Association of Diabetes Care & Education Specialists

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SCHOOL IS IN SESSION: Focusing on the child with type 1 diabetes

Aug 16, 2010

As we head into fall, children of all ages are returning to school. This means that the freedom of summer and lack of routine changes to a more structured daily list of activities. Parents “hand over” the lives of their children to teachers, principals and school nurses to not only provide the child with instruction, but also the opportunity for physical activity and food during the lunch hour. For children with diabetes, this can be a challenging area and has the potential for added frustration.

The child who has a deeper understanding of his/her diabetes and the importance of regular blood glucose checking has a starting advantage. But have you noticed, even the most “compliant” children find multiple distractions when they are with their friends? Checking blood glucose values and giving bolus doses for lunch are often not part of the “to do” list.

Over the last two years, the endocrinologist that I work with and I have started a before school clinic day. It’s really a tune up and is the “diabetes physical” prior to the start of school. We ask the children to come to the clinic and to have their laboratory values drawn before attending. I have copies of the medical management plan to fill out, and provide them with a 504 Plan to work on with their school.

I ask parents to make an appointment with key school personnel prior to the start of the school year that will help them with the management of their child’s diabetes. We live in a rural state, and many of our schools are without a school nurse, which can make management even more challenging. I also have children set key alarms on their insulin pumps as a reminder to check blood glucose values before lunch. Teachers are often willing to watch a child give a bolus, to make sure they are entering their carbohydrate and BG values correctly in their pump.

This year, in conjunction with the American Diabetes Association, school nurses in our state will be offered a special program (H.A.N.D.S) during the annual statewide teachers meeting focused on diabetes in the schools. In Colorado, key nurses are volunteering to be the “go to” nurse with questions about diabetes from other nurses in the district. Many states and several organizations have manuals to help keep children safe at school, but the importance of having one in hand must be emphasized to the schools, or they will stay stored away on computers and in state offices.

What are you doing to help children with diabetes manage their lives at school? Please share your successes and your challenges!

If you want to read more about this issue, review AADE's position statement, "Management of Children with Diabetes in the School Setting."


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  1. Sep 30, 2010

    My son was diagnosed 6 months ago at almost 16. We were very fortunate that all of the staff he comes in contact with was willing to help. He is allowed to test and eat in class, or be released to go to the office if he needs at any time. He can text me during class if he is low or has an important question. I know there are at least a half dozen other kids at his school that are also Diabetic. They have a special cabinet in the office just for the extra supplies they need to keep at school. The day before he was to return to school after diagnoses, we were having an IEP with his teacher and the counsellor and he experienced a low right in front of them, so they got to see what he was going through and would have to do. We are some of the lucky ones. I know other families outside of California that are having serious school difficulties.
  2. Aug 27, 2010

    We have a Diabetes Children's support group for ages 7 thru 12 and meet in August and December. During our August meeting we inform them about the 504 plan and recommend that they meet with school officials and teachers prior to the start of classes. We also discuss healthy lunches and choices.

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