Practical approach to the care of Type-2 diabetes children from case finding to maintain diabetes regimen

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The purpose of this study was to examine the usefulness of the diabetes care manual for school personnel which had been developed by our previous study on scientific research in 2003-2004, and to find effective strategies to help school age children with diabetes.1. 300 copies of the diabetes care manual with an evaluation questionnaire were sent to school nurses, members of educational board of Iwate Prefecture, and professionals of childhood diabetes to obtain comments on the manual. Visited Finland to gather information on childhood diabetes care. The manual was revised using those results and was published as a book.2. 10 school nurses, who had students with diabetes, completed 1-year trial use of school life care plan with consent. Telephone and email consultation were welcomed and two study meetings on care plans and recordings were held during the trial period. As a result, they were able to help the students and parents with respect for their feelings and demands. Also, they found the need for information and consultation services on diabetes care.3. Team approach at the 10 schools showed the importance of a meeting of the patient, family, physician, school nurse and school teacher at the beginning of the diabetes life. Health care team of each school was helpful to accept students with diabetes at the entrance to school. All school personnel should increase their knowledge about type-2 diabetes in childhood. The school nurses in this study were willing to work with students with type-2 diabetes to maintain diabetes regimen.4. The role of school nurses in diabetes care was compared internationally, USA, Finland and Japan. Japan is superior in school urine testing system and school nurse's placement in each school, but is inferior in resources and support system for school nurses in diabetes care. Providing community resources and support system will be an effective strategy to improve diabetes care for school children.