Il mio articolo prende spunto da quanto accaduto in una scuola di Lecce nel 2018 in cui un bambino di 9 anni, diabetico insulino-dipendente, è stato allontanato dalla scuola e riammesso solo, dopo qualche giorno, in presenza della madre, in quanto la scuola si riteneva impreparata a gestire questa specifica patologia. 

Il diabete di tipo 1, malattia non contagiosa, è il risultato della mancanza di produzione dell’insulina, ormone ipoglicemizzante, da parte del pancreas. Tale carenza va colmata con una terapia insulinica, basata sulla somministrazione della stessa attraverso iniezioni sottocutanee, e nel controllo dell’alimentazione che deve essere povera di grassi e di zuccheri. 

Uno studente affetto da diabete, nell’arco dell’orario scolastico, può aver bisogno di misurare il proprio livello di glicemia, così come di praticarsi una iniezione di insulina: sarebbe preferibile che, in questi momenti, potesse avere accesso ad un locale igienicamente sicuro in cui trovare la sua privacy. Inoltre il personale docente deve tener conto della necessità dello studente di recarsi spesso in bagno e di avere, sempre a portata di mano, alimenti o bevande per contrastare l’insorgere dell’ipoglicemia. 

L’ipoglicemia insorge nel momento in cui il livello degli zuccheri si abbassa notevolmente, ad esempio a seguito di esercizio fisico. In tal caso l’organismo emette dei “campanelli di allarme”: tremore, pallore, sudorazione, offuscamento della vista, sonnolenza, fame, mal di testa, vertigini, difficoltà di concentrazione, nausea, pianto, irritabilità e dolori addominali. Tali segnali, se riconosciuti immediatamente, possono far adottare, da chi è presente, dei provvedimenti adeguati a gestire tale situazione di emergenza che porterebbe, altrimenti, a conseguenze importanti come la perdita di conoscenza, stati confusionali o convulsivi. 

In caso di crisi ipoglicemica vanno reintegrati gli zuccheri attraverso la somministrazione di acqua e zucchero o un cucchiaino di zucchero (in alternativa andrebbero bene Coca Cola, aranciata o succhi di frutta) da ripetere nel caso non si sortisca effetto immediato entro qualche minuto. Qualora, anche ripetendo la somministrazione, non ci fossero miglioramenti si dovrebbe far praticare, da personale medico, una iniezione intramuscolare di glucagone, ovvero un ormone che alza in modo rapido il livello della glicemia: è chiaro che raramente è disponibile un presidio medico nella scuola oppure nelle strette vicinanze per cui è importante chiamare l’ambulanza in modo tempestivo. 

Va tenuto presente, comunque, che l’avanzare della tecnologia ha reso più gestibile il controllo della malattia con la creazione del microinfusore o pompa di insulina che permette il diffondersi dell’insulina direttamente sottocute, secondo uno schema prefissato, rendendo inutili le iniezioni. Il microinfusore ha le dimensioni di un cellulare ed è abbastanza resistente anche se la cannula di collegamento tra il microinfusore e il sottocute potrebbe staccarsi o occludersi a seguito di movimenti vari e, quindi, lo studente dovrebbe sostituirla. Non è raro anche l’uso di una sorta di cerotti, denominati “sensori in continuo”, che misurano, ad intervalli regolari, la glicemia inviando segnali ad un ricevitore. 

A livello didattico lo studente con diabete non ha alcun tipo di bisogno educativo speciale in quanto ha le stesse probabilità di successo/insuccesso dei suoi coetanei e, quindi, non va trattato in modo diverso. 

A livello sociale, invece, nella prima età scolare, generalmente, il diabete non rappresenta un ostacolo sociale, mentre verso la fine della scuola primaria e nelle scuole secondarie potrebbe diventarlo. Molti studenti sono preoccupati dal fatto che il diabete possa renderli diversi e, quindi, se gli insegnanti non sono preparati a lavorare su questo aspetto, il rischio di isolamento, già comuni in quella particolare fascia di età, potrebbero assumere connotazioni eccessive. 

Il consiglio che mi sento di dare ai genitori di questi studenti è di tenere sempre un filo diretto con la scuola, di fornire, già al momento dell’iscrizione, tutta la documentazione medica a supporto e tutti i riferimenti necessari a gestire una eventuale emergenza. 

Da parte della scuola è necessario che conosca tutti i riferimenti normativi in vigore in questa materia, che fornisca ai genitori il POF con tutte le attività previste (uscite, alimentazione) e che tenga sempre presenti le indicazioni fornite dalle strutture mediche. 

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