Things to Remember when Sending a Child with Diabetes to School

back to school with diabetesIt’s that time of year again, the time that many parents look forward to and most parents of children with diabetes both anticipate and dread—Back To School!

For a parent, this is a time when we look forward to the return to routine, early mornings and school lunches.  We stare in shock at the number of clothes that no longer fit our offspring and cringe at the many new outfits and shoes that they require for the upcoming school year.

As parents of children with diabetes, we also begin to worry—will our children with diabetes be safe at school? Will our schools allow testing and injecting in the classroom? Will our children’s teachers understand the very real cognitive impairment that comes with highs and lows? Will someone use glucagon on our child if it is needed? Will our older children test and bolus around their peers? And the list of fears go on and on.

To help alleviate some of those fears, I asked parents to give me their top tips for sending a child with diabetes back to school.   I have since put them all together and have come up with the most important points to remember when sending a child with diabetes back to school…

Keep calm and be strong!   You are your child’s advocate.  You are your child’s protector but remember that most educators also love children.  They know how important your child is and will do as much as they can to help you and your child to feel safe in the classroom.

Do not go into meetings in attack mode. Remember to be calm, rational and offer credible arguments to any opposition to your requests. Often your school personnel know little or nothing about diabetes care.  Remember that you once were probably just as ignorant so be patient, educate and be willing to make compromises where it is reasonable.  You also have every right to stand your ground when the alternative will put your child in harm’s way.

Empower your child.  You cannot go to school every day with your child. (I tried once but the teacher kicked me out) It is therefore important that your child be aware of his/her rights and their responsibilities when it comes to diabetes care.

Ensure that your child knows what to do when a teacher impedes them looking after themselves (stops them from finishing their lunch, using the washroom when high, or having access to water for example).  If your child is responsible enough, he/she may carry their supplies with them at all times so that they have access to them in all classrooms and in the event of a lock-down.

Create and present a diabetes care plan or 504 plan for your child.  If you live in the United States and your child attends a publicly funded school, it is important that you put in place a 504 Plan which outlines the roles and responsibilities of the parents, student, and school. Sample plans can be found at www.childrenwithdiabetes.com as well as the ADA website, www.diabetes.org

If you live in a country (like Canada), without such laws to protect your child with diabetes in school, you may still create a care plan.  Often school boards will have their own plans that you can fill out or you can work with many online templates to create your own.

In either case, it is important that you outline the level of care required for your child, the accommodations that need to be made during exams for high or low bg levels, missed school because of diabetes related appointments, how to handle parties or events at school, what to do about school field trips, after school sports activities and more.  This document should note what is expected from the parents (ie. They will ensure that there are adequate supplies in the classroom), the student (ie. he/she will test before exams), and the teacher (ie.  The student will be supervised when low until back in range)

Educate, Educate, and provide information.  Take the time to set up a meeting with all staff who will be interacting with your child.  Ensure that they know what diabetes is as well as the signs and symptoms of highs and lows in your child.

Share a detailed booklet of diabetes care information for your child’s homeroom teacher.  Provide information on your child’s testing and injecting schedule, general information on the insulin pump and errors that could occur if your child is pumping, ensure that your emergency contact information is highlighted and easily available. Make sure that everyone is aware of policies on eating in the classroom or on the bus as well as whether the school will have someone trained to administer glucagon in an emergency situation.

Provide posters or flash cards that can be placed in the staff room as well as the classroom noting the signs and symptoms of highs and lows.  You may also wish a picture of your child posted in the staff room so that all staff are aware of your child and will not rush them out of a lunchroom or penalize them for being in a hall to get water when high.

Finally, if your child is willing, go into the classroom and present information to the students on diabetes and diabetes care. Knowledge is power.  When children learn to understand the realities of diabetes, they are often your best source of support for your child when you are away from them.

Be a Teacher’s Pet!  If you have the ability, volunteer with your child’s school.  Make yourself and your child visible to the staff. Help out at events or volunteer to chaperon field trips.  This can allow the staff to better know you and understand your concerns.  This can also help you to come to know the staff and feel safer about leaving your child when you aren’t around.

If you are not able to be at the school, reward good behavior! Remember to thank your child’s teacher for a job well done.  Provide thoughtful gifts at Christmas and year end to let them know you appreciate all they do when you are not around.

Don’t forget your supplies.  Make sure that you have a comprehensive list of supplies to send to school with your child as well as a system in place for refilling items as they are used. An emergency red box may be placed in the classroom with low supplies, syringes, spare test strips and batteries.  Depending on your child’s age, supplies may be left in other rooms, at the office or carried by the child.

Some of the items that you may wish to send to school can include:

  • Free snacks
  • water bottles
  • Spare insulin, test strips, infusion sets, site tape, batteries, syringes, glucometer, ketone strips, juice boxes, granola bars, Handi-snacks, hand wash, alcohol wipes, glucose tablets.
  • Spare clothes for younger children who may have bladder control issues when high
  • Cell phone to contact you if they are unsure of what to do with their care if an office phone is not readily accessible.

Send notes.  Make sure that you keep an open line of communication between yourself and your child’s teacher(s).  This can be done through emails or notes left in the child’s daily school planner.

Attach sticky notes to your child’s food noting the carb counts or exchanges on each item. This can help to ensure proper insulin to carbohydrate/food dosing for children of all ages.

Managing gym class.  Physical activity is important for everyone but it is especially important for people living with diabetes.  It is important for gym teachers to know that diabetes should not stop our children from taking part in events.  Your child should know to test before he/she starts any physical activity. Make sure that everyone knows the range that it is safe for your child to exercise in.  If your child is on a pump, you may wish to set a special “gym day” profile to reduce basal rates or perhaps you simply want to give the child 10 grams of carbohydrates before class to help them maintain their bg level during activity.

My final tip is the most important…Relax and have fun! School should be a time of fun, education, and friendships.  Diabetes can sometimes interfere and make things a challenge but do not let it stand in your way.  Remember that our children are children first and children with diabetes second.  Help them to learn to live with diabetes in the most positive way.  Work with staff in your child’s school so that everyone is comfortable and your child can get the very best out of their school year.

If you have a tip that I missed, please let me know! 

3 thoughts on “Things to Remember when Sending a Child with Diabetes to School”

  1. That list is good for people going into hospital as well. Here a teacher would not have the power to order you out of the classroom. You have the right to be there. A nurse can order you out of the recovery room [after surgery] at the hospital though. I wanted the nurse to do a blood test for ketones because my husband was over 14 but, of course, the doctor hadn’t ordered it so she couldn’t do the test and wanted rid of me in a big hurry. I was pleased to hear that the hospital had ketone sticks in its arsenal. 6 years ago it didn’t have any and I had to rush home with a bottle of pee because I’d forgotten to bring my vial of sticks. Fortunately, in both instances–I finally got my husband’s urine sample an hour later–there were no ketones just high blood sugar levels.

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