Reality Alert: A child with diabetes enrolled in a YMCA day camp program. While testing her blood sugar levels before lunch one day, the child’s friends were curious about her testing supplies. The child ended up poking many of her friends’ fingers, potentially exposing them to bloodborne pathogens. Each child required months of blood tests afterwards.
Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood. There are two different types of diabetes: type 1 and type 2. In type 1, also sometimes called juvenile diabetes, the pancreas does not make any insulin. People with type 1 rely on insulin injections to survive. In type 2, the pancreas does not make enough insulin. This can be caused by obesity or genetics. Even if the person does not need insulin injections, they will often need to test their blood sugar levels throughout the day.
The prevalence of diabetes among children has been on the rise. The number of children with type 1 diabetes rose 21% between over a nine year period. Type 2 has risen more than 30% in that same time frame. This is especially concerning because this rise is associated with the rise in childhood obesity. It’s becoming more and more likely child care centers, camps, and youth programs may have a child with diabetes in their care.
Diabetes is considered a disability and must be accommodated, according to the Americans with Disabilities Act, or ADA. Therefore, a child cannot be excluded from any program or activity due to their diabetes. In addition, their parent or guardian cannot be required to come and help them inject insulin or test their blood sugar. This means the staff working with a child with diabetes must be trained to perform these procedures themselves or be able to assist the child.
Despite the availability of safer injection devices, using needles for injecting insulin and for testing blood sugar levels will always carry the risk of bloodborne pathogen transmission. The CDC has a variety of best practices for keeping staff members and children safe while accommodating their diabetes care needs. These tips include:
When an organization enrolls a child with diabetes, it’s important to work closely with his or her family and health care provider to create a diabetes medical management plan. This will ensure staff members are able to recognize if a child’s blood sugar is getting too high or too low and also provide instructions for testing and administering insulin if needed.