Diabetes care in schools  
This survey was developed to assess the experience of families with children and adolescents with type 1 diabetes and their care during the school period. It was translated into different languages and will be shared in various parts of the world, identifying the barriers to diabetes care during the school period in different countries and guiding the measures that can be taken to improve school diabetes care globally. We kindly ask for you not to respond to the survey twice (if you already completed it successfully once, please do not do it again). If you have more than one child with diabetes and want to share your impressions separately, please do so. The responses are confidential and will be used for research proposal only.
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ELECTRONIC CONSENT:

Please select your choice below. Clicking on the "agree" button below indicates that:

• you have read the above information

• you voluntarily agree to participate

• you are at least 18 years of age

If you do not wish to participate in the research study, please decline participation by clicking on the "disagree" button.

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What country do you live in? *
Which State ? *
Which City ? *
ZIP Code 
(not mandatory)

What is your relationship with the child with diabetes?

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Child age today (in years) *
Child age at diabetes diagnosis (in years) *
If less than 1 year old, please write months

Which of the following best represents how you think of your child

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School year *
The school is *

Do you know if there are other children/adolescents with Type 1 Diabetes in the same school?

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Has the child ever changed schools because of diabetes care?

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Have you (or any other caregiver in your family) quit working or reduced working hours because of diabetes care? 

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Do you believe the child has some difficulty in school due to diabetes (isolated, excluded, stigmatized, bullied)?

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Does the child measure sugar levels at school ? *
If the child doesn´t measure sugar levels - why not ?
If your previous answer was YES, you can skip this question
Clear selection
If the child measure sugar levels at school, how is it done ?
If your previous answer was NO, you can skip this question
Without supervision
With supervision
Done by a school personnel
Done by a family member
Blood test /Finger stick
Glucose sensor
Clear selection
Does the child administer insulin at school ? *
If the child doesn´t administer insulin at school - why not ?
If your previous answer was YES, you can skip this question
Clear selection
How does the child administer insulin at school ?
If your previous answer was NO, you can skip this question
Without supervision
With supervision
Done by a school personnel
Done by a family member
Syringe
Pen
Insulin Pump
Clear selection

Is insulin prescription different in school from what´s done at home? (for example – at home you use carbohydrate count but at school you use a fixed dose or sliding scale)

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How is insulin prescribed for the school meal? 

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Do you use a different insulin dose in school to avoid hypoglycemias (low blood sugar)?

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Does your child participate in extracurricular activities like sports, clubs or excursions?

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Has the child ever had hypoglycemia at school that required someone else's help to improve and recover?

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Does the school have a written action plan for the treatment of hypoglycemia?

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Do you consider the school dietary resources suitable for the child´s needs (in terms of diabetes)?

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Required

Does the diabetes center taking care of the child offer a training course for school staff personnel?

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Are there one or more school staff members responsible for your child’s diabetes care during school time?
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How often is the child kept at home on school days for fear of not having proper care for diabetes at school?

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Are you satisfied with the school’s support for the child (in terms of diabetes)?

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Has the child ever experienced discriminatory behavior from the school staff regarding diabetes?
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If a school employee (not a health professional) was trained to assist the child’s diabetes care during the school period, would you accept this help? *
Are there additional staff resources in school because of the child´s diabetes (a nurse, for example)? 
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Is there a suitable place for the child to measure glucose levels and/or inject insulin at school, if needed? 

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Is there a suitable place to store insulin and diabetes management supplies (including glucagon) at school?

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How do you feel about the knowledge of school staff about diabetes?
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Required

Do you have a written Diabetes Management Plan to share with the school?

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Do you maintain frequent contact with the school concerning diabetes care? 

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Required
How do you communicate with the school? 
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Required
Is there any thoughts, suggestions or experiences you would like to share (feel comfortable to do it, this questionnaire is anonymous)
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