Knowledge about the symptoms of hypoglycemia and its risk among primary school teachers in Riyadh, Saudi Arabia

Background: Hypoglycemia is one of the most common acute complications of the treatment of type 1 diabetes. As children spent major part of their daytime at school, the role of school personnel in recognizing and managing diabetic emergencies such as hypoglycemia is very critical for children safety at school. Objective: To assess the level of knowledge about hypoglycemia and its management among teachers of boys’ primary schools in Riyadh. Additionally, evaluate the experience with hypoglycemia recognition and management among them. Methods: Observational cross-sectional study was conducted between January and December 2020 among primary school teachers. Approximately 20 teachers were conveniently recruited from each school. The schools were randomly selected to represent the five geographic regions of Riyadh. Administrative and other auxiliary school employees were excluded. The data were collected using a structured study questionnaire. This included data on socio-demographic characteristics of teachers, knowledge questions about hypoglycemia, previous experience with hypoglycemia, and related health education and training received. Results: A total 404 teachers were included in this analysis. All teachers were Saudi males and the majority (68.1%) of teachers were above the age of 30 years. The majority (64.4%) of teachers had more than 10 years of working experience. The mean knowledge score about hypoglycemia among the study teachers was 77.2%. The majority of teachers were aware that low blood sugar is dangerous (99.0%), need immediate care (99.8%), may be caused by increased dose of treatment (89.1%), and can lead to serious complications including death (77.2%). Only 21.0% of teachers were aware of the first aid measures for low blood sugar. More than half (54.2%) of the teachers have seen a colleague who suffered from low blood sugar. Only 22.6% the teachers who have seen a colleague who suffered from low blood sugar were able to help; by calling emergency (52.6%) or giving him candy (43.9%). Approximately 71% of the teachers have been provided with health education about low blood sugar. However, the majority (89.1%) of teachers believed they need training to deal with low blood sugar conditions. The preferred methods of such training included workshops (48.6%), lectures (36.7%), brochures (12.8%), and mobile messages (1.9%). There was significantly higher knowledge score among teachers who have been provided with health education about low blood sugar. There were no significant associations between knowledge score and socio-demographic characteristics of teachers. Conclusions: We are reporting fair knowledge about hypoglycemia but limited knowledge and skills to manage it among primary school teachers. There is urgent need for diabetes related educational programs targeting teachers working in primary schools to improve their knowledge and confidence in dealing with diabetic emergencies such as hypoglycemia.