Given the increase in the numbers of children who are at risk for, or who have been diagnosed with, diabetes, school personnel must work as a team to effectively manage and support those children in school-based settings. Understanding the diabetic condition, developing an individualized healthcare plan that addresses the medical and academic needs of children, and working as a team to minimize schoolrelated factors that are shown to constrain a child's education potential are all essential elements of diabetes management in school. Such strategies ensure the healthy academic, physical, and social/emotional development of children with diabetes. In this article the authors advocate for school personnel to work as a team to construct a diabetes-management plan that addresses the individual physical, psychological, and educational needs of students with diabetes.A child with diabetes in the classroom can pose various challenges for the classroom teacher. The teacher needs to be alert to the child's blood-sugar fluctuations, which sometimes cause such responses as increased thirst, increased urination, constant hunger, confusion, inattention, blurred vision, headache, and fatigue (NIH, 2003;Rosenthal-Malek & Greenspan, 1999). These symptoms may affect the child's participation in the classroom activities. Children with diabetes sometimes experience more learning problems than their peers (Holmes, Dunlap, Chen, & Cornwell, 1992;Sandberg & Barrick, 1995), with reading and spelling appearing to be more affected than arithmetic (Sandberg & Barrick). Multiple hospital admissions that increase the child's number of missed school days may have a further impact on his or her school performance (Thies, 1999). These challenges to learning may affect the child's overall achievement and school success.
Definition and Prevalence DataDiabetes is a chronic metabolic disorder that results from failure of the pancreas to produce insulin (Type 1) or from insulin resistance with inadequate insulin secretion to sustain normal metabolism (Type 2; American Diabetes Association, 2003; Centers for Disease Control, 2002). Insulin is a hormone that regulates metabolism. Type 1 diabetes occurs more often in children and young adults than any other age group. An estimated 18.2 million Americans have diabetes (National Institutes of Health, 2004), and diagnosed cases of diabetes increased 49% from 1990 to 2000 (Centers for Disease Control). According to the Juvenile Diabetes Research Foundation International (JDRFI), each day 35 children are diagnosed with Type 1 diabetes (JDRFI, 46 ■ COUNCIL FOR EXCEPTIONAL CHILDREN
