Australian children with Type 1 Diabetes are not doing well - recent research has demonstrated that 73% are not meeting the international targets and hence are at increased risk of short and long-term health complications. This is simply unacceptable.
The lack of access and implementation of the T1D child’s prescribed treatments at school has been cited as a primary factor for this serious and concerning result. The urgent need to provide credible, flexible, accessible, evidence-based education, learning and training protocols for school staff who support and take responsibility for a student with Type 1 could not wait any longer.
The responsibility for medical advice resides with the treating team and health care professionals with direct experience in T1D with paediatric and adolescent patients. Improving the care for all those living with T1D requires benchmarking the guidance, education, learning and training protocols on those world authorities who are leading the way. This world first e-learning platform resulted from the voluntary efforts of best in field health care professionals who have delivered superior health care outcomes and results for patients across Australia and around the world, along with leading consumer advocates, teachers, parents and adolescents living with T1D.
The T1D Learning Centre is a not for profit, e-learning platform promoting the international care guidelines and best practices recognised by ISPAD, representing paediatric and adolescents with type 1 diabetes globally. The original courses were launched in November 2017, with over 10,000 visits to the site and over 3000 courses completed at no cost. The aims and objectives of the e-learning courses take a national approach and are consistent with the Federal Government Australian National Diabetes Strategy 2016-2020.
The content of the original school e-learning courses was generally sourced from and consistent with the ISPAD Clinical Practice Consensus Guidelines 2014 Compendium on “The delivery of ambulatory diabetes care to children and adolescents with diabetes.” https://www.ispad.org/?page=ispadclinicalpract. The content is also consistent with NICE guidelines and the Australasian National Evidence-Based Clinical Care Guidelines for Type 1 Diabetes in Children, Adolescents and Adults.
The e-learning content is endorsed by the Australian Paediatric Society (APS) and ISPAD. APS is a special society of the Royal Australasian College of Physicians and represents over 400 consultant paediatricians, of whom at least 100 directly manage over 3000 young Australians with type 1 diabetes, across all of Australia. The APS is responsible for diabetes management of over twice the number of children managed by the largest Australian metropolitan specialist child diabetes centres and represents the largest of number of health professionals providing this care. The diversity of practice location and resources has led to some innovative solutions to delivery of equitable services to children with diabetes in regional Australia. More creativity and support, including bipartisan Government support for this initiative is required to make a difference to all Australians living with T1D.
APS is the only Australian medical organisation to have a position statement on children with diabetes in schools. For the past ten years, the APS has facilitated annual clinical diabetes workshops for health care professionals in conjunction with ISPAD that are the largest Australian child diabetes clinical meetings, attracting delegates from all parts of Australia and New Zealand. Presenters include both international and local ISPAD members to bring international standard diabetes care to all regions of Australia. APS strongly supports the 2018 ISPAD international guidelines for management of children with diabetes in schools. The clinical contributors to these modules comprise members of APS, Australasian Paediatric Endocrine Group (APEG), Australian Diabetes Educators Association (ADEA) and ISPAD, all of whom have direct responsibility for medical management of children with diabetes in school. It has been initiated in response to the lack of accessible, flexible, transparent, evidence based education available to Australian school staff who support and take responsibility for a student with Type 1.
Ongoing close cooperation, support and communication between the 3 responsible stakeholders - parent, medical team and school - is the foundation that will enable the student with Type 1 to overcome their disability and have equal opportunity to participate in school life on the same terms as their peers and enjoy the best possible outcome for their physical and emotional health.
The responsibilities of the 3 main stakeholders (ISPAD Guidelines for Management of Type 1 Diabetes in School 2018) are:
· The parent is ultimately responsible for the medical decisions made on behalf of their child. Therefore, the parent’s informed consent and decisions regarding the health and well-being of their child are paramount. It is imperative that parents remain engaged as part of the team even when the student with T1D reaches adolescence.
· The student’s treating doctor or nurse practitioner is responsible for prescribing medications. The medical team is responsible for outlining in detail the recommended medical requirements for that student. The medical team usually comprises a doctor and diabetes educator and may also include, if available, dieticians, psychologists, social workers and exercise specialists who work directly with the child and family.
· The school and the authorities responsible for managing schools are responsible for executing the parental and medical orders outlined in the student’s Diabetes Management Plan and for facilitating the training of school staff, to ensure that they are competent to execute the care plan recommended by parent and medical team.
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