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Old 11.12.2019, 10:27
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Diabetes type 1 in the school

Good morning forum,

I would like to know if someone else has a child with Diabetes type 1 in the school and how is it working for them.
Till now, when out daughter was in the Kita or even in Spielgruppe, teachers were billing to take care of our daughter (so checking blood sugar regularly, weight any food she eats and calculate the amount of insuline to be delivered).

In August our daughter started in the Kindergarten and now we've seen a radical change. Still the teacher checks the glucose level and gives the corresponding insuline in the Znüni but yesterday we received a letter from the school saying that our daughter cannot join any of the activites planned outside the school (example: they are taking all the children to the teather).
I found this totally discriminating and I could hardly understand why suddenly my daughter has to be treated differently.

I'm trying to find solutions (maybe SPITEX could help us on these concrete days, 5 or 6 times a year) but I would like to ask the forum if someone else had a similar experience and if they can even do that (which sounds weird to me).

Thanks in advance for any comments.
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Old 11.12.2019, 10:42
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Re: Diabetes type 1 in the school

Not got direct experience with diabetes but for the school trip could you or your wife/husband offer to accompany the class? It's sort of a compromise, which they may be willing to go for?
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Old 11.12.2019, 10:55
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Re: Diabetes type 1 in the school

Dear @Sandgrounder

thanks for your reply. Of course we could do this, but I'm questioning how much of a solution is this? Eventually, in the primary school, they will go out and sleep outside. Shall we also go then together? And honestly, being me or my wife there immediatelly makes my daughter different.
I can hardly understand that in the Kita or SpielGrüppe they could handle the situation but not in the Kidergarten. As I understood when my daughter turns 5, the Kindergarten is mandatory. If so, the school should provide all the necessary attention so my daughter is in a safe environment and, to my understanding, this is applicable to all the activities planned by the school.
We can always do compromises, I agree, but I'm more looking for a solution that works also in the future scenarios.

Maybe I'm being naive, I'm just trying to see if someone else had a similar situation and how they solve it.
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Old 11.12.2019, 11:03
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Re: Diabetes type 1 in the school

Does she have an Abbott Free Style Libre? It is a “flash” Glucose Monitoring System. This consists of a glucose sensor attached to the back of the arm which can be read with a hand held reader, or most modern cell phones (iPhone 7 and up, Android as well).

These can easily be upgraded to be continuous (meaning scanning isn’t necessary, the data is sent by Bluetooth to your phone and (some) smart watches). This is not supported by Abbott but is development of the We are not waiting Group. Lots of information in facebook groups.

Teachers can scan with the reader much easier than finger sticks, literally takes less than 5 seconds, and no blood is involved.

In Switzerland these are covered by basic health insurance, if prescribed by a diabetes specialist.

I use this and it has changed my life. My A1c has dropped from the mid to high 7s to the low 6s.

Here is a link in French. https://www.freestylelibre.ch/fr_CH/ Change the fr to de or it if you want German or Italian. Or use https://www.freestylelibre.co.uk if you are looking for English. You won’t be able to buy from there.
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Old 11.12.2019, 13:05
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Re: Diabetes type 1 in the school

https://www.bbc.com/news/av/uk-engla...-play-football

I remembered seeing this recently. No idea what its called, but could that be an option?

Edit: Ahh... think it's this https://www.medtronicdiabetes.com/tr...n-pump-therapy
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Old 11.12.2019, 13:22
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Re: Diabetes type 1 in the school

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Maybe I'm being naive, I'm just trying to see if someone else had a similar situation and how they solve it.
I do hope you resolve your issue, but in the meantime I suggest you avoid shouting "discrimination". They're clearly doing what they can to manage the medical-related problems and I'm sure will also be pleased if you can together find a way to improve things, but you need to be realistic in your expectations of what a school is prepared to take responsibility for, and be aware of the effect that things like staffing levels and additional training requirements will have on this.
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Old 11.12.2019, 13:30
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Re: Diabetes type 1 in the school

At some point your daughter will be much more confident and independent. She will do all the needed procedures for herself and might only need some supervision.

A hypoglycemia situation can arise in any situation, not just school trips. I do not see this alone as a reason to deny participation.

I suggest ask the Kindergarten in a non confronting way what the actual reasons and concerns are, if it complies with mandatory schooling, and what conditions would have to be met that she is not excluded and can participate in the excursions.

Sometimes things are just done out of unfounded fear or misunderstandings. It is importing that you do not accuse them but are open for their concerns. This allows to find a solution which both sides can mutually agree on. In the end you must trust each other or things can become very complicated.

Education laws of canton Lucerne:
https://volksschulbildung.lu.ch/rech..._fi_schulrecht
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Old 11.12.2019, 14:15
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Re: Diabetes type 1 in the school

I fully agree on avoiding confrontation and finding a common solution. In fact, that would have been my expectation: instead of communicating to me that, from now on, my daughter cannot attend excursions or any outside activities, I would have expected them to express theirs concerns and try to find a solution together.
In my opinion (and vocabulary, sorry maybe is just a different understanding of the word) what they did (so far, hopefully this will change) is discrimination. And I'm asking myself: what kind of message do they give to the other children? The moment someone becomes a problem, just put him/her aside? Is this what we really want in our society?

If tomorrow the teacher gets cancer (I hope it never happens), shall I tell her to not educate my daughter anymore? Because now she also has a disease and might not allow her to take proper care of the childern. I'm pretty sure everyone would say no way. If I would do it I would be discriminating her without foundations, but based on fear. And that's what I think is happening here.

At the end, I've learned (unfortunatelly the hard way) that health situations changes from one day to another. Therefore we should be willing for a society where people is integrated accepting the diferences and helping each other. Because today I need help, but tomorrow might be you.

Said this, I really appreciate your comments and I fundamentally agree with them.
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Old 11.12.2019, 16:23
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Re: Diabetes type 1 in the school

I think she is a little young to use a pump.

If there is discrimination it is passive. They are not singling her out for no reason. Diabetic Children, and adults, do need additional care. I've been a T1 for over 45 years. It is difficult.

If a teacher were to make a mistake, or forget, it could very well be fatal. Teachers are not nurses.

I'm certain you don't want this responsibility either, but with care she can grow up and live a productive life.
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Old 11.12.2019, 16:36
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Re: Diabetes type 1 in the school

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If a teacher were to make a mistake, or forget, it could very well be fatal. Teachers are not nurses.
This.

I have never heard of a teacher controlling sugar levels/administering insulin.

Tom
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Old 11.12.2019, 16:45
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Re: Diabetes type 1 in the school

I‘m pretty sure it‘s not discrimination per se, but being incredibly cautious and not wanting to take responsibility for a hypoglycemic event. It is a bit passive and I totally get that it‘s frustrating. It feels a bit inflexible.

So, as has been suggested before, talk to the school and understand from them what risks they perceive. If this were the US I’d say they were worried about litigation. Maybe for you to offer to accompany your daughter is a solution. Excluding her is not a solution but it‘s probably the easiest, risk averse response. Is there a diabetes specialist you work with? Maybe this individual can help you approach the school.

Good luck!
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Old 11.12.2019, 16:59
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Re: Diabetes type 1 in the school

I’m a teacher in a public school. I’ve had a few students with T1 diabetes over the year, albeit a bit older than the OP. In Vaud, all the adults who will work in contact with the child meet with a specialized nurse who teaches us what diabetes is and how to recognize signs of hypo or hyperglycemia, as well as the emergency measures to adopt should it happen.

However, teachers are expressly and strictly forbidden to administer any medication, even if it’s asked by the parents. Teachers are not nurses, and nor should they be.

So far my students had well controlled diabetes and were able to check their glycemia on their own.

As a teacher, you are in charge of a whole class, and for a day out there are two adults per class. I fully understand that taking care of injections and so on is not possible in addition to being responsible for all the other students.

Moreover, as a teacher I wouldn’t want to be legally responsible if I made a mistake in dosing or injecting insulin. It’s a huge responsibility.
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Old 11.12.2019, 16:59
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Re: Diabetes type 1 in the school

Hi,

What a challenge to deal with bureaucrats =/ You expected them to write a letter where they express their concerns and invite you to find a solution together. But they wrote a rude one....patience. The translation of this letter from bureaucrat jargon to human speak is an invitation to discuss the issue with the school principal

As aSwissInTheUS said, careful with confrontation. I'd assume you're after a solution for your kid, not a fruitless semantics discussion and ensuring possible collaborations never happen.

Also, I read about this case earlier this year in Basel.

A Spitex/nurse comes everyday to a kindergarten to measure insulin and adjust the pump for the kid. The parents complain this situation is not good for the child since it isolates him from the group. The parents argue that before,in the Spielgruppe, someone took the responsibility of the insulin, they are surprised why no kindergarten teacher takes this responsibility. The kindergarten manager says that if the teacher has to deal with the diabetic kid, she will not look after properly at the other kids. The opinion of teachers is unknown. The parents complained to cantonal authorities (Education, Culture and Sport admin Basel)and the answer was: there is neither prohibition nor obligation for teachers to inject insulin to kids.
  • since there's no regulation, the decision depends on the competences (formation) and willingness of the teacher.
  • in principle, the insulin treatment for a minor is the responsibility of the parents,
  • one alternative is to teach the kid how to self-manage the medication
  • ...or ask to teachers to cooperate: get training in a hospital to handle the situation and take responsibility
https://www.bzbasel.ch/basel/baselbi...nton-134465578

That was Basel. I have no idea what regulations are in place in Luzern. But one thing is clear, there are managers fearful of liability and teachers that simply may not know what to do. Since there are no regulations, everything should be solved with diplomacy.
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Old 11.12.2019, 18:12
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Re: Diabetes type 1 in the school

A positive story from kindergarten teacher:
https://www.d-journal.ch/kind-und-di...-kindergarten/

Here from other parents with similar issue, in the Original post it was not the teacher but the principal which had issues:
https://www.swissdiabeteskids.ch/fra...diabetes-typ-i
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Old 11.12.2019, 18:14
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Re: Diabetes type 1 in the school

Dear all,

many thanks for all the points you bring to this discussion.
For clarification: my daughter is 4 years old so forget about self-administration, calculation of needed insuline, etc. She is wearing an insulin pump that requires no injection from the teacher. Moreover, we (parents) weight and calculate every day the amount of carbs that she has in the Znuni and try to make it as simple as possible to the teacher.

Also to be fair: the teacher has always been willing to take care of her. With the insuline pump, the only required thing is to check the glucose level (my daughter is very easy with this one, so we never had a problem there) and to administer the insuline through a remote controller (again, no injection needed) after Znuni or if the glucose level is too high.

Personally I'm looking for solutions, no problems. Unfortunatelly problems come by themselves.

I was looking for others who maybe had a similar situation (can even be with other diseases).

Many thanks for all your contributions to the discussion. I really see all your points. I'm just a parent trying that her daughter lives the most 'normal' life possible given the circumstances. Unfortunatelly for others, I'm not the kind of person that easely accepts the situation, specially when I think there are alternatives to improve it.
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Old 11.12.2019, 18:43
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Re: Diabetes type 1 in the school

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Dear all,

many thanks for all the points you bring to this discussion.
For clarification: my daughter is 4 years old so forget about self-administration, calculation of needed insuline, etc. She is wearing an insulin pump that requires no injection from the teacher. Moreover, we (parents) weight and calculate every day the amount of carbs that she has in the Znuni and try to make it as simple as possible to the teacher.

Also to be fair: the teacher has always been willing to take care of her. With the insuline pump, the only required thing is to check the glucose level (my daughter is very easy with this one, so we never had a problem there) and to administer the insuline through a remote controller (again, no injection needed) after Znuni or if the glucose level is too high.

Personally I'm looking for solutions, no problems. Unfortunatelly problems come by themselves.

I was looking for others who maybe had a similar situation (can even be with other diseases).

Many thanks for all your contributions to the discussion. I really see all your points. I'm just a parent trying that her daughter lives the most 'normal' life possible given the circumstances. Unfortunatelly for others, I'm not the kind of person that easely accepts the situation, specially when I think there are alternatives to improve it.
With my latest diabetic student, his mum would accompany us to days out and even came to camp with us. She would try to be as discreet and unobtrusive as possible to let her son have a normal day out with his school friend.
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Old 11.12.2019, 20:05
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Re: Diabetes type 1 in the school

Ok, not diabetes, but you asked for other related experiences. A child in my daughter's class was very ill with cancer and going through chemo, age 4/5. It was never very clear how she would react after or during treatment and what she could or shouldn't do for activities such as gym and recreation. Her mother literally stayed all day at school with her for the duration of her illness. She had a small space in an open common area of the school but was not in the classroom so didn't disrupt anything. More a precautionary measure and always there to monitor her child. Luckily nothing ever went horribly wrong at school. But I think she did monitor fatique and kept cleanliness/hygiene up to the highest standards due to the risks.
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Old 11.12.2019, 20:28
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Re: Diabetes type 1 in the school

Teachers are there to teach, not to deal with students' medical conditions.

Tom
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Old 11.12.2019, 20:32
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Re: Diabetes type 1 in the school

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Teachers are there to teach, not to deal with students' medical conditions.

Tom
Under ‘in loco parentis’ to a certain degree they are. I guess it’s a grey area where responsibility stops and risk starts but usually they carry some such responsibility.
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Old 13.12.2019, 18:32
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Re: Diabetes type 1 in the school

I echo the others who advised you to deal with this in a non-confrontational way.

Often the Kindergarten teachers would ask parents to help out when they have a planned activity outside the school. And my kids loved it when I would travel with them to the zoo, the Verkehrshaus, the Wald or the local farm. At that age, small kids do not feel embarrassed when sitting next to their parent. Far from it; it’s a badge of honour.
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