I remember diabetes at school. Being diagnosed shortly after I turned 12, I went through my middle school and high school years managing diabetes. I remember carrying a bright purple Caboodle (do you remember those things? Turns out, they’re still a thing!) with me each day. It held my blood sugar meter, which probably looks giant now compared to today’s models, my lancets and testing strips, and all the T1D things I needed for the day. Once I got to school, I dropped it off in the office, and I would stop by there to check my blood sugar throughout the day.
Mind you, this was 1992 when I was in sixth grade. So I wasn’t wearing an insulin pump or a CGM like I do now. Diabetes care looked very different back then.
Things Have Changed for Diabetes at School
Things have changed so much since 1992 — and for the better in diabetes management. Between insulin pumps and continuous glucose monitors, those alone have streamlined care. With more children having diabetes, more school personnel are aware of the disease and able to better help the children living with it.
But as a parent, even with the improvements, sending your child with diabetes to school can be intimidating or even downright scary. How will you trust a teacher you barely know to help manage a complicated disease while she’s trying to teach a class of 20 kids? What will happen when there’s a low blood sugar? What if PE is immediately after lunch and your child has to exercise with insulin on board?
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There are a host of “what if” questions we sometimes allow to race around in our minds, but a more productive choice might be to focus on some things to help prepare your child and the school staff for the upcoming year. These are things that will help ease your mind, knowing that whatever happens, there is a plan in place.
So here are 7 ideas to get you started:
1. Diabetes at school is manageable
This is the first step in preparing for diabetes at school — for you as the parent to acknowledge that diabetes is manageable at school, just as it is anywhere else. Yes, there are other things to do to be fully prepared for school, and we will tackle those in a minute, but the first step is for you to mentally prepare.
Remember, what you’re doing in all this preparation is creating a predictable and reliable diabetes care plan for your child’s school day. Yes, it takes time and effort, but it will pay off in the long run. And it will help your child and ease your mind at the same time.
2. Have a Plan for Diabetes at School
First of all, we need a plan. The ADA offers a Diabetes Medical Management Plan form on their website if you’d like to go through it. I will say, it’s several pages long, but also very thorough. They suggest you complete the form with your child’s healthcare team and provide it to the school nurse (that we’ll talk about in the next point).
Another option is to create a system of communicating with the teacher/nurse each day. My co-blogger Brandy has a notebook she and the nurse trade back and forth. She writes the carbs for her son’s lunch for the nurse and any other notes she needs to have for the day. Then the nurse will write any diabetes-related activity during the day — low corrections, high corrections, lunch bolus given, etc. It’s always in her son’s backpack and it goes back and forth between school and home for each day.
Whether you use a specific form or a notebook system or something else entirely, you’ll want to consider a few things as you make your plan:
- The content and timing of lunch.
Will your child eat lunch early or late in the day? Will he bring a lunch that you know carb counts for? Will your child eat the school lunch and need to know carb counts? Who will dose your child just prior to eating? - The timing of PE.
When will your child have PE class during the day? Will there be active insulin on board from breakfast or lunch at that time? Is PE every day or certain days of the week? How will you adjust accordingly to the increase in activity? Should you connect with the PE teacher to communicate up front about low symptoms and treatment, for example? - For younger kids, the timing of recess.
Similar to the PE question above, you’ll want to consider timing and insulin on board so you can adjust accordingly. - Bus schedules.
If your child is riding a bus to school, will he have low snacks on hand in case they are needed during the bus ride? Is your bus driver aware of your child’s diabetes and what it may require?
3. Connect with the School Nurse early
Once you have your plan from step #2 in place, you’ll want to connect with the school nurse. Consider your child’s school nurse to be your lifeline during the day. You should develop and maintain open communication on a daily basis in one way or another in order to ensure your child is getting good diabetes care during the school day.
Share your diabetes plan with her. Ask her about her experience with any other children with diabetes. Ask her about monitoring your child’s CGM throughout the day (if applicable). Get her preferences on how best to communicate with you. Make sure she has your phone number and email so she can get ahold of you at any time.
And allow the nurse to ask you whatever questions she needs to have clarified. Consider this a time of both information gathering and relationship building. Parents and nurses who have good communication can have great results with diabetes care at school.
Visit the Devotions on Diabetes blog for an interview with a school nurse about her experience caring for children with diabetes at school.
4. Inform the Teacher Before School Starts
Even if your child’s teacher has had a child with diabetes in her class before, no two kids with diabetes are identical. It’s important to set a time to chat before the year begins. Here are a few things a classroom teacher should know about diabetes.
- A basic overview of diabetes.
The 30,000 foot view is really what the teacher needs to know — the main basics. The ADA has a great resource for schools on their website. It’s complete with a quiz and a full list of downloads specific to managing diabetes at school. - Blood sugar levels can change quickly.
With so many factors affecting blood sugar, levels can change quickly. Especially during PE or recess. And when they start to change quickly, they may require immediate action. Your child’s teacher should realize that this isn’t a “wait and see” situation, but something that needs to be addressed right then. - Low blood sugar requires immediate attention.
Again, quick changes in blood sugar aren’t “wait it out” situations. Low blood sugar is definitely one of the quick changes that needs immediate action. The teacher should know some common symptoms to watch for: fast heartbeat, shaking, sweating, nervousness or anxiety, irritability or confusion, dizziness, and hunger. - High blood sugar can cause different behaviors.
While a nurse can help your child with a correction dose of insulin to bring a high blood sugar down, it may linger high for a while. Highs don’t respond to correction near as quickly as lows. A teacher can help identify those symptoms as well: increased thirst, frequent visits to the bathroom, blurred vision, feeling weak or tired. Later symptoms include things like: dry mouth, pain in the abdomen, nausea, or vomiting. - Kids with type 1 can still eat sweets.
This is particularly helpful to know when planning for a birthday celebration at school. Kids with diabetes are able to eat sweets as long as they plan accordingly and dose properly. Kids want to be treated like anyone else in the class. There’s a good chance if the store-bought sweets list the carb counts per serving, that the child with diabetes can dose and enjoy them too.
* If there is not a full time nurse at your child’s school, the teacher will need to also know everything in point #3 above.
5. Prepare Diabetes Supplies for School
It may be wise to create a checklist of all the diabetes supplies your child may need to take along to school each day. Post is somewhere that is easy to check frequently to make sure you restock as needed. Here are some ideas for your checklist:
- blood sugar meter, testing strips, lancets, extra battery
- ketone test strips
- insulin (even as a back up if a pump is used)
- alcohol prep wipes
- fast acting sugar to treat lows (fruit juice, glucose tabs/gummies, etc.)
- back up CGM or pump site supplies
- other things your child is accustomed to using or having available
You may want to create a small bag of supplies that can be kept in the nurse’s office for lows. That bag could include things like glucagon (or whatever emergency low treatment you use), additional test strips, fast acting sugar, and some crackers, for example.
6. Work with the School Staff
You may also want to work with the school staff or leadership to develop additional plans for your child. For example, a 504 plan is something you can create for your child to make sure they have the access to education they need.
For example, what happens if a low occurs in the middle of a test? Your child should have the time to make up the remainder of the test, and a 504 plan would indicate that. Your child’s teacher or the school nurse can help you get in touch with school leadership who can help you with this. The ADA shares more info on 504 plans on their website as well.
7. PRAY UP
I didn’t leave this for last because it’s least important, but because its something that can and should be ongoing after steps 1-6 are done. Praying for your child is super important any day, but especially for a child with diabetes who is heading to school each day to be cared for by others.
Sending your child to school can be an anxious time — and not just for the parent, but also for the child. Take your fears and worries and anxiety to God. He cares for you and He listens. He knows what you are facing. Ask Him for his help, His guidance, His wisdom, and His peace.
Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.
Philippians 4:6-7
Praying along with your child can be super impactful as well. Not only does it help you and your child connect with God, but it also models prayer for your child so that she can learn to pray about her health and care as well.
Remember, your child is a child of God, and you were chosen to help guide him and care for him. This battle ultimately belongs to the Lord. And He is the one who fights our battles.
The Lord will fight for you; you need only to be still.
Exodus 14:14
So, pray up as the school year starts, or as your child is changing schools, or as your child is newly diagnosed mid-year. And continue praying for those caring for your child at school. I’ll pray for you as the parent as we close.
Dear God, I thank you for the parent reading this blog post, wanting to provide the best care for their child. I pray You would calm any worries and concerns they have. Help them walk through these steps knowing they are doing all they can to be prepared well. I pray they would turn to you when feelings of anxiety and fear creep in throughout the school days. And I pray that You would provide them with Your peace that transcends all understanding. Guard their hearts and minds, Lord, as only You can. Amen.
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