parents and school officials to develop a doctor-approved management and treatment plan “to meet the unique health care needs of a student with diabetes in the school setting.”
North Carolina approved a similar law in 2002. It allows students to carry necessary supplies in school and treat their diabetes whenever or wherever necessary, including in the classroom, if such treatment is part of the plan approved by parents and school officials.
The National Association of School Nurses is concerned that some school districts don’t have enough nurses to cope with students with serious diseases like diabetes, says Executive Director Wanda Miller.
The Texas law also is worrisome, she says, because it allows schools to train employees to become diabetes care assistants. That might be appropriate for older students and those who have learned how to care for themselves. But it’s a risky strategy in other situations.
“Diabetes is a serious health-care problem, and the younger the child, the newer the onset of diabetes, the more vulnerable the child is to ups and downs in the health-care process,” Miller says. “That type of situation warrants a health professional who is knowledgeable about diabetes.”
At the local level, most school systems tackle the issue of diabetes in a peripheral manner: mentioning the disease as part of the health curriculum, while emphasizing good nutrition and physical activity as important strategies for a healthy lifestyle. Many districts also are helping fight diabetes indirectly by providing healthier fare in the cafeteria and removing junk food from vending machines.
But school districts with high-risk populations are taking their efforts a step further -- and implementing targeted programs to educate and prevent the disease.
Collaboration with researchers plays a key role in many of these programs.
The Guillen Middle School program, developed in collaboration with the University of Texas at El Paso, recruited 40 students identified with a high risk of developing the disease. They meet twice a week during the school year -- and attend an eight-week summer camp -- to learn more about the disease, study nutrition, and participate in a variety of sports and other physical activities.
The goal is to teach students new lifelong habits to maintain their health, Adams says.
Several Colorado school systems are participating in a research project sponsored by Colorado State University, called Project Energy, that weaves lessons on diabetes, nutrition, and physical activity into a health-science curriculum.
Students study the chemistry of blood glucose, plan meals, and use a pedometer to calculate how long they need to walk to burn away a meal’s calories, says Campfield.
In San Antonio, school officials are working with researchers at the Social and Health Research Center in a study of more than 600 local students who are being encouraged to lower fat intake and increase dietary fiber intake and physical activity.
For Janice Fox, the district’s executive director of food services, the program has increased awareness among her staff about the disease and led to healthier school meals with fewer high-fat foods and more fruits and vegetables.
“I’d like to think we’re on the cutting edge” in making meals healthier, she says.
Although these programs focus mostly on helping students avoid or delay the onset of diabetes, the program at Cedar Lane Elementary School in Middleton, Del., focuses on students who already have it. Students in the Sugar Busters Club learn how to test their blood glucose levels, control their diets, and give themselves insulin shots.
School nurse Loretta Newsom says the after-school club gives students a chance to talk to peers who understand what it’s like to live with the disease.