Association between knowledge, hypoglycemia management, and attitudes of school and preschool staff toward the care of children with type 1 diabetes: a cross-sectional study

Type 1 diabetes in children requires continuous support in preschool and school settings, where staff knowledge and attitudes are important for safe diabetes care. This study aimed to investigate the association between diabetes knowledge, hypoglycemia management, and attitudes toward care of children with type 1 diabetes. This cross-sectional study included 618 Croatian preschool and school staff. The Inventory of Negative Attitudes Toward the Care of Students with Diabetes Mellitus Type 1, the Hypoglycemia Management Scale for Teachers, and the Diabetes Knowledge Questionnaire were used. Group differences were examined using the Mann-Whitney U and Kruskal-Wallis tests. Multivariable linear regression models assessed associations between variables. Preschool teachers showed the lowest diabetes knowledge ( p < 0.001) and hypoglycemia management preparedness ( p = 0.004), while subject teachers showed the highest negative attitudes toward children with diabetes ( p = 0.034). Higher diabetes knowledge was associated with better hypoglycemia management (β = 0.59; p < 0.001). Negative attitudes were associated with lower diabetes knowledge (β=−0.13; p = 0.022) and poorer hypoglycemia management (β=−0.21; p < 0.001). Diabetes education was associated with better hypoglycemia management (β = 0.16; p < 0.001) and less negative attitudes (β=−0.14; p = 0.001). Structured diabetes education for preschool and school staff may improve diabetes knowledge, hypoglycemia management, and care for children with type 1 diabetes.