Intensive insulin therapy for children in early primary school : the narratives of parents, school teachers and diabetes educators

The number of early primary school (EPS) children (aged 4-8 years) with type 1 diabetes (T1D) rises each year. The current recommended treatment regime for children with T1D is intensive insulin therapy (IIT) supported by carbohydrate counting and regular blood glucose level monitoring. An insulin injection, or two insulin pump boluses, and blood glucose monitoring are usually required during the school day. Young children typically rely on their parents to provide diabetes care. Therefore, children attending EPS (the first 3 years of compulsory school) require more planning and resources from parents, school personnel and diabetes educators (DEs) than older children do. School attendance is compulsory in Australia and children spend a significant amount of time at school: 6 hours a day, 5 days a week, 40 weeks of the year. Therefore, management of T1D needs to be optimal at school to support learning, social and emotional development and to prevent health complications. In addition, educational experiences and outcomes influence future employment and functioning in society.