Improved diabetes management in Swedish schools: results from two national surveys

Background: Support in diabetes self-care in school is essential to achieve optimal school performance and metabolic control. Swedish legislation regulating support to children with chronic diseases was strengthened 2009. Objective: To compare the results of a national survey conducted 2008 and 2015 measuring parents' and diabetes specialist teams' perceptions of support in school. Method: All pediatric diabetes centers in Sweden were invited to participate in the 2015 study. In each center, families with a child being treated for T1DM and attending preschool class or compulsory school were eligible. The parents' and the diabetes teams' opinions were collected in two separate questionnaires. Results: Forty-one out of 42 eligible diabetes centers participated and 568 parents answered the parental questionnaire in 2015. Metabolic control had improved since the 2008 survey (55.2 +/- 10.6 mmol/mol, 7.2% +/- 1.0%, in 2015 compared with 61.8 +/- 12.4 mmol/mol, 7.8% +/- 1.1% in 2008). The proportion of children with a designated staff member responsible for supporting the child's self-care increased from 43% to 59%, (P < .01). An action plan to treat hypoglycemia was present for 65% of the children in 2015 compared with 55% in 2008 (P < .01). More parents were satisfied with the support in 2015 (65% compared with 55%, P <.01). Conclusions: This study shows that staff support has increased and that more parents were satisfied with the support for self-care in school in 2015 compared with 2008. More efforts are needed to implement the national legislation to achieve equal support in all Swedish schools.