[Special needs of schoolchildren with diabetes mellitus. Point of view of parents and teachers].
BACKGROUND
The daily care of a diabetic (IDDM) child is essential for the short and long term evolution of the disease, and must include the hours the child spends in school. The presence of Trained personnel are needed who will be able to intervene in time if a serious complication, such as hypoglycemia, occurs. Their presence can help to ensure correct control of the disease and avoid long term complications.


OBJECTIVE
To understand of the day to day life of children with IDDM, focusing on their school hours. To understand the attitude of primary and secondary school teachers towards pupils with IDDM.


METHODS
Descriptive and transversal study on IDDM patients between the ages of 3 and 18, treated within the Healthcare Area number 3 in the Madrid Region, and their teachers. Two different kinds of surveys were distributed: the 1st survey by Fundación para la Diabetes (Foundation for Diabetes) contained 80 questions aimed at patients between the ages of 3 and 18 and their parents. Questions were related to patient's daily life and school environment. The 2nd survey, which allowed free response, was aimed at primary and secondary school teachers about their own experiences working as professionals with pupils with IDDM.


RESULTS
Fifty questionnaires addressed to parents and patients were valid in our remit, and we emphasize the following: the ages of major participation were 10 to 14 years; 86% of children knew how to measure blood glucose and 66% how to administer insulin; 74% had no problems with school integration, however, up to 50% of children under 6 years had suffered a problem occasionally; on the 50% of the occasions when a patient needed insulin administration during school hours, it was done by a relative; 66% of hypoglycaemias were resolved by the patient. Health personnel is present only in 8% of the schools studied; 98% of those surveyed think teachers should have written instructions on the signs and symptoms and action to be taken if a hypoglycemia occurs. Questionnaires for teachers were answered by 54% of them (76 of a total of 140), we would like to point out the following: 71% of them recognise having a diabetic pupil; the degree of teacher knowledge on diabetes, rated on a scale from 1 to 7 shows a median of 3 and a mode of 4; 47% of teachers feel insecure when having a diabetic pupil because they do not have instructions on actions to take in case a complication occurs; 97% of teachers affirm to know what a hypoglycaemia is, however only 67% and 57% of them recognise its signs and symptoms and know how to act when they occur.


CONCLUSIONS
The school integration and acceptance of pupils with IDDM is good, according to both teachers and parents. Children with IDDM take responsibility for their disease at an early age and are able to develop certain skills. However they still need help, which they get from their family even during school hours. Generally, teachers are willing to learn new skills to be able to help these children, however, further training is required to improve the understanding and management of this disease.
Gómez Manchón
M
M
Servicio de Pediatría, Hospital Universitario Príncipe de Asturias, Departamento de Especialidades Médicas, Alcalá de Henares, Madrid, España. mergoman2@hotmail.com
Gómez Carrasco
J A
JA
Ramírez Fernández
J
J
Díez Fernández
T
T
García de Frías
E
E
D000293:Adolescent; D001290:Attitude; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000628:therapy*; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D012574:Schools; D011795:Surveys and Questionnaires