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[IP] For Kids Suffering Diabetes, School Is Real Test
Source: The Commercial Appeal
Publication date: 2002-02-24
The insulin pump that will likely protect 5-year-old Ahmed Latif's kidneys,
eyes and other organs from the long-term ravages of diabetes is complicating
life at school.
These days Mahjabeen Kazmi, a family friend, stops by Lausanne Collegiate
School around lunchtime to check Ahmed's blood sugar and program the pump to
deliver the correct dose of the hormone his body needs to transform food
She visits because Lausanne does not employ a nurse. Since the school year
began, Ahmed's parents have scrambled to arrange the support he needs to
manage his disease, for a time hiring a private nurse.
State law prohibits school staff and teachers who aren't also licensed
health professionals from performing such tasks. With the incidence of type
1 or insulin-dependent diabetes climbing and school nurses in chronically
short supply, schools and families are scrambling to respond.
The situation has prompted the parents of a Bristol, Tenn., second- grader
to launch a grass-roots effort to make it easier for Tennessee students with
diabetes to receive the care they need. A bill now under consideration by
the General Assembly in Nashville would permit trained school staff to
administer the drug glucagon if a diabetic student's blood sugar fell
Eventually, hopes Kelly Mitchell, who asked state Sen. Ron Ramsey
(R-Blountville) to introduce the current proposal, Tennessee will adopt an
approach pioneered in Virginia that requires all schools to have staff
trained to handle both emergency and routine diabetes care.
"We are very fortunate at this time," said Mitchell, whose 7-year- old son,
Preston, was 20 months old when his diabetes was diagnosed.
Faculty and staff at his school have worked closely with the family to help
Preston manage his diabetes, she said, and she is able to leave work if
needed to administer insulin.
"But I have talked to parents in the school systems around us who are having
horrible experiences. It isn't fair. None of these kids chose to be
Shereen Arent, the American Diabetes Association's national legal advocacy
director, wasn't surprised. Despite a federal law designed to guarantee
access to education, she said it is a continuing problem for diabetic
youngsters in both public and private schools.
In Memphis and Shelby County, public schools rely on more than 80 nurses.
"There aren't enough to go around. The nurses have to organize their day
around insulin pumps, blood sugar monitoring or insulin injections," said
Kathleen Johnston, the local Health Department's school health supervisor.
Some, but not all, private schools employ nurses.
"Diabetes as a clinical problem in schools is significant. Locally the
numbers are increasing fairly dramatically," Johnston said. Exact numbers
Ahmed's parents are particularly knowledgeable about his disease. His
father, Dr. Kashif Latif, is completing a fellowship in endocrinology at the
University of Tennessee Health Science Center. Dr. Shazia Hussain, Ahmed's
mother and Latif's wife, is a Germantown pediatrician.
They were baffled by the state requirement that schools use licensed health
professionals to check blood sugar or administer insulin or glucagon.
They were also annoyed that it took several meetings and the first half of
the school year for Lausanne to provide the monitoring and support the
family requested in August.
Ahmed was 11 months old when his diabetes was diagnosed. It carries a
sobering list of possible short-term and long-term problems, including heart
disease, blindness, nerve pain and kidney failure.
Lausanne officials said they worked hard to find a solution, including
meeting several times with Ahmed's parents and arranging for several
teachers and staff to participate in diabetes education that Ahmed's parents
Dr. George P. Elder, Lausanne's headmaster, said the school explored several
options, including recruiting volunteer nurses or hiring a nurse to oversee
care, but none proved workable.
Schools routinely rely on secretaries to dispense other prescribed
medications. Johnston said diabetes is different because the medication is
injected. Since 1996, it has been considered a procedure, meaning if a
student cannot handle it alone, it must be done by a nurse or other licensed
Lausanne receives federal funds. And federal law requires such schools,
public or private, to provide the support that students with diabetes need
to attend school, although it doesn't spell out how. Local and national
authorities said problems securing such support are common.
"We hear more complaints about public schools, but there are more kids in
those schools," Arent said. She said diabetes is second to asthma as the
most common chronic illness affecting American children.
There simply aren't enough school nurses, said Ivan Lanier, the diabetes
association's Southern regional advocacy director. That is why the
association is backing legislation modeled after the Virginia law that
requires that schools have trained staff to provide monitoring and support
to diabetic students.
"We are rolling it out now across the country," he said, including in South
Carolina and Washington.
There are no plans this year to seek such changes in Tennessee. But Ramsey
said he is optimistic the bill allowing trained school staff to administer
glucagon will win approval.
Elder said Lausanne cannot afford to hire a nurse and couldn't find another
school to share the cost and services. The school has 680 students from age
3 through grade 12. He said one other student needs help managing his
diabetes, but that student has a parent on the Lausanne faculty.
Elder has headed five private schools in 25 years. Until recently, few had
money budgeted for a nurse, but in the last two years, he said, the topic
has come up more often with colleagues and at professional meetings. With
more parents both working outside the home, he said all schools are being
asked to do more.
- Mary Powers: 529-2383
Publication date: 2002-02-24
) 2002, YellowBrix, Inc.
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