Unzureichende Versorgung gefährdet Inklusion von Kindern mit Diabetes mellitus Typ 1

Background inclusion of children with type 1 diabetes in kindergarten and school needs the implementation of insulin management in these institution. Children below the age of 12 years need age related support therefore. Methods We conducted an online questionnaire of parents of children with type 1 diabetes that go to kindergarten or school regarding care in this institutions, participation support, participation restrictions and consequences on parental employment. Results We could analyze data on 1189 participants from all over Germany. Children visited in 32.1% kindergarten in 48.8% primary school and in 19.8% secondary school. To secure care for these children a support by individualized participation helpers or ambulatory nursing services was organized in many cases. Not all requested services were supported by the insurance companies or social welfare offices. Children with diabetes could not always take part in kindergarten (14.6%) or school trips (up to 23.6%). A reduction of working time to bridge the care gaps was reported by 53.1-72.3% of parents. In up to 27% one parent had to give up the job totally. Almost twice as often (8.1% in primary school) children with diabetes do not attend a regular school. Conclusions Children with diabetes more frequently do not visit a regular school or are excluded from outside school/kindergarten activities due to insufficient diabetes management care. More than half of the parents have to reduce their working time. To implement the right of unrestricted participation in the view of the authors supplementary institutional inclusion personnel is mandatory.