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School is starting! If you are freaked out like I am, you are not alone.
Having a child with diabetes, going back to school, and managing diabetes in school means anxiety and maybe even a bit of a panic attack for us T1D parents.
I do not know about you mama, but I get extremely anxious that another person is going to be looking over my daughter for almost the entire day, and not having this control over her diabetes can be very scary.
From my experience, when my daughter started Preschool in the Fall of 2018, I had to train the school nurse and the teachers on how to manage her diabetes. Amanda was the first preschooler with diabetes, so this was a new thing for them.
Although this was a new thing for them, the school was very accommodating to our needs as parents, and the communications between us was amazing.
Side note: I used to be a special education teacher, so I KNOW how hard it is to be a parent of a child with a disability. I used to see the concerns in parent’s eyes, and now that my own child has a condition, I totally get where they were coming from.
Let’s talk more about how to manage your child’s diabetes at school.
Tips for better blood sugar control while your child is in school.
1. First Visit to the School Nurse or School Personnel
Your nurse will be and has to be your BFF. You need to talk to the school personal, see the school setting, and figure out how is the care to students with type 1 diabetes.
When my daughter started going to Preschool, I had to go to her school to speak to the nurse and teachers. I had to explain her medical condition, how her participation in school was going to be and how we manage her blood glucose levels at home.
This may come as a shock, but there are some nurses, that even though they have their degree in Science/Medicine, do NOT know how to manage Diabetes. Especially in little kiddos as my child was when she started Preschool school at 4 years old. Amanda was the first preschooler that had Diabetes in her school, so a lot of training and consults were done.
On your visit to the school nurse, you need to hand over your child’s supplies. These supplies NEED to stay in the school for the entire year. Your Endo team should always provide duplicate or more quantity of the supplies since one portion needs to be in your home and another goes to the school.
During the entire school, year, your child’s school will need the following:
- Insulin vial(s). Make sure that the nurse knows that these need to be stored in the fridge, and to NOT open one unless needed. If you want, you can have them consult with you before opening one.
- Syringes and/or pen needles. If your child uses a pump, in case of pump failure, you still need this as a backup.
- Glucose Meter. Have your child’s Endocrinologist doctor prescribe another one for school.
- Test strips, lancets, lancing device, extra batteries, and/or charging cords for the insulin pump. Make sure the test strips are not expired.
- Ketone strips or ketone meter (I LOVE the ketone meter best, it’s more accurate and current)
- Glucagon/Baqsimi (be sure to check the expiration date)
- Supplies to treat lows (like glucose tabs, juice boxes, crackers, snacks)
- Continuous glucose monitoring supplies (extra sensors and other CGM supplies that you use. We use the Dexcom G6, and it’s only the sensor that we need to leave at school)
- Insulin Pump Supplies (extra cartridges, and infusion sites)
- Alcohol wipes, and adhesive wipes
2. What To Do If There Is No School Nurse
I know, you might think this cannot happen, but yes, it can. If this is the case for your child’s school, you would need to either consider moving your child to another school or just have a designated person inside the school to manage their Diabetes.
Things that you can do:
- Meet with the school principal and stress about the importance of having a school nurse. Diabetes is a serious illness, and should not be taken lightly.
- Meet up with other T1D moms from other students in the school and talk to the School Department and/or School Principal about the importance of having a nurse in the school.
- If there is not going to be a school nurse, designate a person that will be managing your child’s Diabetes.
- Go into the school every month in order to make sure the diabetes supplies are well-stocked, especially snacks since they can run fast.
- For insulin storage, talk to the teacher and/or school principal about the proper storage of the insulin vials. If they do not have a safe place, then a backup plan is for you to get a small refrigerator, with the only intention that your child will use it to store the insulin, only. No other person or student is allowed to use if for their personal use.
3. Blood Sugar Checks In School
If your child checks their blood sugar by themselves, inquire if this can be done in the classroom, or do they need to head over to the nurse’s office or an office not in use.
Some kids do not mind checking in public, but others do. You know your child best, think of how you manage your child’s diabetes while out in public, like when in a mall or restaurant, and replicate those same strategies for school.
In our case, the nurse is constantly checking my daughter’s sugar levels, because she wears her Dexcom G6 CGM. The nurse has an iPad that follows her iPhone, and the teacher has at all times her iPhone and checks from her end as well.
These accommodations (i.e the iPad) were already in place when my daughter started Preschool. This was because a group of moms in my town advocated for this in the School Department because they wanted their children to be safe. So now, when my daughter starts school every year, every nurse that is going to be overseeing her blood sugars, they need to have the iPad (provided by the School Department) with them or in their office and follow the protocol established on her 504 Plan.
Keep open communications with all the school personnel that comes in contact with your child (i.e. nurse, teachers, principal, etc. ), you never know who you might need to contact and help you with your child.
4. What To Tell Other Students About Type 1 Diabetes
The younger your child is, the easier it will be. Little kids do not mind you telling other kids and teachers about their Diabetes.
If you wish to teach other children about Diabetes, you can get some stories, and have a day to read it to them or have the teacher read the story during storytime.
Some of the stories that you can read to the kids are:
If your child is older, things will get a bit harder. There are some kids/teenagers that are private about their Diabetes. Please tell them that the more people know about their condition the better. You never know what could happen in an emergency.
Have a meeting with your child, teachers and other school personnel that are going to be in charge of your child. Your child will not like it due to possible embarrassment, but it needs to be done. This is for their safety, you need to tell them that constantly. They should not be ashamed of their Diabetes, it’s a condition that could not have been prevented.
5. School Bus Ride in the School Year
If your child takes the school bus to and from school, the bus driver and bus monitor need to know about your child’s Diabetes. Most of the drivers and bus monitors are trained to deal with chronic illnesses, but they need to be aware of your child’s medical condition. This way they can have the awareness of any abnormal symptoms, like low blood sugar signs that your child may be exhibiting.
Talk to the school bus company and inquire about the bus route. For my daughter, there was an arrangement made that she needs to be almost the last student to be picked when heading over to the school in the morning, and one of the first ones to be dropped off when school is done.
See if a similar arrangement can be done for your child. If not, then you need to prepare your child for a long bus ride and have the bus driver and bus monitor very closely your child to make sure he/she is okay.
Talk directly to the bus driver and/or bus monitor, and make them realize that if your child needs to eat something, that this is going to be medically necessary due to your child experiencing a low.
Also, tell the bus driver that your child may be testing their sugars on the bus with a lancet device, but this will not be left on the bus, it’s only to confirm low blood sugar in order to treat accordingly.
6. Recess and Lunch in the School Year
We can often forget about recess and lunch aides. Make them part of the school team meeting, if possible. Make sure to voice that they should always have some fast-acting glucose tablets or snacks to treat low blood sugars. Your child should always feel comfortable going to them, especially if he/she feels low.
Lunch aides can assist in making sure that your child if independent in managing their Diabetes, that they bolus correctly for their meal. Lunch Aides are there to ensure kids are eating their foods and for your diabetic child, they need to make sure that they eat their food and bolus correctly for the food they ate.
If your child is going to be taking food from home, make sure to write down the carbs on the lunch box or baggies, so your child, nurse or person in charge of bolusing, can do so correctly.
If buying food from the cafeteria, try to see the menu and inquire with the school cafeteria about the carbs.
Make sure that every teacher and other school personnel know that your child is allowed to eat all foods. He/she is not prohibited from not eating anything, especially if there is a birthday party celebration.
Lastly, inform that taking food away is a big no-no, especially if your child has just been bolused. He/she needs that food in order to cover the insulin already dosed.
7. School Care Plan
On one of your child’s Endo visits, you need to inform the Endo team that your child will be starting school soon. If your child is of school age, they should already have an idea of the paperwork they need to submit to the schools.
The Endo team, parents, and the school staff (teachers, nurses, and other school personnel) need to prepare a written plan on the diabetes management plan.
The diabetes management plan specifies in a very detailed manner every little thing that the school personnel needs to do to manage their diabetes.
If it’s not written on the plan, the school will not be able to act. This is due to a legal issue and to prevent a lawsuit. You will and might get frustrated (I know I did), and common sense things/actions needed to be done, but since it was NOT written on the plan, the nurse could not act.
Concluding Managing Diabetes in School
Every year, you and your child will have new issues that may arise when managing their Diabetes. Always be clear and straightforward with your child’s school staff personnel, especially the nurse.
Make sure that all teachers, physical education teachers, coaches, music teachers, art teachers, and anyone your child is in contact with, know and recognize the symptoms of low and high blood sugars.
The more people know and are trained in managing your child’s Diabetes, the better you will feel leaving your child in school, and the safer your child will be.
The school is your extended arm in assisting you and your family battling this chronic illness. Teach them about diabetes management, be an advocate, voice your concerns, and let them help you and your family in his journey.
If you think the school nurse needs more education on managing Type 1 Diabetes in children, you can refer them to the Sugar Surfing Training for Nurses website here. Dr. Ponder is a Pediatric Endocrinologist, who has Type 1 Diabetes himself, and he is AMAZING! He has a book called Sugar Surfing and it’s filled with knowledge.