Improving students' diabetes management through school-based diabetes care.

Introduction: The purpose of this pilot study was to conduct periodic diabetes care visits in school, with the goal of promoting optimal management of diabetes for high-risk youth.

Method: A convenience sample of 27 students receiving care at a university-affiliated children's diabetes center and enrolled in a large urban school district received the diabetes visit intervention. Intervention effect was measured by parent survey of home/school diabetes management practices, the Self-Efficacy for Diabetes Tool, and a diabetes care-provider survey of subjects' usual care, management competence, and glycemic control.

Results: The frequency of diabetes care office visits, insulin adjustment, and home and school blood sugar monitoring all increased. The percentage of children receiving insulin in school doubled. Pre-intervention to post-intervention changes in glycemic control and student self-efficacy did not reach statistical significance. The response to the program was universally positive.

Discussion: This study demonstrated that diabetes care visits in school are feasible and not disruptive to the students' educational program. The visits improved diabetes management at home and at school. School nurses' knowledge about diabetes and confidence in diabetes management was improved through a role-modeling approach.