Introduction and Objective: T1D management may require frequent interventions which disrupt the school day, though the missed class time and impact on students are not described. We aimed to determine the frequency, duration, and type of school disruptions for students with T1D.Methods: We analyzed data for 16 children (age 9.0±1.8 years, 62% female, 31% public insurance, mean HbA1c 7.5±1.1%, T1D duration 3.7±2.4 years) from 9 districts in SPACE, a school-based T1D intervention, in 2024. Nearly all students used devices (94% CGM, 75% AID). School nurses reported T1D management outside of routine dosing, including the reason, time to resolve, and parent/clinic contact. We calculated an event rate per student, accounting for the number of in-person school days for each district during active study duration.Results: In 3 months, 350 events were reported (2-89/student) with a median of 1.2 events/week (IQR 0.5, 2.8, min: 0.6, max: 6.5). Median event time was 5 minutes (IQR 3, 13, min:1, max:65), though 72 (21%) required ≥15 minutes. Impending or true hypoglycemia were reported most often (218, 62%), followed by hyperglycemia (109, 31%). Few (<5%) were related to device issues or ketones. Most events required presentation to the nurse (307, 87%). Half (167, 48%) of events resulted in parent contact, whereas only 4 (1%) required contact with the medical team. Nearly all (99%) events were handled in school. There were no associations between event rates and age, T1D duration, or HbA1c.Conclusion: Young students with T1D have on average at least one school disruption related to acute management weekly. As our findings do not include routine care or parent/student communication, this is an underestimate. Medical teams may be unaware of these experiences, as parents are usually the point of contact. Diabetes education should include strategies to mitigate school day disruptions to benefit student learning and well-being.
C. March: None. V. Stouffer: None. E. Naame: None. C. Moon: None. I. Libman: None.
National Institutes of Health (1K23DK135800)
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