Sunday 19 November 2017

Diabetic students need breaks, support and awareness

Diabetics have been urged to take the breaks they are entitled to during exams.
Diabetics have been urged to take the breaks they are entitled to during exams.
Eilish O'Regan

Eilish O'Regan

SCHOOLCHILDREN with diabetes are being urged to avail of the breaks they are entitled to during the upcoming Junior and Leaving Certificate exams to ensure their performance is not affected.

A group of doctors at the Department of Endocrinology at Temple Street Hospital in Dublin looked at a sample of their patients who had type 1 diabetes and sat the Junior Cert three months previously in 2012.

"Rest breaks are available for students with type 1 diabetes to complete each examination, but just over a quarter of patients in this study availed of this support," the doctors led by Diarmuid Scully found.

People with type 1 diabetes need to take insulin injections for life and must make sure their blood glucose levels stay balanced.

"These breaks are intended to facilitate diabetes self-care including glucose checks during the examination. On the day of examination, the student should be prepared for the possible stress-related increase in insulin requirement," they added.

The teenagers run the risk of hypoglycaemia when the glucose level is too low and the body does not have enough energy. Typical early warning signs are feeling hungry, trembling or shakiness, and sweating. In more severe cases, there can also be confusion and difficulty concentrating. In some severe cases, the person experiencing hypoglycaemia will lose consciousness.

The immediate treatment for hypoglycaemia is to have some food or drink that contains sugar, such as dextrose tablets or fruit juice, to correct the blood glucose levels.

The student must be prepared to identify and treat this promptly in the tightly regulated setting of the examination centre, the study in the Irish Medical Journal warned.

"Almost half of the patients did not bring a glucometer (to measure glucose in the blood) into the examination centre. Only 53pc checked their capillary glucose levels during the examinations and 13pc did not have a hypo remedy with them.

"Adolescents, their parents and schools need to ensure that this equipment is available during examinations," the doctors stressed.

They pointed out that state-regulated examinations represent a stressful event in the life of the adolescent. Three patients experienced hypoglycaemia during one or more examination, but whether or not this affected performance is unknown."

They pointed out that in the event of hypoglycaemia during an examination, it is possible that the allowance of extra time may be insufficient to overcome the cognitive effects of the episode of low blood glucose.

"Glycaemic control in the study participants was suboptimal. Possible reasons for this include low priority of diabetes control during the examination year and stress associated with the Junior Certificate, as well as other well-recognised issues affecting diabetes control in adolescence."

The doctors aknowledged the limitations of this study because the sample only included 25 students. However, they said a number of areas where care of adolescents preparing for this examination could be improved were identified.

"Almost half of patients in this study felt that their diabetes affected their examination performance.

"A plan should be in place for the day of the exam, where a checklist is provided for the adolescent outlining the equipment that should be brought into the examination centre . . . parents should be informed of the special accommodations available."

They said they would also recommend that the Department of Education issue all schools with clear guidelines for accommodating children with diabetes.

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