The Little Ways Diabetes Has a Big Impact on Schoolwork

As a mother of a son with Type 1, I tend to focus on the big picture when it comes to managing his diabetes. By this I mean I want to ensure that he doesn't have a severe hyperglycemic low that renders him unconscious or, on the other end of the spectrum, doesn't overindulge on carbohydrates and end up in the ICU in DKA.

Now that the school year is in full swing and charging towards the end of the first grading period, I find myself finally stepping back and looking at the smaller, albeit important, details of managing diabetes on a day-to-day basis. I'm coming to understand and appreciate the magnitude of the impact that diabetes can have daily living for a school-aged child, particularly in terms of schoolwork.

My son is an eighth grade middle schooler. He carries a full load of honors classes and my husband and I expect him to earn good grades. Like many of his counterparts, he can possess an aversion to homework, particularly if he's having a tough time in the class. He's struggled of late in a class or two, and upon listening to him as to what has been affecting his grades, I realized the myriad of ways, sometimes subtle, that diabetes affects his day.

First are the lows, which are the most obvious because of the almost immediate threat they have. Almost all those with diabetes loathe a BG low - the feeling of being out of control coupled with the threat of being embarrassed by passing out. He's gotten to the point where he can come to expect and even prepare for BG lows, particularly on the days that he has the late lunch scheduled or he runs the mile in gym. However, there are those unexpected lows that can throw his whole day off: he's late for the bus and forgets to eat the banana that he corrected for at breakfast or it's much colder than he expected on the way to school and his BG levels plummet. Experiencing a BG low wins him a ticket to the health clinic.

Next are those highs, which I hadn't really considered as an impact to his daily life because they are not as threatening.  This is one area of diabetes management that it has taken my sometime to come to terms with how much high BG levels can impact one's academic performance. My son describes having a high blood glucose level (which for him is any reading above 300) as feeling like he is poisoned; his head pounds, nausea threatens, he feels dizzy. If you've ever been hung over or pulled an all-nighter with too much caffeine, you can probably relate.

We've all felt the stress from taking a test. To exacerbate the feelings of pressure are the spikes in BG levels that accompany this stress. Taking an exam or even a quiz can be nearly impossible with these symptoms, so he therefore must reschedule to take the test for another day and again make a trip to the clinic to drink water and take a corrective dose of insulin. High BGs, for my son, often take longer to correct than a BG low, so he can feel lousy for much of the day.  

Finally, there is the consideration of lost time. Like I mentioned above, when my son experiences a BG low or high, he must go to the health clinic to correct the situation and have it monitored by the clinician. From the time he gets to the clinic, takes his glucose tablets, waits the fifteen minutes to retest his BG level, and then returns to class, that can constitute 20 to 25 minutes out of class. This translates into almost half of a 55-minute class period and not quite a third of a longer 90 minute class period.