P-69: WHO manages type 1 diabetes at school in Mexico? families bear the burden
M E Sainz de la Maza Viadero, E Picasso Rivera, A Miranda Lora, B E MarksAbstract
Introduction
Access to safe, inclusive education is a fundamental right for all children regardless of where they live. Although Mexican law protects these rights, children with type 1 diabetes (T1D) continue to have many unmet needs. We aimed to identify the impact of gaps in school-based T1D care on families.
Objectives
To identify the impact of gaps in school-based T1D care on families.
Methods
This qualitative study is part of a broader research protocol (ESCUELA T1D) seeking to adapt existing diabetes management plans for use in Mexico. Five semi-structured focus groups were conducted with key stakeholders involved in the care of children attending primary school. All sessions were conducted in Spanish and were audio-recorded, transcribed (median duration:100min), and double-coded by two independent coders. Modified inductive coding was used for thematic analysis. Thematic saturation was achieved.
Results
Focus group participants included: parents (n=12; Female=100%, Agechild=9.5yrs, range:7-12yrs, 50% public school), teachers (n=7), school health personnel (n=7), and pediatric endocrinologists (n=7). Three themes emerged (Fig.1): Theme 1: Although some private schools provide medical personnel, many families are forced to provide T1D care during the school day. Theme 2: Fear of liability, lack of training, and misconceptions about T1D management creates mistrust of school personnel among families Theme 3: Inadequate support in the school environment limit opportunities for children with T1D to fully participate in school life.
Conclusions
Inadequate T1D care in the school environment creates a hidden burden affecting economic stability, educational access, and overall health. Developing structured T1D management plans and training programs has the potential to support equitable, inclusive care in Mexico.