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SACRAMENTO, Calif. — A Sacramento Superior Court ruling Friday marks a major shift in the treatment of nearly 14,000 California schoolchildren with diabetes.

Judge Lloyd Connelly sided with the California School Nurses Organization, the American Nurses Association, the California Nurses Association and other nursing groups in their challenge to a 2007 rule that enabled trained school staff not just school nurses to administer insulin shots to diabetic kids.

"This is a big setback," said Jim Stone, who has a 12-year-old diabetic son and has fought, with other parents, to expand the number of people who can administer insulin to diabetic children in public schools.

There are 2,800 nurses in the 9,800 public schools across the state.

In a class-action lawsuit filed in 2005, parents had argued that with so few school nurses left in California, they were having to keep their diabetic children out of school or leave jobs to administer insulin shots themselves.

The California Department of Education settled with parents in 2007 and sent an advisory to districts throughout the state urging them to allow trained, unlicensed school staff to give the shots if a nurse or parent wasn't available.

Friday, Connelly ruled that the advisory is in conflict with state law that says only licensed nurses can administer injections.

Nancy Spradling, the executive director of the California School Nurses Organization said that "state law and the Business and Professions Code and the Nurse Practice Act all state clearly what falls under the category of nursing, which includes administering injections."

Improper administration can lead to low blood sugar, which can result in coma and death, she said.

The American Diabetes Association joined the four families who filed the original lawsuit in 2005. Together, they alleged that diabetic public schoolchildren were not getting the federally mandated care they needed during the school day, in violation of the Americans with Disabilities Act and the Rehabilitation Act of 1973, which ensure disabled students' rights to receive a public education.

"I thought the (2007) compromise was good," said David Vollmar, who administers the school nurse program for Elk Grove Unified School District. "Parents were holding their (diabetic) children out of school. These kids weren't getting an education .... This (ruling) will make it harder for a number of districts."

The intent of the 2007 agreement, said James Wood, the attorney who represented the Diabetes Association, was to lessen the burden of parents, guardians and grandparents whose diabetic children attended a public school without a school nurse.

"I'm literally sick to my stomach," said parent Lisa Shenson, who has a 17-year-old diabetic daughter and attended Friday's hearing. "There are thousands of children in California who (now) will not be able to safely attend school."