Managing Type 1 Diabetes at School
Parents of children with type 1 diabetes shouldn't fear sending their child to school.
By Regina Boyle Wheeler
Medically Reviewed by Pat F. Bass III, MD, MPH
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The thought of sending a child with type 1 diabetes to school can send shivers down a parent’s spine. Juggling blood tests, insulin, diet, and exercise is a dizzying responsibility on the best of days. But parents can put their minds at ease if they have a detailed diabetes plan in place at school and an open relationship with teachers.
“Communicate, communicate, communicate with the school,” says Joyce Allers, RN, manager of the school health and child health promotion department at Children’s Healthcare of Atlanta. Everyone who supervises your child, from the bus driver to the lunch lady, needs to be in the loop, she says.
Type 1 Diabetes: A School Medical Management Plan
Parents and educators need to work as a team to make sure they meet the child’s medical and educational needs. Step one for parents is to have your medical team fill out a Diabetes Medical Management Plan (DMMP). This document outlines the specific needs of your child. According to the National Diabetes Education Program (NDEP), it should include the following information:
- Blood sugar target range and usual testing times
- Insulin schedule, either by injection or insulin pump
- List of diabetes supplies
- Meal and snack plan
- Information on the student’s ability to perform self-care
- Instructions on what to do in case of low blood sugar (hypoglycemia) or high blood sugar (hyperglycemia)
- Emergency contact numbers
Before the start of every school year, parents need to meet with administrators and teachers to go over the DMMP. Everyone needs to agree on how it will be implemented and what medical accommodations, educational aids, and services the child needs.
Type 1 Diabetes: Know the Law, Know Your Child’s Rights
The Juvenile Diabetes Research Foundation (JDRF) advises parents to also create a formal legal plan to make sure the student’s educational rights are protected and their medical needs are met.
If your diabetic child attends a public school or a private school that receives federal dollars, you are entitled to set up what’s called a Section 504 plan. This plan is based on a 1973 civil rights law that protects disabled people from discrimination. Under the law, type 1 diabetes is a medical disability.
Children attending schools that don’t take federal funds can set up similar plans under the Americans with Disabilities Act or the Individuals with Disabilities Education Act. The plan enacted for your child needs to address specific needs, but will likely include these typical accommodations:
- Identifying where and when blood testing and treatment will take place
- Naming all people — school nurses, coaches, teachers — trained to help your child with her diabetes care and treat high and low blood sugar
- Providing ready access to the bathroom and the water fountain
- Eating whenever and wherever necessary
- Permitting extra absences for sick days or doctor visits
- Allowing her to take a test at a different time if she is experiencing hypoglycemia or hyperglycemia at exam time
- Ensuring full participation in sports, extracurricular activities, and field trips with trained diabetes care personnel on hand
Section 504 or similar plans can guard against a school saying things like, “Suzy can’t go on the field trip unless her mommy comes,” says Allers. It’s especially important to have a legal plan in place in middle and high school so your student is guaranteed accommodations during standardized testing, including the SATs, she adds.
For more information on the 504 plan and the Americans with Disabilities Act, go to .
Type 1 Diabetes: Advice from a Mom
Anne-Marie Catapano’s daughter Catherine was diagnosed right before she entered first grade in Rochester, N.Y., six years ago. Catapano says it’s essential that the child and the parents are comfortable with the diabetes plan. “Make your child feel safe in school,” she says.
It’s also important to educate teachers, other parents, and your child’s classmates about diabetes and what diabetics need to do every day. Says Catapano, “We wanted the other children to understand that Catherine is like everybody else, and we wanted to make them feel comfortable around her.” It’s also important to ask other parents to give you a heads-up about special snacks or birthday treats, so your child has the insulin needed to cover the food, she says.
Today, Catherine wears an insulin pump that delivers a constant baseline of insulin. The pump is a sophisticated device that takes training to operate, but in Catherine’s case “it’s a huge and significant change that gives her a lot of independence,” says her mom. “You can’t go from class to class with a syringe, but you can go from class to class with a pump.”
Even though Catherine is now 12, “the fears never go away,” says Catapano. “As a team, we try to anticipate all the possibilities, but life is unpredictable and diabetes can throw a child a curve at any time. That’s just part of the many challenges that accompany type 1 diabetes."
Having the right plan in place, however, makes those challenges so much easier to meet.
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