Vol. 7, Issue 2, Decembar 2011.



Anthi Peppa1, Katerina Asonitou1, and DimitraKoutsouki1
1Department of Physical Education and Sport Science, Laboratory of Adapted Physical
 Activity / Developmental and Physical Disorders, University of Athens, Greece

COBISS.BH-ID: 2433304 
UDC: 616.379-008.64:796



FULL TEXT (.pdf) free of charge

Diabetes mellitus is the metabolic disease of disturbed glycemic control and can mainly be divided into two categories: diabetes type 1 (DMT1) which is more common in students and diabetes type 2 (DMT2). Physical exercise has been shown to have various beneficial effects on diabetic patients and therefore it is strongly recommended for diabetic students at school. The work of physical educator in Greek public schools is obstructed by lack of formal educational seminars, required facilities, and information among society as well as phenomena of school phobia and stigmatization. The role of physical educator is encouraging and supporting diabetic students in regularly taking part in school sport activities, monitoring blood glucose levels and recording exercise plan and response to certain activities. Furthermore, from a psychological point of view, physical educator can help diabetic students to develop their special skills, adopt an optimistic attitude, obtaining self-confidence and learn to benefit from physical exercise. Finally, physical educator could be viewed as the coordinator of interactions among doctors, parents, school teachers, non-diabetic students and diabetic students regarding participation of diabetic students in school sport activities and their exercise performance along with achieving a balance on glycaemic levels.


Key words: health – diabetes mellitus; physical activity; physical education; special needs students; teacher responsibility.



Abdel Gawwad, E. S. (2008). Teacher’s Knowledge, Attitudes and Management Practices about Diabetes Care in Riyadh’s Schools. J Egypt Public Health Assoc, 83(3-4), 205–222.

Adolfsson, P., Nilsson, S., & Lindblad, B. (2011). Continuous glucose monitoring system (CGMS) during physical exercise in adolescents with type 1 diabetes. Acta Paediatr.

Aktop, A. (2010). Socioeconomic status, physical fitness, self-concept, attitude toward physical education, and academic achievement of children. Percept Mot Skills, 110(2), 531–546.

Alnasir, F. A., & Skerman, J. H. (2004). Schoolteachers’ knowledge of common health problems in Bahrain. East Mediterr Health J, 10(4-5), 537–546.

Aouadi, R., Khalifa, R., Aouidet, A., Ben Mansour, A., Ben Rayana, M., & Mdini, F. (2011). Aerobic training programs and glycemic control in diabetic children in relation to exercise frequency. J Sports Med Phys Fitness, 51(3), 393–400.

Athanasakis, K., Ollandezos, M., Angeli, A., Gregoriou, A., Geitona, M., & Kyriopoulos, J. (2010). Estimating the direct cost of Type 2 diabetes in Greece: the effects of blood glucose regulation on patient cost. Diabet Med, 27(6), 679–684.

Bekiari, A., Kokaridas, D., & Sakellariou, K. (2006). Associations of students’ self-reports of their teachers’ verbal aggression, intrinsic motivation, and perceptions of reasons for discipline in Greek physical education classes. Psychol Rep, 98(2), 451–461.

Boule, N. G., Haddad, E., Kenny, G. P., Wells, G. A., & Sigal, R. J. (2001). Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA, 286(10), 1218–1227.

Brands, A. M., Biessels, G. J., de Haan, E. H., Kappelle, L. J., & Kessels, R. P. (2005). The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes Care, 28(3), 726–735.

Carlson, S. A., Fulton, J. E., Lee, S. M., Maynard, L. M., Brown, D. R., & Kohl, H. W. (2008). Physical education and academic achievement in elementary school: data from the early childhood longitudinal study. Am J Public Health, 98(4), 721–727.
PMid:18309127    PMCid:2377002

Chipkin, S. R., Klugh, S. A., & Chasan-Taber, L. (2001). Exercise and diabetes. Cardiol Clin, 19(3), 489–505.

Christodoulos, A. D., Douda, H. T., Polykratis, M., & Tokmakidis, S. P. (2006). Attitudes towards exercise and physical activity behaviours in Greek schoolchildren after a year long health education intervention. Br J Sports Med, 40(4), 367–371.
PMid:16556796    PMCid:2586165

Coe, D. P., Pivarnik, J. M., Womack, C. J., Reeves, M. J., & Malina, R. M. (2006). Effect of physical education and activity levels on academic achievement in children. Med Sci Sports Exerc, 38(8), 1515-1519.

Daniels, S. R., Arnett, D. K., Eckel, R. H., Gidding, S. S., Hayman, & L. L., Kumanyika, S. (2005). Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment. Circulation, 111(15), 1999–2012.

De Feo, P., Di Loreto, C., Ranchelli, A., Fatone, C., Gambelunghe, & G., Lucidi, P. (2006). Exercise and diabetes. Acta Biomed, 77 Suppl 1, 14–17.

Deary, I. J., Crawford, J. R., Hepburn, D. A., Langan, S. J., Blackmore, L. M., & Frier, B. M. (1993). Severe hypoglycemia and intelligence in adult patients with insulin-treated diabetes. Diabetes, 42(2), 341–344.

Digelidis, N., & Papaioannou, A. (1999). Age-group differences in intrinsic motivation, goal orientations and perceptions of athletic competence, physical appearance and motivational climate in Greek physical education. Scand J Med Sci Sports, 9(6), 375–380.

Fairclough, S., & Stratton, G. (2005). “Physical education makes you fit and healthy”: Physical education’s contribution to young people’s physical activity levels. Health Educ Res, 20(1), 14–23.

Faro, B. (1995). Students with diabetes: implications of the Diabetes Control and Complications Trial for the school setting. J Sch Nurs, 11(1), 16–21.

Franz, M. J. (1987). Exercise and the management of diabetes mellitus. J Am Diet Assoc, 87(7), 872-880.

Gagliardi, M., Neighbors, M., Spears, C., Byrd, S., & Snarr, J. (1994). Emergencies in the school setting: are public school teachers adequately trained to respond? Prehosp Disaster Med, 9(4), 222–225.

Gallivan, J., & Greenberg, R. (2003). “Helping the student with diabetes succeed”; A new resource for effective diabetes management in school. School Nurse News, 20(4), 44–45.

Gershell, L. (2005). Type 2 diabetes market. Nat Rev Drug Discov, 4(5), 367–368. doi: 10.1038/nrd1723.

Giannini, C., de Giorgis, T., Mohn, A., & Chiarelli, F. (2007). Role of physical exercise in children and adolescents with diabetes mellitus. J Pediatr Endocrinol Metab, 20(2), 173–184.

Gold, A. E., Deary, I. J., & Frier, B. M. (1997). Hypoglycaemia and non-cognitive aspects of psychological function in insulin-dependent (type 1) diabetes mellitus (IDDM). Diabet Med, 14(2), 111–118.<111::AID-DIA309>3.0.CO;2-S<111::AID-DIA309>3.3.CO;2-J

Goodrich, S. W., & McDermott, R. J. (1989). Changing roles and challenges for teachers of students with diabetes. J Sch Health, 59(8), 341–345.

Hasanein, P., & Shahidi, S. (2011). Effects of Hypericum perforatum extract on diabetes-induced learning and memory impairment in rats. Phytother Res, 25(4), 544–549.

Haywood, K. M. (1991). The role of physical education in the development of active lifestyles. Res Q Exerc Sport, 62(2), 151–156.

Hellems, M. A., & Clarke, W. L. (2007). Safe at school: a Virginia experience. Diabetes Care, 30(6), 1396–1398.

Henderson, G. (2005). Standards of care for students with type 1 diabetes: Ensuring safety, health and inclusion in school. Paediatr Child Health, 10(1), 25–27.

von Herrath, M., Sanda, S., & Herold, K. (2007). Type 1 diabetes as a relapsing-remitting disease? Nat Rev Immunol, 7(12), 988–994.

Kadohiro, J. K. (2009). What it means to be an adolescent with diabetes. School Nurse News, 26(3), 25–29.

Kalyva, E., Malakonaki, E., Eiser, C., & Mamoulakis, D. (2011). Health-related quality of life (HRQoL) of children with type 1 diabetes mellitus (T1DM): self and parental perceptions. Pediatr Diabetes, 12(1), 34-40.

Kanioglou, A. (2008). Achievement in physical education and self-concept of Greek students in grades 5 and 6. Percept Mot Skills, 107(1), 65–69.

Kaufman, F. R. (2002). Type 2 diabetes mellitus in children and youth: a new epidemic. J Pediatr Endocrinol Metab, 15 Suppl 2, 737–744.

Kollipara, S., & Warren-Boulton, E. (2004). Diabetes and physical activity in school. School Nurse News, 21(3), 12–16.

Koutedakis, Y., & Bouziotas, C. (2003). National physical education curriculum: motor and cardiovascular health related fitness in Greek adolescents. Br J Sports Med, 37(4), 311–314.
PMid:12893715    PMCid:1724688

Le Heuzey, M. F. (2008). School phobia or school refusal?. Rev Prat, 58(7), 741–744.

Lionis, C., & Papathanasiou, A. (2008). Primary care diabetes in Greece. Prim Care Diabetes, 2(2), 97–99.

Ma, R. C., & Chan, J. C. (2009). Diabetes: incidence of childhood type 1 diabetes: a worrying trend. Nat Rev Endocrinol, 5(10), 529–530.

Maiorana, A., O’Driscoll, G., Cheetham, C., Dembo, L., Stanton, K., & Goodman, C. (2001). The effect of combined aerobic and resistance exercise training on vascular function in type 2 diabetes. J Am Coll Cardiol, 38(3), 860–866.

Marschilok, C. (2008). Diabetes care in school: prepare for the unexpected. School Nurse News, 25(5), 39–40.

McCarthy, A. M., Lindgren, S., Mengeling, M. A., Tsalikian, E., & Engvall, J. C. (2002). Effects of diabetes on learning in children. Pediatrics, 109(1), E9.

Nakamura, M., Kanematsu, Y., Yokota, M., Takeda, J., Nakamura, N., & Maru, M. (1997). Social support of chronically-ill children and healthy children. Nihon Kango Kagakkaishi, 17(1), 40–47.

Nichols, P. J., & Norris, S. L. (2002). A systematic literature review of the effectiveness of diabetes education of school personnel. Diabetes Educ, 28(3), 405–414.

Nimsgern, A., & Camponeschi, J. (2005). Implementing a new diabetes resource for Wisconsin schools and families. Prev Chronic Dis, 2 Spec no, A11.

Ohki, Y., Kishi, M., Orimo, H., & Ohkawa, T. (2004). The factors affecting glycemic control in Japanese adolescents with type 2 diabetes mellitus. J Nihon Med Sch, 71(3), 156–159.

Olympia, R. P., Wan, E., & Avner, J. R. (2005). The preparedness of schools to respond to emergencies in children: a national survey of school nurses. Pediatrics, 116(6), e738–745.

Owens-Gary, M. D., Shea, L., & Lewis, S. (2010). Helping students cope with diabetes: the role of the school nurse. School Nurse News, 27(4), 29–30.

Papadaki, A., Linardakis, M., Codrington, C., & Kafatos, A. (2008). Nutritional intake of children and adolescents with insulin-dependent diabetes mellitus in crete, Greece. A case-control study. Ann Nutr Metab, 52(4), 308–314.

Parent, K. B., Wodrich, D. L., & Hasan, K. S. (2009). Type 1 diabetes mellitus and school: a comparison of patients and healthy siblings. Pediatr Diabetes, 10(8), 554–562.

Pathogenesis and management of human diabetes mellitus. Workshop at the 23rd Annual Meeting of the European Society for Clinical Investigation. 1989, Athens, Greece. (1992). Horm Metab Res Suppl, 26, 1–151.

Peterson, K., Silverstein, J., Kaufman, F., & Warren-Boulton, E. (2007). Management of type 2 diabetes in youth: an update. Am Fam Physician, 76(5), 658–664.

Rheault, W., & Shafernich-Coulson, E. (1988). Relationship between academic achievement and clinical performance in a physical therapy education program. Phys Ther, 68(3), 378–380.

Robertson, K., Adolfsson, P., Scheiner, G., Hanas, R., & Riddell, M. C. (2009). Exercise in children and adolescents with diabetes. Pediatr Diabetes, 10 Suppl 12, 154–168.

Ryan, C. M., & Williams, T. M. (1993). Effects of insulin-dependent diabetes on learning and memory efficiency in adults. J Clin Exp Neuropsychol, 15(5), 685–700.

Sachon, C., Grimaldi, A., Digy, J. P., Pillon, B., Dubois, B., & Thervet, F. (1992). Cognitive function, insulin-dependent diabetes and hypoglycaemia. J Intern Med, 231(5), 471–475.

Sallis, J. F., McKenzie, T. L., Kolody, B., Lewis, M., Marshall, S., & Rosengard, P. (1999). Effects of health-related physical education on academic achievement: project SPARK. Res Q Exerc Sport, 70(2), 127–134.

Silverman, S., Devillier, R., & Ramirez, T. (1991). The validity of academic learning time-physical education (ALT-PE) as a process measure of achievement. Res Q Exerc Sport, 62(3), 319–325.

Students with chronic illnesses: guidance for families, schools, and students. (2003). J Sch Health, 73(4), 131–132.

Tahirovic, H., & Toromanovic, A. (2006). How much can school staff help children with diabetes type 1 in school?. Med Arh, 60(4), 222–224.

Tahirovic, H., & Toromanovic, A. (2007). How far are physical education teachers from elementary school prepared to help pupils with diabetes while they are at school? Minerva Pediatr, 59(6), 767–773.

Telford, R. D., Cunningham, R. B., Fitzgerald, R., Olive, L. S., Prosser, L., & Jiang, X. (2011). Physical Education, Obesity, and Academic Achievement: A 2-Year Longitudinal Investigation of Australian Elementary School Children. Am J Public Health.

Wagner, J., Heapy, A., James, A., & Abbott, G. (2006). Brief report: glycemic control, quality of life, and school experiences among students with diabetes. J Pediatr Psychol, 31(8), 764–769.

Wagner, J., & James, A. (2006). A pilot study of school counselor’s preparedness to serve students with diabetes: relationship to self-reported diabetes training. J Sch Health, 76(7), 387–392.

Wallberg-Henriksson, H., Rincon, J., & Zierath, J. R. (1998). Exercise in the management of non-insulin-dependent diabetes mellitus. Sports Med, 25(1), 25–3