Some students and parents become especially nervous in March when a new school year begins. They are type 1 diabetic children and their mothers and fathers.

Type 1 diabetes is often called “children’s diabetes” because many patients are children and adolescents.

According to a study by Professor Kim Ho-seong of the Department of Pediatric Endocrinology at Severance Children’s Hospital and Professor Chae Hyeon-uk of the Department of Pediatrics and Adolescents at Gangnam Severance Hospital, the number of type 1 diabetes patients under 15, which stood at 32.85 per 100,000 people in 2007, rose to 41.03 in 2017.

The number of type 1 diabetes patients newly occurred during this period totaled 29,013.

However, the schools these patients attend do not have a system for them.

As the awareness of type 1 diabetes is low, parents become busy in the new semester. Children need the help of homeroom teachers, health teachers, and schools to manage type 1 diabetes appropriately in school. Because they have no choice but to rely on goodwill, their school lives vary widely depending on the homeroom teacher they meet.

The community of type 1 diabetes patients also gets busy upon the start of new semesters. Parents prepare manuals that provide basic information, ranging from what type 1 diabetes is to various know-how to cope with the ailment. Some parents go as far as to make leaflets for the entire class or requests for injecting glucagon in times of emergency accompanied by doctors’ signatures.

Even these preparations get nowhere if homeroom teachers reject them, saying they are busy or cannot take responsibility for these children. In addition, some teachers don’t think it is significant, making parents lose strength.

Kim Mi-young, who heads the Korean Society of Type 1 Diabetes, said she understands that type 1 diabetic child cannot receive special treatments at school. Kim is also the mother of a son who is an eighth grader with type 1 diabetes.

However, she emphasized that for children patients to live a normal school life, it is necessary to improve the system in terms of “relative equality” rather than “absolute equality.”

“If school officials discuss and pay attention to children with type 1 diabetes and other diseases, it will help to ease the hardship of these kids who endure such difficulties by themselves,” Kim said.

Type 1 diabetic schoolchildren experience joy and sorrow every semester

Parents who have children with type 1 diabetes cannot remain relaxed as soon as their kids leave home. It's because of the blood sugar level that keeps going up and down. If blood sugar continues to drop, low blood sugar shock can lead to an emergency, so they must eat candy or drink even during class. However, children tend to be wary of teachers and friends around them, not to be seen as snacking in class. In some cases, classmates take issue with their eating snacks.

That explains why it is important for such children to have homeroom teachers who understand their situations. Because schools are not obliged to support type 1 diabetic children, homeroom teachers’ role is important.

“Even in the middle of class, these students need to eat soft drinks or candies or get insulin injections,” Kim said. “For these children to deal with such situations in an unfamiliar environment, we need to notify homeroom teachers of these, but often cannot know student numbers before a new semester begins.”

After the first class on the first day of a new semester, parents find out the names of homeroom teachers and explain the situation to the school authorities, and the results depend on the teachers’ inclinations. Some express their understanding, but others send the data back through students, saying, “Please, take care of your children.”

“There are teachers among such parents, but even such teachers say they cannot help under the current school system,” Kim said. “Some say they did not know previously but found the school environment is very unreasonable for students with diseases.”

For diabetic students, test time and school distance matters

Even senior students accustomed to managing their blood sugar have their problems. In middle school, they must submit smartphones to school before class starts. However, problems arise because children check their blood sugar levels with smartphones in real-time.

So exceptionally, they keep a smartphone even in class. The type 1 diabetes patient group has prepared and shared a plan to link a smartwatch and a continuous blood glucose meter just in case. For children with type 1 diabetes, smartphones and smartwatches serve as medical devices.

Usually, it is okay to have a smartphone, but it is sometimes difficult during the test period due to concerns such as cheating. This is because each city and provincial education office has different standards for allowing smart devices.

So, the patient group is pushing to make a decree which allows students with type 1 diabetes to possess smartphones or submit them to exam supervisors and manage blood sugar in real-time.

The distance from home to school is also a problem. That’s because if schools run out of supplies or hypoglycemic medication, students must get as close as possible to their homes.

“The shorter the distance between home and school, the better because if they don't have any medicine at school, they have to take some medicine at home,” Kim said. “In areas where students are overcrowded, they are sometimes assigned to distant schools. It's hard to deal with problems while going to school far away. So, type 1 diabetes must be included in the eligibility for short-range assignment.”

Health teachers are too busy, and schools need to hire more medical personnel

Kim said that besides health teachers in the school, it is necessary to recruit medical support personnel, including nurses.

"Even if an automatic insulin injector is attached to a lower grade student, various problems can occur, such as the clogging of needles and the dropping of adhesive tapes holding the injector. If medical support personnel are added, the students will be able to receive prompt support in the school."

Kim also said that health teachers should be able to inject insulin. However, they tend to be reluctant to administer insulin because the legal criteria are unclear.

“In the case of low-grade students who are unable to use medical devices or who are allergic to tapes that secure medical devices, the insulin injection problem is not addressed, so parents have to quit their jobs and follow their children around,” Kim said. “For this reason, they need help from health teachers.”