The Management in a Developing Country of Children with Type 1 Diabetes Mellitus at School: A Review of Attitude of Parents

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.