EUGENE, Ore. (AP) — For the past two years, Tanner Underwood has carried two backpacks to school — one with his books and binders inside and one with his diabetic supplies.
The 11-year-old, who is a sixth-grader at Shasta Middle School in west Eugene's Bethel School District this year, takes alcohol swabs, a glucagon shot, glucose tablets, batteries and other supplies to school every day.
Tanner keeps a pump in his pocket that delivers insulin to his body through a needle inserted into his stomach to stabilize his blood sugar.
Tanner has Type 1 diabetes, formerly called juvenile diabetes. His pancreas does not make insulin, a hormone needed to convert sugar and other food into energy. He has to check his blood sugar levels before he gets on the school bus and before he eats a meal or a snack.
Students have asked Tanner whether they could catch whatever it was that required him to carry the insulin pump and additional backpack.
"That really hurt his feelings," said his mother, Jennifer Underwood.
Tanner is among a growing number of students in Eugene-Springfield area schools who have been diagnosed with type 1 diabetes.
A study last year funded by the Centers for Disease Control and Prevention and the National Institutes of Health found that the number of children with type 1 diabetes increased 23 percent nationwide in the past decade. The increase in children with type 2 diabetes was 21 percent.
Researchers aren't sure why more children are being diagnosed with type 1 diabetes.
The influx of diabetic students has strained local schools' already limited nursing staff, which has to spend hours to train teachers, principals and secretaries how to handle diabetic students.
Parents such as Underwood also are concerned that their children feel different from their peers when they're asked to go to the nurse's office or step outside the classroom to check their blood sugar levels. For students who are too young to inject themselves with insulin, parents worry that they may be incorrectly dosed.
Unlike type 2 diabetes — which is largely tied to obesity — type 1 diabetes may be caused by a number of factors, such as genetics or if a child is not exposed to viruses and bacteria that help the immune system mature.
Each year, more than 13,000 children are diagnosed with type 1 diabetes nationally. About 151,000 people age 19 or younger have type 1 or type 2 diabetes, making it among the most common chronic disease in children, according to the CDC.
The disease can lead to other health problems, such as heart and kidney disease.
Neither Lane County, the state Department of Education or Oregon Health Authority directly tracks how many children have type 1 diabetes, but individual districts do.
The Bethel School District has 14 students with type 1 diabetes out of the district's 5,700 students. The number of diabetic students has more than doubled in the past five years, district nurse Sherine Forrest said. The district has six students with type 2 diabetes this year, she said.
In Springfield — a district of about 11,000 students — the number of students with type 1 diabetes has doubled in the past five years, to 26, district spokeswoman Devon Ashbridge said. The district has just one student with type 2 diabetes.
The Eugene School District reported that 42 students have type 1 diabetes this year and just two students have type 2, said Maxine Proskurowski, program manager for health services.
For the past five years, the district of about 16,000 students has had about 40 students with diabetes. Before that, Proskurowski said, the district had only four diabetic students. Even some kindergartners now have the disease.
"It's strained (the nurses) to almost beyond capacity," Proskurowski said. "Each diabetic that comes in needs about 40 hours of nurse time to write a care plan, to discuss the doctor's orders with the family, and to talk with staff, secretaries and assistants who are not used to working with diabetic children."
The district has the equivalent of about nine full-time nurses who each provide services to four to five schools, Proskurowski said. That's about one full-time and halftime nurse more than last school year.
Nurses set up times to talk every day with teachers and principals who have diabetic students in their schools, she said. Once the nurse thinks the school staff is capable, nurses will check in with the staff less frequently.
The nurses especially focus on care for younger students, Proskurowski said. Once students reach middle and high school, she said, they are fairly self-sufficient.
At Shasta Middle School, Tanner checks his levels in the back of the classroom, but can't eat lunch with his friends. His school's lunchtime is at 10:50 a.m. — usually just two hours after he has eaten breakfast, instead of the minimum three hours he must observe before he can eat again. He sits with his friends during lunchtime, but has to eat his lunch in the back of his classroom around noon, while his peers are working.
"It was uncomfortable at first," Tanner said. But since the beginning of the school year, he said he has gotten used to it.
Underwood hopes to transfer Tanner to the Willamette Leadership Academy charter school in Springfield next week, largely because Shasta's lunch schedule doesn't work well with her son.
Dana Tessler started a group about four years ago to help parents who have kids with type 1 diabetes in the Eugene School District. Tessler's 18-year-old daughter, Elliana, was first diagnosed with diabetes when she was 11. Tessler said she felt isolated when Elliana — who graduated from South Eugene High School last year — was first diagnosed because she didn't know other parents who also had diabetic children.
"I just really found this void in dealing with all this stuff and people not understanding," she said. "It's a disease that many people don't understand."
Tessler said she has had to tell teachers that when Elliana's blood sugar levels get too low or too high, she can't take a test or continue working on an assignment because she is unable to think and see clearly. Sometimes, it takes children 30 minutes or several hours to recover, Tessler said.
She said she feels lucky that Elliana went to school with an accommodating staff.
Other parents haven't been as fortunate, she said.
Some have told her that they have trouble working with teachers to reschedule tests if a student wasn't able to complete the test after having low or high blood sugar, she said.
"There's a lot of frustration (among parents)," she said. Parents with diabetic children have to constantly be near their cellphones, or otherwise be available, she said.
The type 1 parent group meets monthly and will hold its first meeting of the new school year today, she said.
In elementary school, Underwood's son used to go to the nurse's office to check his blood sugar levels.
Now, he has learned to be "quick and discreet" when checking his levels in the back of the classroom, Underwood said.
"When he was pulled from the classroom and had to walk with a buddy to the office, that made him feel more distant from his classmates and made him feel like an outsider," she said. "As a parent, you just want your kid to fit in and not have problems in school."
Information from: The Register-Guard, http://www.registerguard.com