IJCM  Vol.9 No.4 , April 2018
The Management in a Developing Country of Children with Type 1 Diabetes Mellitus at School: A Review of Attitude of Parents
Abstract: Background: Optimal glycaemic control is essential in preventing diabetes related complications in children with diabetes. The school is an important component of care and support to achieve good outcome as children spend a considerable time in school. In some developed countries, there are guidelines and regulations on support and care of children with chronic diseases such as Type 1 Diabetes Mellitus (Type 1 DM). In most developing countries where these regulations are not in place, parents have an important role to play in encouraging optimal care for their wards while at school, which include informing school authority, submission of care plan in collaboration with the healthcare team and providing equipment necessary for care task at school. Aim and Objectives: The aim of this study was to review the attitudes of parents in a developing country towards management of their children with Type 1 Diabetes Mellitus (DM) at School. Methods: Parents of all children with Type 1 DM seen at the endocrine unit of the University of Port Harcourt Teaching Hospital were invited to participate. Data were collected using a questionnaire. Information on bio data, details of care in school and challenges experienced were documented and HbA1c was done for all children. Results: The Parents of eighteen children and adolescents with Type 1 DM participated in the study. The age range of the children was between 5 and 17.3 years, mean age of 12.37 ± 4.2 years. Mean duration of DM 3.37 ± 2.6 years and mean HbA1c was 10.02% ± 2.5%. All children except one attended school as day students. Two parents (11.1%) did not inform the school of child’s diabetes. No parent gave a written plan of diabetes care/treatment of hypoglycaemia in school and 4 parents (22.2%) did not make contact with school when child was in school. No child had a glucometers or took insulin to school. Five parents (27.8%) adjusted or omitted morning insulin dose to prevent hypoglycaemias in school. Fifteen (83.3%) children were on twice daily insulin injections. Six children (33.3%) are from high socioeconomic class. All responses were from mothers and 15 (83.3%) of responders had at least secondary education. Conclusion: This study demonstrates poor attitude and deficiencies in care of children living with Type 1 DM in school. There is need for education of parents and presentation of written plans for care of every child with Type 1 DM in school.
Cite this paper: Tamunopriye, J. (2018) The Management in a Developing Country of Children with Type 1 Diabetes Mellitus at School: A Review of Attitude of Parents. International Journal of Clinical Medicine, 9, 327-334. doi: 10.4236/ijcm.2018.94028.

[1]   Patterson, C.C., Dalquist, G.G., Gyurus, E., Green, A. and Soltesz, G. (2009) Incidence Trends for Childhood Type 1 Diabetes in Europe during 1989-2003 and Predicted New Cases 2005-20: A Multicentre Prospective Registration Study. Lancet, 373, 2027-2033.

[2]   United Nations (2008) End Poverty 2015. Fact Sheet on MDG 4. Reduce Child Mortality.

[3]   Diabetes Control and Complications Trial Research Group (1994) Effect of Intensive Diabetes Treatment on the Development and Progression of Long-Term Complications in Adolescents with Insulin-Dependent Diabetes Mellitus: Diabetes Control and Complications Trial. Journal of Pediatrics, 125, 177-188.

[4]   Nordwall, M., Arnquist, H.J., Bojestig, M. and Ludvigsson, J. (2009) Good Glycaemic Control Remains Crucial in Prevention of Late Diabetic Complications—The Linkoping Diabetes Complications Study. Pediatric Diabetes, 10, 168-176.

[5]   Muze, K.C. and Majaliwa, E.S. (2015) Type 1 Diabetes Care Updates; Tanzania. Indian Journal of Endocrinology and Metabolism, 19, S12-S13.

[6]   Ogle, G.D., Middlehurst, A.C. and Silink, M. (2016) The IDF Life for a Child Programm Index of Diabetes Care for Children and Youth. Pediatric Diabetes, 17, 374-384.

[7]   Ogle, G.D., Kim, H., Middlehurst, A.C., Silink, M. and Jenkin, A.J. (2016) Financial Cost for Families of Children with Type 1 DM in Low Income Countries. Diabetic Medicine, 33, 820-826.

[8]   Wilson, V. and Beskine, D. (2007) Children and Young People with Type 1 Diabetes Mellitus: Managing at School. Journal of Diabetes Nursing, 11, 392-398.

[9]   Craig, M.E., Jefferies, C., Dabelea, D., Balde, N., Seth, A. and Donaghue, K.C. (2014) Definition, Epidemiology, Diagnosis and Classification of Diabetes Mellitus. Pediatric Diabetes, 15, 4-17.

[10]   Oyedeji, G.A. (1985) Socioecomic and Cultural Background of Hospitalized Children in Ilesha. Nigerian Journal of Paediatrics, 12, 111-117.

[11]   Sarnblad, S., Berg, L., Detlofsson, I., Josson, A. and Forsander, G. (2014) Diabetes Management in Swedish School: A National Survey of Attitudes of Parents, Children and Diabetes Teams. Pediatric Diabetes, 15, 550-556.

[12]   Skollagen. (SFS 2010:800). Stockholm: The Swedish National Agency for Education.

[13]   Gonder-Frederick, L.A., Fisher, C.D., Ritterband, L.M., et al. (2006) Predictors of Fear of Hypoglycaemia in Adolescents with Type 1 Diabetes and Their Parents. Pediatric Diabetes, 7, 215-222.

[14]   Perantie, D.C., Lim, A., Wu, J., et al. (2008) Effects of Prior Hypoglycaemia and Hypoglycaemia on Cognition in Children with Type 1 Diabetes Mellitus. Pediatric Diabetes, 9, 87-95.

[15]   Parent, K.B., Wodrich, D.L. and Hasan, K.S. (2009) Type 1 Diabetes Mellitus and School: A Comparison of Patients and Healthy Siblings. Pediatric Diabetes, 10, 554-562.

[16]   Hellems, M.A. and Clarke, W.L. (2007) Safe at School: A Virgininia Experience. Diabetes Care, 30, 1396-1398.