Type 1 diabetes and schools: the Indian experience

Background : Type 1 diabetes (T1D) management in schools requires properly trained staff capable of glucose monitoring, insulin delivery, and blood glucose management. Objective: Our study assessed the management practices and challenges related to T1D among school-going children and youth to identify gaps and propose strategies for effective diabetes care and support in the school environment. Methods: Using a quantitative, cross-sectional design, we collected data through an anonymous questionnaire distributed via healthcare professionals using convenience and snowball sampling techniques. Results: Responses were received from 335 youth with T1D (n = 160, 47.8% male), from 18 Indian states; mean ± SD age and T1D duration were 13.1 ± 4.5 and 6.3 ± 7.3 years. Some students had faced issues getting into (10.3%) and missed out on school (42.7%) or extra-curricular activities (43.3%) due to their T1D. There were concerns relating to T1D management safety in school settings. Some teachers were not aware of the respondent’s T1D diagnosis (7.7%) and hypoglycaemia experience (36.5%). Similarly, some schools did not allow either blood glucose to be measured (7.5%) or insulin to be administered (23.9%). Safety appeared to be better in the south of India, with a greater proportion of respondents practising carbohydrate counting, having a T1D management plan and administering insulin while at school. Further, a greater proportion of respondents from South India advised that their school allowed blood glucose testing and that their school allowed insulin to be administered on school grounds. Conclusion: These findings highlight substantial gaps in T1D support within Indian schools, potentially impacting both educational achievement and health outcomes. The results underscore the urgent need for comprehensive interventions to enhance T1D management in Indian school settings.