New law makes it
possible for diabetics to stay healthy in school
By CINDI ROSS
SCOPPE Associate
Editor
WHEN I GO to work every morning, my glucose monitor and test
strips, a reusable syringe filled with a month’s worth of insulin
and a modest supply of candy go with me. They’re there when I go to
lunch or dinner, on a bike ride or out shopping. I even take them
with me when I go to the basement of my office building for a
45-minute workout.
They’re essential tools for the lifelong job of keeping my
blood-sugar levels as near that as a non-diabetic as possible. That
job, in turn, is essential to protecting me from what not too long
ago were the normal and expected consequences of diabetes: kidney
failure, blindness, amputation, stroke.
But if I were a student in many S.C. schools, I wouldn’t be able
to keep my medical kit close at hand; I would have to turn it over
to the assistant principal, a nurse, a teacher or whatever adult the
school designated as keeper of my health. In some schools, I
wouldn’t even be able to bring any of it on campus. I could only
have access to it if a parent drove to campus, picked me up and took
me off campus to test my blood-sugar or inject insulin.
Or, I should say, that used to be the case. Not anymore.
Late last month, Gov. Mark Sanford signed into law a bill that
requires schools to allow diabetics, asthmatics and others with
chronic conditions to self-monitor and self-administer medication
“in the classroom and in any area of the school or school grounds,”
at school-sponsored activities and on the way to and from
school.
The new law, five years in the making, moves our schools from
among the most dangerous to among the safest in the nation for
children with diabetes and other conditions that require routine or
emergency testing or medication. And that allows children to control
their diabetes in a way that no rational person would have dared
tried before.
In the last two decades, we have learned that diabetics can live
completely healthy lives if they maintain low blood-sugar levels.
But that means testing before and after every meal and sometimes
other times as well, and taking shots with each meal and whenever
sugar levels go too high. It also means frequent episodes of low
blood-sugar, or hypoglycemia, which leave you dizzy, disoriented,
irritable and drowsy and which can, in extreme circumstances, cause
permanent brain damage.
If their children can’t be guaranteed immediate access to testing
equipment and fast-acting carbohydrates to treat hypoglycemia, many
parents will decide not to keep their children’s diabetes as well
controlled as is universally recommended. And as a former teenage
diabetic and someone who has heard all the horror stories about that
genus, I can tell you that even if parents insist on tight control,
a lot of teens will skip that lunchtime insulin injection if it
requires a trip to the principal’s office, or if they can’t be
guaranteed easy access to candy when they take too much. They’ll
probably back off on their morning dose for the same reason: At
least when your sugar’s a little high, you don’t feel like you’re
going to die until the carbs kick in.
Not only children but society in general will reap long-term
rewards from allowing children to control their diabetes the way
they should, because it will mean avoiding the hugely expensive
complications later in life.
The new law isn’t perfect. It has a giant loophole that allows
schools to bar students from taking care of themselves if there is
“sufficient evidence that unsupervised self-monitoring or
self-medicating would seriously jeopardize the safety of the student
or others” — and it fails to define “sufficient evidence.”
And it doesn’t go as far as diabetes advocates hoped. Hunter
Limbaugh is a Columbia lobbyist, father of a diabetic daughter and
chairman of the American Diabetes Association’s national government
affairs and advocacy committee. He had initially tried to require
all schools to have at least three employees trained in the basics
of diabetes, such as recognizing high and low blood-sugar levels,
administering blood-sugar tests and insulin injections and
administering a super-fast-acting shot that raises blood-sugar
levels when a patient is unconscious or having a seizure.
Without that, he worries that no one in the schools will be
willing or able to administer the emergency glucagon shot. “In terms
of those schools who don’t have a nurse, I frankly don’t know what
they would do if a kid has a severe case of hypoglycemia, other than
calling 9-1-1,” he said. “It could just be a real tragedy if that’s
the reaction.”
School officials and nurses balked at the idea of requiring
anyone other than nurses to administer injections even though, as
Mr. Limbaugh points out, glucagon “is pretty much idiot proof,” and
it can’t harm you, even if you don’t need it.
But the reason the law finally passed was that it was a
compromise, which emerged largely because Cathy Young-Jones, who
works as a liaison between the state Education Department and DHEC,
pulled school officials and nurses together with Mr. Limbaugh,
longtime sponsor Rep. Joe Brown, doctors and other diabetes
advocates last summer to work out their differences.
Despite its shortcomings, Mr. Limbaugh considers the law a major
improvement for children with diabetes, because it “creates a
presumption that they can manage their disease wherever that might
require them to do it.”
“I think it’s going to be a change in a lot of schools, and I
actually expect that there will be places that are resistant to it
and don’t implement it in good faith, but I think there will be a
lot that do,” he said. “There are a lot that do fine now, even
without the statutory provision, and I hope this will move the
situation for the better as a general rule.”
Ms. Scoppe can be reached at cscoppe@thestate.com. |