Public school students with diabetes could inject themselves with insulin and monitor their own blood sugar during school hours if Governor Mitt Romney signs legislation passed this week on Beacon Hill.
The bill seeks to have all public school districts follow a uniform practice for students with diabetes, a potentially life-threatening disease in which blood sugar is too high or too low and needs to be monitored.
The bill, which arrived on Romney's desk on Monday, is under review, said spokeswoman Jodi Charles. The governor has 10 days from the day the bill arrived to sign or veto the measure, called Ashley's Bill, after Ashley Dacanay, a former Seekonk student who did not want to go to the school nurse every time she had to check her blood sugar.
Dacanay's mother, Cynthia Proctor-Dacanay, inspired state Senator Jo Ann Sprague to file the legislation about four years ago for the first time. Yesterday all three cheered the news that the measure had passed the House and was on the governor's desk.
''We've been waiting so long now," said Ashley, now 18 and a nursing student at Rhode Island College. ''It's too late for me, but not for other kids."
Health officials did not know how many children in the state have diabetes. School districts vary in their handling of students with diabetes, said Sally Fogerty, associate commissioner of the state Department of Public Health. Some schools let students carry syringes for insulin and prick their fingers to check their blood sugar. Others require students to visit the school nurse for care. Boston public schools handle diabetes on a case-by-case basis, spokesman Jonathan Palumbo said.
Parents say children must learn to handle diabetes on their own, especially since the children might have a life-threatening situation without an adult present. The bill would let students treat themselves only if their physician certifies in writing that they are able to do so.
If the bill passes, Fogerty said it is doubtful that children would be using needles on the playground. Many use insulin pumps, so that syringes are not always needed. Others are trained to discreetly inject insulin. Students can quietly check their own glucose levels by pricking their fingers for blood and pressing it against a meter small enough to fit in a backpack.
''Kids just won't be taking out a needle and using it," Fogerty said. ''It will all be done in a thoughtful way."
Nationally, about 206,000 people under age 20, less than 1 percent of that age group, have diabetes, according to a 2002 survey, the most recent available from the National Institute of Diabetes and Digestive and Kidney Diseases in Maryland.
Not all diabetics require insulin shots, according to the institute. There are two main kinds of diabetes: Type 1 diabetes, the kind Dacanay has, usually occurs in children and requires insulin shots or a pump and monitoring of blood sugar. Type 2 diabetes, the more common form in adults and children, is often linked to obesity and may not require insulin.
Parents whose children need insulin shots take their children's independence seriously. Many have taught their children early to manage the disease. Like an asthmatic child with an inhaler, diabetics carry their syringes, insulin, and blood-sugar meters everywhere, to birthday parties, the beach, and to school.
''There are parents who teach their children from the moment they can understand that this is how you take care of yourself because I'm not always going to be with you," Proctor-Dacanay said.
''When she was 4 years old she was pricking her own fingers," Proctor-Dacanay said of her daughter.
Moira McCarthy Stanford, past president of the New England chapter of the Juvenile Diabetes Research Foundation, said it is important for parents and schools to work together, because making it easier for children to check blood sugar will probably keep them healthier. When her daughter Lauren was in elementary school, Stanford visited the classroom, talked to students and teachers, and tried to make managing diabetes as normal as possible, she said.
Now 13, Lauren checks her blood sugar four to 10 times a day, often quietly in class. ''That's all it takes," said Stanford, who lives in Plymouth. ''It's just so much more normal to pull out your meter and do it at your desk."
Still, parents said schools should treat students individually. Young children or newly diagnosed diabetics might need the help of a school nurse. Others probably can handle it on their own. ''A kindergartner would need help with blood sugar testing and injections, of course," said Diane Covert of Belmont, whose son Thom, now 21, has diabetes. ''But there are 10-year-olds who do it for themselves."
As one of her last acts in office, Sprague, whose term in office ends next month, sent Romney a letter urging him to sign the bill. ''We were just about to give up hope," she said.