Managing Diabetes at School

Start the year off right

Getting back into the school routine takes a little more preparation for kids with diabetes. And since kids spend much of their day in school, dependable diabetes care really matters.

Some students can test their own blood sugar, inject insulin, and adjust levels on an insulin pump. Younger students and those recently diagnosed will need help with everyday diabetes care.

You'll work with the school to keep your child safe and healthy, no matter what the school day brings. Here are some important pointers.

Make a diabetes management plan

No two kids handle their diabetes exactly the same way. Before the year begins, meet with your child's health care team to develop a personalized Diabetes Medical Management Plan (DMMP). Then visit the school and review the DMMP with school staff. Anyone responsible for your child during the day and after school should be familiar with the DMMP.

The DMMP explains everything about diabetes management and treatment, including:

• Target blood sugar range.
• Whether your child needs help checking their blood sugar.
• Your child's specific low blood sugar (hypoglycemia) symptoms.
• How to treat low blood sugar.
• Insulin or other medicines used.
• Meal and snack plans, including for special events.
• How to manage physical activity/sports.

The DMMP works with your child's daily needs and routine. Make sure to update it every year or more often if treatment changes.

504 plan

You may want to work with the school to set up a 504 plan. The plan explains what the school will do to make sure:

• Your child is safe.
• Your child has the same educational opportunities as other students.

The 504 plan makes the school’s responsibilities clear and helps avoid misunderstandings. A new plan should be set up each school year.

Team up with school staff

Work with teachers and other staff to make sure all the bases are covered for a safe and successful year.

School nurse

The school nurse is usually the main staff member in charge of your student's diabetes care. One or more backup school employees should also be trained in diabetes care. This employee should be on site at all times during the day, including after-school activities. The 504 plan explains how this works.

Teachers

Make sure to visit the classroom(s). Some teachers may have had kids with diabetes in class before. But there's still a learning curve because every student is unique—and so is every teacher.

This is a great time to talk about class rules. Are students allowed to leave the room without asking? Should they raise their hand? The more your child and teacher understand each other's needs, the easier self-care activities will be.

You may want to ask if the teacher could talk to the class about diabetes. What is diabetes? What needs to be done every day? Ask the teacher to do this without pointing out that your child has diabetes.

Also let the teacher know signs to look for if your son or daughter's blood sugar is too low. Does he or she get irritable or nervous? Hungry or dizzy? The teacher may notice the signs before your child does. He or she can alert your child to eat a snack or get help.

Kids with diabetes need to be physically active just like other kids. In fact, physical activity can help them use less insulin because it lowers blood sugar. Talk with the physical education instructor about what your child needs to participate fully and safely.

Cafeteria

Get menus and nutritional information from nutrition services (the school cafeteria) to help your child plan insulin use. Some students bring lunch from home because it's easier to stick to their meal plan.

After-school staff

Get familiar with the daily school schedule, including any after-school activities. You'll want to know where and when you can find your child if needed. Some parents use a free smartphone app to help them stay informed and in touch with their child.

Make a diabetes checklist

Create a backpack checklist you and/or your child can use every day to be sure all supplies are packed:

• Blood sugar meter and extra batteries, testing strips, lancets
• Ketone testing supplies
• Insulin and syringes/pens (even if an insulin pump is used)
• Antiseptic wipes
• Water
• Glucose tablets or other fast-acting carbs like juice or hard candy

Put together a "hypo" box (see below) for the school office in case of low blood sugar.

Also make sure your child:

• Wears a medical ID necklace or bracelet every day.
• Tests blood sugar according to schedule.
• Knows where and when to go for blood sugar testing if help is needed.
• Knows who to go to for help with low blood sugar.

Make a "hypo" box

In case of low blood sugar, provide a go-to box of supplies for the school office or nurse's office. Provide another for the classroom if possible. Label it with your child's name and remember to keep it stocked!

• Glucagon
• Test strips
• Lancets
• Blood sugar monitor
• Glucose tablets
• Juice boxes
• Crackers

Stay well all year

Make sure your child has had all recommended shots, including the flu shot. Kids with diabetes can get sicker from the flu and stay sick longer. Being sick can make blood sugar harder to manage.

Remind your child to wash hands regularly, especially before eating and after using the bathroom. It's one of the best ways to avoid getting sick and spreading germs to others.