Authors: Izabela Rizzardi and Gabrielle Gimenes (FEBRAF, Brazil)
Type 1 diabetes mellitus (type 1 DM) is a metabolic disease characterized by hyperglycemia resulting from a deficiency in insulin secretion. Type 1 DM is the most common chronic childhood disease, affecting roughly 2/3 of all cases of diabetes in children. The pharmacological therapy of type 1 DM consists of subcutaneous insulin replacement. Low doses of insulin can cause hyperglycemia, while high doses can cause hypoglycemia. Among the signs and symptoms characteristic of hyperglycemia, the following stand out: elevated glucose rate that causes intense thirst, increased urinary volume, nausea, vomiting, drowsiness, and abdominal pain. Hypoglycemia, on the other hand, characterized by low blood glucose, shows signs and symptoms such as sweating, tremors, pallor, and mental confusion. Knowing how to identify clinical manifestations is essential for the quickest correct diagnosis followed by appropriate rapid intervention. [1,3]
Treatment goals depend on family changes for the child to change eating habits, in addition to multiple daily subcutaneous doses and frequent blood glucose monitoring. At the social level, the impact is related to participation in events, difficulty in entering schools, and more specific special needs in the school environment, which end up excluding the child from social life, limiting their interpersonal relationships. 
The management of diabetes in children has presented itself as a challenge, since inappropriate behaviors, skills, and knowledge hinder treatment adherence, reflecting on long-term complications. Social and family support and a relationship of trust in health professionals influence self-care behaviors, resulting in increased adherence to treatment, resulting in glycemic control. [2,3]
The family concern in relation to the performance of school professionals in the management of diabetes, such as identifying signs of hypoglycemia and hyperglycemia, or of discrimination in the institution that can harm children's learning. The teacher has an important role in recognizing and acting in adverse situations on school health, in order to be able to help. Research shows difficulties and concerns experienced by family members at school, given the insecurity and little preparation of teachers and principals when dealing with children with DM. With the long coexistence time between school and child with DM, it is essential to know the signs and symptoms characteristic of glycemic crises, by the responsible caregivers, so that they can be identified in time and quickly resolved. [1,2,3]
Accordingly, among the important aspects for the proper management of type 1 DM in schools, reveal the need for newsletters about the disease, creation of a care plan with on-site care, training of a person responsible for insulin administration, and the importance to contain carbohydrate counting in school snacks and meals, for calculating insulin doses.
 Jackson CC, Albanese-O'Neill A, Butler KL, Chiang JL, Deeb LC, Hathaway K, et al. Diabetes care in the school setting: a position statement of the American Diabetes Association. Diabetes Care. 2015;38(10):1958-63
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