At Linden-Mckinley STEM Academy, 7th-12th graders eagerly await their upcoming summer break. While this long break from school is much needed for all students and teachers alike, it can cause further nonadherence issues in students with diabetes. Teenagers and young adults at this high school, and many in the United States, are struggling with compliance to their diabetes management plans.
Currently, at Linden-Mckinley, there are two students registered with the nurse’s office with a diagnosis of Type 1 Diabetes Mellitus. There are also another two students with Type 2 Diabetes Mellitus. One of the school nurses, Sasha Ackerman, explains that there are multiple other students in the school that are diagnosed with Type 2 Diabetes, but remain unregistered with the nurse’s office due to non-insulin-controlled therapies including metformin.
Students with diabetes are supposed to come to the school nurse in the morning and check their blood sugar, eat breakfast, and cover their meals with insulin if need be. On multiple occasions, students will have sugars over 800 mg/dL in the morning. Their measurements fluctuate so often they might have a hypoglycemic event later in the day after gym class. Students at Linden-Mckinley, especially towards the end of the school year, are often suspended or skip class. Consequently, students who require treatment for their diabetes may not even be present for illness management. Adherence is further complicated by disincentives of painful needlesticks, the nuisance of carrying or wearing insulin administration devices, premature shift in responsibility for management from parents to teens, fatigue from chronic illness, and physiologic changes leading to greater insulin resistance during puberty.
Positively, there are many successful school-based implementations at Linden-Mckinley, such as the Diabetes and School Health (DASH) Program through Nationwide Children’s Hospital. This program works with the school nurses to provide additional access and care for Type 1 diabetics. This program works through direct on-site clinical care, education, further support, and more accountability for patients. However, this program only works with Type 1 diabetics, but there have been conversations of a program that reaches those with Type 2 diabetes as well.
Students in this school district, and many around the United States, come to school to escape their struggles from their home lives. Adding an intense diabetes regimen only increases their stressors leading to more challenges in reaching successful illness management. Further resources are needed at this school, including a glucose monitor, such as an Accu-Check, available for all students, in addition to more nutritious school lunch options and after school exercise programs. The United Nations sustainable development goal that corresponds best with this issue is good health and well-being. To summarize, these students deserve more support and more resources to find success in their journey to overall wellness. The school nurses do an outstanding job of supporting their students throughout their day, but sometimes it’s what happens after school is over that is pivotal.
Resources
Azar, S., Maroun Abou Jaoude, N., Kędzia, A., & Niechciał, E. (2024, September 24). Barriers to type 1 diabetes adherence in adolescents. MDPI. https://www.mdpi.com/2077-0383/13/19/5669
L;, B. J. (n.d.). Adherence challenges in the management of type 1 diabetes in adolescents: Prevention and intervention. Current opinion in pediatrics. https://pubmed.ncbi.nlm.nih.gov/20489639/
United Nations. (n.d.). The 17 goals | sustainable development. United Nations. https://sdgs.un.org/goals
Yen, F.-S., Wei, J. C. C., Liu, J.-S., Hwu, C.-M., & Hsu, C.-C. (2023, November 1). Parental income level and risk of developing type 2 diabetes in Youth. JAMA network open. https://pmc.ncbi.nlm.nih.gov/articles/PMC10690454/
