Diabetes care in the school setting: a position statement of the American Diabetes Association.

Diabetes is one of the most common chronic diseases of childhood (1). There are approximately 200,000 individuals ,20 years of age with diabetes in the U.S. (2). The SEARCH for Diabetes in Youth (SEARCH) study recently reported that 1.93 per 1,000 (aged ,20 years) were diagnosed with type 1 diabetes, an increase of 21% from 2001 to 2009. Increases in the prevalence of type 1 diabetes were seen in all ethnic groups, but non-Hispanic whites were disproportionately affected. Because type 2 diabetes rarely occurs in younger children, its prevalence in the population aged,20 years is not readily available. For type 2 diabetes in youth between 10 and 20 years of age, the SEARCH study reported a prevalence of 0.46 per 1,000 youth of all ethnicities, an increase of 31% from 2001 to 2009 (3). These statistics demonstrate the rising prevalence of diabetes in children and the increased need for diabetes management. The majority of young people with diabetes spend many hours at school and/or in some type of child care program. Trained and knowledgeable staff are essential to provide a safe school and child care environment for children with diabetes. This includes the provision of care during the school day, field trips, and all school-sponsored activities in the school setting and in preschool, day care, and campprograms in the child care setting. Staff play a critical role in helping to reduce the risk of shortand long-term complications of diabetes and ensuring that children are well-positioned for academic success and normal growth and development. The child’s parents/guardians and health care provider(s) should work together to provide school systems and child care providers with the information necessary to enable children with diabetes to participate fully and safely in the school and child care setting experiences (4–6). The purpose of this position statement is to provide the diabetes management recommendations for students with diabetes in the elementary and secondary school settings based on the American Diabetes Association’s (ADA’s) “Standards of Medical Care in Diabetesd2015” (6) and “Type 1 Diabetes Through the Life Span: A Position Statementof theAmericanDiabetes Association” (7). For information on young children aged,5 years, ADA’s position statement “Care of Young ChildrenWith Diabetes in the Child Care Setting” (8) should be reviewed for specific recommendations for settings such as day care centers, preschools, camps, and other programs.