Children's and parents' use of diabetes technologies in the primary school environment: a scoping review.

Abstract

Objective: This scoping review aimed to map the evidence on the use of diabetes technologies by primary school children (aged 6 to 12 years) with type 1 diabetes and their parents in primary school settings. Specifically, it aimed to identify the types of technologies used, who is responsible for managing and supporting their use, and the benefits and challenges associated with their use during the school day.

Introduction: Technological advances in diabetes care have revolutionized the management of diabetes, but their integration into school settings introduces new challenges for children, parents, and school staff. Evidence about their use during the primary school day remains fragmented.

Eligibility criteria: Qualitative, quantitative, and mixed methods studies, as well as systematic reviews, that included children aged 6 to 12 years or their parents and focused on the use of diabetes technologies in the primary school environment were eligible for inclusion. Gray literature was also considered.

Methods: A search for relevant records was conducted in April 2025 across CINAHL Ultimate (EBSCOhost), Embase (Embase.com), MEDLINE (EBSCOhost), Web of Science Core Collection, and Google Scholar. Gray and unpublished literature were searched in ProQuest Dissertations and Theses Global and Google Scholar. Two reviewers independently screened titles, and abstracts, and full-text sources. The findings are presented in tables, accompanied by a basic content analysis and a descriptive narrative summary based on the review questions.

Results: Twenty-three studies were included in this review: 15 qualitative studies, 4 quantitative studies, and 4 mixed methods studies. Studies were conducted in multiple countries, including the United Kingdom, the United States, Australia, New Zealand, Denmark, Canada, Poland, Belgium, and Turkey. There were also 2 multicountry sources. Publication years ranged from 2004 to 2025. Results from child and parent reports showed that continuous subcutaneous insulin infusion devices, continuous glucose monitoring, flash glucose monitoring, and hybrid closed-loop systems are being used by children in the primary school environment. These technologies are managed during the school day through a collaborative approach, involving the children, their parents, and various school personnel. The benefits of using diabetes technology in the primary school environment were identified across 4 main categories: i) improved school participation, academic engagement, and social-emotional well-being; ii) increased independence, confidence, and self-management; iii) enhanced safety and monitoring; and iv) reduced burden on parents and school staff. The challenges were identified across 4 categories: i) device-related challenges; ii) social stigma and peer interaction ; iii) school personnel competency and training; and iv) parental stress and family.

Conclusions: This scoping review offers insights into the use of diabetes technology during the primary school day from the perspectives of children and their parents. It highlights that diabetes technology can support children's inclusion, autonomy, and confidence during school. It also highlights the need for structured training for school personnel, clear role delineation, and supportive school policies to ensure the safe and sustainable use of technology.

Review registration: OSF https://osf.io/fhw3x.