Alexandria, Virginia - As parents get ready to send their kids back to school this fall, those whose children have diabetes have more than book bags and school supplies to get organized: It's time to review and plan for how their children's diabetes management needs will be met while they are at school.

"Diabetes is a disease that must be managed 24/7," said American Diabetes Association Safe at School Working Group Co-Chair Linda Siminerio, RN, PhD, CDE. "Failure to do so can result in serious short- and long-term medical complicationsharmful effects of diabetes such as damage to the eyes, heart, blood vessels, nervous system, teeth and gums, feet and skin, or kidneys. Studies show that keeping blood glucose, blood pressure and low-density lipoprotein cholesterol levels close to normal can help prevent or delay these problems.. It's therefore imperative that every student with diabetes has a plan in place to meet their diabetes needs at school as well as off site, during field trips and at all school-sponsored activities."

Parents should reach out to schools before classes start to write and update diabetes care plans, make sure the school has ample supplies, meet with the school nurse, administrators and other school staff responsible for providing care, and become familiar with federal and state laws that provide legal protections to students with diabetes, she said.

With more than 208,000 children under the age of 20 living with diabetes in the United States, the American Diabetes Association (Association) is raising awareness through its Safe at School campaign to highlight the importance of ensuring all children are able to have access to proper diabetes care during the school day and at all school-sponsored activities so they can remain medically safe and healthy while learning. One way the Association meets this goal is through its state legislation and regulatory efforts. To date, 30 states have laws in place ensuring children with diabetes have access to proper care at school; other states, such as Maryland, are considering this type of legislation.

"Having a full-time school nurse is a great start, but what we're really talking about here is having other school staff trained to provide needed care because even a full-time school nurse can't be everywhere at all times," said Siminerio. "In some cases, as with older children, the student may be able to self-manage his or her diabetes, but sometimes state laws or policies place barriers to care calling for the need to change those laws."

States such as Arkansas and Hawaii recently passed legislation that allows school staff to volunteer to be trained to administer insulina hormone that helps the body use glucose for energy. The beta cells of the pancreas make insulin. When the body cannot make enough insulin, it is taken by injection or through use of an insulin pump and glucagona hormone produced by the alpha cells in the pancreas. It raises blood glucose. An injectable form of glucagon, available by prescription, may be used to treat severe hypoglycemia. The opposite of insulinX and allows capable students to self-manage their diabetes. States with laws containing these provisions - coupled with federal protections - enhance the ability of schools to provide effective diabetes care to students.

Jane K. Kadohiro, DrPH, a Certified Diabetes Educatora health care professional who teaches people who have diabetes how to manage their diabetes. Some diabetes educators are certified diabetes educators (CDEs). Diabetes educators are found in hospitals, physician offices, managed care organizations, home health care and other settings., Advanced Practice Registered Nurse and advocate who led the effort to pass Safe at School legislation in Hawaii, said having this legislation in place is an important first step, but now parents and schools must work together to ensure the continuity in care that the law requires is being provided, by identifying those teachers and other school staff willing to be trained to provide back-up care. "Teachers and other volunteers can be trained to do a fine job," she said, "especially if parents and diabetes educators are available for consultation during the training process. Teaching a teacher or a volunteer is no different than teaching parents how to maintain diabetes control for their children."

The Association and the Safe at School campaign are committed to achieving effective school-based diabetes management for all children living with diabetes. But unfortunately, not all school systems are the same, and problems with access to diabetes care at school can occur. To address these problems, the Association provides a network of dedicated lawyers, health care professionals and Diabetes Advocates who can assist families and schools with implementing practical and safe solutions to diabetes school care issues.

The American Diabetes Association is leading the fight to Stop Diabetes and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. For the past 75 years, our mission has been to prevent and cure diabetes and to improve the lives of all people affected by diabetes.

For more information please call the American Diabetes Association at 1-800-DIABETES (800-342-2383) or visit www.diabetes.org.