A criança com diabetes mellitus tipo 1: necessidades especiais em ambiente escolar

Abstract

This is an applied, qualitative action research study that aims to enable the implementation of care for children and adolescents with type 1 Diabetes Mellitus (DM1) in municipal schools in Goiânia, through a Technical Note (NT). The methodology involved a literature review (2018–2025) and document analysis of legal and programmatic frameworks (Brazilian Federal Constitution of 1988, Statute of Children and Adolescents, Lucas Law, School Health Program, municipal/state regulations). The findings highlight the absence of specific operational protocols for DM1 in the school environment, recurrent confusion between DM1 and DM2, and relevant social, economic, and ethical impacts—such as family burden (“pancreas mothers”), clinical risk due to hypo/hyperglycemia, and inequalities in access to care. The legislative analysis shows normative paralysis (proposals focused on supplies without clinical routine; municipal veto due to procedural flaws), reinforcing the administrative route. As a product, a structured Technical Note is proposed for adoption by joint Municipal Health Secretariat/Municipal Education Secretariat, encompassing: Individual Care Plan (ICP), Standard Operating Procedures (SOPs) for hypo/hyperglycemia and insulin/sensors/pump, initial and annual training, intersectoral flow with the reference Primary Health Care Unit (UBS), infrastructure requirements, and indicator panel (active ICPs, training coverage, incidents, response time). It is concluded that the sub-legal regulation is legally sound, clinically necessary, and operationally agile to transform already established rights into auditable routines, guaranteeing the safety, inclusion, and school retention of children with type 1 diabetes.