Are children and adolescents with type 1 diabetes in Saudi Arabia safe at school?

Objectives: To examined the safety of schools, availability of school personnel to help in diabetes management, glycemic control, absenteeism, and differences in diabetes care between public and private schools. Methods: This cross-sectional study used an online platform to circulate surveys to parents of children with type 1 diabetes mellitus (T1DM) attending school or kindergarten in all regions of Saudi Arabia from February to May 2019. Results: The 411 questionnaires received were completed mostly by mothers (80.8%). Limited trained staff were found to be responsible for management of diabetes at school, and parents had relatively poor perceptions regarding the care of children with diabetes at school. Glucagon availability, trained staff, possibility of contacting a treating physician during school hours, a written plan for diabetes, and parents' confidence in schools all scored low and were significantly related to school type. Hemoglobin A1c (HbA1c) level was significantly related to insulin regimen. Conclusion: Parents had poor perceptions regarding diabetes care at school. There was no or very limited availability of glucagon kits and trained staff for management of children with T1DM. This study suggests a need to improve the management of diabetes at schools.