title: Improved diabetes management in Swedish schools: results from two national surveys.
abstract: BACKGROUND
  Support in diabetes self-care in school is essential to achieve optimal school performance and metabolic control. Swedish legislation regulating support to children with chronic diseases was strengthened 2009.
  
  
  OBJECTIVE
  To compare the results of a national survey conducted 2008 and 2015 measuring parents' and diabetes specialist teams' perceptions of support in school.
  
  
  METHODS
  All pediatric diabetes centers in Sweden were invited to participate in the 2015 study. In each center, families with a child being treated for T1DM and attending preschool class or compulsory school were eligible. The parents' and the diabetes teams' opinions were collected in two separate questionnaires.
  
  
  RESULTS
  Forty-one out of 42 eligible diabetes centers participated and 568 parents answered the parental questionnaire in 2015. Metabolic control had improved since the 2008 survey (55.2 ± 10.6 mmol/mol, 7.2% ± 1.0%, in 2015 compared with 61.8 ± 12.4 mmol/mol, 7.8% ± 1.1% in 2008). The proportion of children with a designated staff member responsible for supporting the child's self-care increased from 43% to 59%, (P < .01). An action plan to treat hypoglycemia was present for 65% of the children in 2015 compared with 55% in 2008 (P < .01). More parents were satisfied with the support in 2015 (65% compared with 55%, P < .01).
  
  
  CONCLUSIONS
  This study shows that staff support has increased and that more parents were satisfied with the support for self-care in school in 2015 compared with 2008. More efforts are needed to implement the national legislation to achieve equal support in all Swedish schools.
authors.affiliation: School of Medicine, Faculty of Medical Sciences, Örebro University, Örebro, Sweden.|Department of Pediatrics, University Hospital Örebro, Örebro, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Särnblad
authors.affiliation: Department of Pediatrics, Ryhov County Hospital, Jönköping, Sweden.|Futurum-The Academy of Health and Care, Jönköping University, Jönköping, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Åkesson
authors.affiliation: Swedish Diabetes Association, Stockholm, Sweden.
authors.forename: Lillemor
authors.initials: L
authors.lastname: Fernström
authors.affiliation: Department of Pediatrics, Ryhov County Hospital, Jönköping, Sweden.
authors.forename: Rosita
authors.initials: R
authors.lastname: Ilvered
authors.affiliation: Institution of Clinical Sciences, Sahlgrenska Academy, Department of Pediatrics, University of Gothenburg, Gothenburg, Sweden.|The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Gun
authors.initials: G
authors.lastname: Forsander
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003920:Diabetes Mellitus / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology; D012574:Schools / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012648:Self Care; D011795:Surveys and Questionnaires; D013548:Sweden
keywords: adolescent; child; diabetes mellitus, type 1; schools; self-care