
April 27, 2008
Other
Question from Pittsford, New York, USA:
My daughter was diagnosed with type 1 six years ago at age 14. Before her diagnosis, she had all the classic signs and had lost weight quickly, down to 104 pounds at 5 feet, 10 inches. The day before we went to the hospital she saw our family doctor and he wasn’t extremely concerned, saying “have some blood work done when you have a chance.”
I now go into health classes every semester at the high school and talk about our experiences with type 1. There are always students who want to know what their fasting blood sugar is, most with type 2 running through the family. Why can’t the school nurse give the students the opportunity to do, for themselves, a fasting blood sugar check once a semester? Legally, could I offer the students an opportunity to check, with sterile sharps, of course, when I am there? Why isn’t this standard procedure, like height and weight checks, in the doctor’s office? I wouldn’t presume to “diagnosis” anyone, just to let them know it may be time for a general checkup.
Answer:
As a non-employee but a volunteer in the school system, it’s terrific that you discuss diabetes with the kids. But, I would not want you to check anyone’s blood glucose levels, only to suggest who is at risk and to empower and encourage them to get this done through their own physician’s offices. Of course, anyone with symptoms should be checked urgently (by a health professional). Anyone with signs of type 2 diabetes or strong family history, also should discus this in some detail with their health care providers. It would be very appropriate for you to advise about what these signs and symptoms are – especially if you are also talking about the obesity epidemic and type 2 diabetes in America as well as around the world: excess weight, high blood pressure, menstrual irregularity, hirsutism, acanthosis nigricans. Checking lipid levels would be important as well. Referring them to our web site, as well as those of the ADA, JDRF and dLife web sites are also good resources and recommendations.
SB
Additional comments from Dr. David Schwartz:
I do not know the complete answer to your questions, but I imagine the following. School is for teaching and imparting a curriculum of sorts to young people. It is not a one-stop shopping for all of society. Yes, the school “health classes” and biology classes may teach about diabetes, I suppose, but doing an invasive intervention (no matter how trivial it seems – like a fingerstick glucose) is not in the school’s purview.
On the other hand, often there are free health fairs sponsored by local hospitals or the health department or places of worship. You could put your energies there.
DS
Additional comments from Dr. Larry Deeb:
In most states, it requires a license to do what you just said. Testing yourself, your child, etc. is just fine, but others is practicing medicine, nursing, etc. Do not do it.
LD