The Role of School Nurses in Early Diabetes Detection: Shara Bialo, MD

In recognition of National School Nurse Day on May 6, 2026, Shara Bialo, MD, senior medical director, Sanofi, discusses the unique position school nurses play in early diabetes detection in a student’s life.

School nurses are often able to notice subtle, progressive changes in a child’s health. These can include increased thirst, frequent urination, fatigue, stomach pain, and more frequent visits to the nurse’s office. Although these symptoms may appear minor in isolation, school nurses who see children regularly can detect meaningful patterns over time and prompt families to seek further evaluation before a crisis occurs, explained Bialo.

Bialo outlined the 3 stages of type 1 diabetes. In stage 1, children have at least 2 diabetes autoantibodies, normal blood glucose, and no symptoms. In stage 2, blood sugars become mildly abnormal, but symptoms may still be minimal or absent. By stage 3, more obvious clinical signs emerge, including those often first noticed in the school setting. A simple blood test to detect diabetes autoantibodies can identify children in the earliest stages, long before they present to medical care in diabetic ketoacidosis or with severe illness.

However, school nurses do not need to manage the full clinical workup or treatment plan themselves. Instead, their primary power lies in awareness, pattern recognition, and communication—especially in children with a family history of type 1 diabetes, who face up to a 15-fold increased risk if they have an affected first-degree relative. By recognizing risk, sharing information about autoantibody testing, and encouraging families to speak with their physicians, school nurses can help drive earlier diagnosis, safer care, and a better overall disease experience for children living with or at risk for type 1 diabetes.