Sending any child to school may often cause a parent great anxiety. The thought of leaving their child in the care of strangers for an extended period of time can be worrisome. This anxiety becomes ten-fold when sending a child with diabetes to school. No one can possibly care for our child as well as we do. How then do you keep your child as safe as possible when you aren’t there?
School policies for children with diabetes
Before sending your child with diabetes to school, take a moment to familiarize yourself with their policy regarding diabetes care.
If you live in the USA, you should have a 504 Plan in place. It outlines the quality of care and responsibilities legally required by the school. If you live in Canada the road is not as clear.
In Canada, education policies fall under provincial jurisdiction. While there may be a provincial policy regarding the care of children with diabetes in school, some board have policies as well.
You can check out the policies in place in all provinces and territories on our Canada page.
Who can administer insulin or glucagon at school?
The administering of insulin and/or glucagon in school depends on where you live. In some areas, a school nurse will assist with insulin delivery and be fully trained in glucagon. Other districts will require the parents to find someone to administer insulin and will not administer glucagon in an emergency.
Who can administer insulin and glucagon in the US?
If you live in the US and have a school nurse, it will be the nurse’s responsibility to assist with diabetes care. He/she will also be responsible for the administering of Glucagon via injection or nasal spray.
If your school does not have a nurse, the American Diabetes Association states that you still cannot be made to go to school to care for your child’s diabetes. The school must arrange for the training of staff members in necessary diabetes procedures like insulin injection and glucagon administration.
Administering Insulin and Glucagon in the United Kingdom
If you live in the United Kingdom, the situation is quite similar to the United States. There is usually a pediatric diabetes specialist nurse assigned to the child with diabetes who will be responsible for care. Other staff members may be asked to support a child with diabetes but must first be trained. Training usually will be done by a pediatric diabetes specialist nurse. Once trained, staff members will be able to assist with both insulin injections and glucagon administration.
Insulin and Glucagon administration in Canada
In Canada, schools for the most part, no longer have full-time nurses. In most districts, the injection of insulin falls to the parents. They must either arrange someone to come to the school or do it themselves if the child is not old enough.
There are some provinces that do offer assistance, however. Outside nursing services can sometimes be utilized to assist with the diabetes care of small children. To find out the policy of your province, see our school policy section.
The administering of glucagon also depends upon where you live. There are some boards that allow for a staff member to be trained in the administering of glucagon for emergency situations. There are other boards however who are not as accommodating. Often when speaking with school staff, you will find someone who will gladly take on this responsibility.
Preparing a school plan
Whether your school board has a policy regarding children with diabetes in school or it is guided by a 504 Plan, it is the parents’ responsibility to do as much as they can to prepare the school to care for their child.
Before school starts, contact your school and ask for an in-service with all personnel who will be in contact with your child. You may wish to have your CDE or public health nurse attend as well to ensure that everyone is properly trained and aware that you will be sending a child with diabetes to their school.
If your child is on an insulin pump, you show the pump or have pictures of it made available so that everyone understands that it is a piece of medical equipment. Discuss some of the alarms so that staff
Do the same with your child’s CGM and glucometer.
- Ensure that your child wears his/her MedicAlert identification at all times.
- Provide your child with an emergency kit—preferably a red box or something else that is easily identifiable. On the outside of this kit paste instructions for hyper and hypoglycemia. Also, include emergency contact names and phone numbers.
- Inside the kit should be such things as fast-acting glucose, glucose gel, ketone strips, spare supplies, etc. This kit should be kept in a safe place that is known to the child’s teacher and/or aide.
- Ensure that your child with diabetes has a glucometer for school that is working and kept well stocked with strips. If your insurance doesn’t cover a spare meter, ask the Customer Service people at the meter company with which you deal. They will often provide spare meters for such purposes. A pharmacist may also be able to help with this.
Meeting with school staff
When you sit down with school staff to discuss the needs of your child, provide basic information on diabetes. Also have the specific guidelines for your child’s care. Place it in a bright folder or duo-tang with a photo of your child with diabetes on the cover and the pertinent information on the inside. This will help to ensure that it is not lost in other paperwork.
This folder can also be available for supply teachers who will quickly be able to identify the child with diabetes in the class. For larger schools, a poster with your child’s photo again and information regarding his/her care may also be posted in the staff room. This way all personnel are aware of the child and his/her diabetes care needs.
Diabetes is one of the most common chronic illnesses found in school-aged children. Sadly, there is still need to ensure that your school district, your administrator, and your child’s teacher are all comfortable and well educated in the care requirements that you and your diabetes care team have deemed appropriate.
All school personnel who will come in contact with your child must have a basic understanding of the disease. A specific number of staff members should be trained in your child’s daily care as well as how to handle emergency care. It is vital that all staff understand that all students with diabetes will need help with emergency diabetes care. This education should be done with both the parents and either a Certified Diabetes Educator (CDE) or your local Public Health Nurse. Whenever possible, have at least two staff members trained in the use of Glucagon.
In the case of severe hypoglycemia, one staff member should be administering Glucagon while the other calls 9-1-1 and then the parent/guardian. It is also vital that schools understand the insulin pump if your child is using one. A child on a pump can go into DKA within hours of a pump malfunction and therefore a high must be treated as a serious event as well.
Make sure that there is a clear understanding of everyone’s roles and responsibilities. Let the school know that you wish to have open communication with them. You will be available to answer any questions that may arise.
Also, ensure that your child with diabetes understands his/her roles. Make sure that they know what they are and are not allowed to do in school. Ensure that they are confident in case they are challenged by a teacher who may not fully understand their needs.
- Diabetes Care Plan
- School Advisory Tool Kit for Families
- Diabetes Canada KIDS WITH DIABETES IN SCHOOLS offers some great guidelines and posters for hyper and hypoglycemic emergencies. It also brings to attention some of the concerns that teachers may have that need to be addressed by parents. The “Test Your Knowledge” Section could easily be used to aid in a presentation or in-service with staff.
- Information for Teachers provides an excellent overview of diabetes care, terms, and what to do in various situations.
- 10 Things teachers should know about having a student with Type 1 diabetes
- The signs of high and low blood sugar levels.
- List of diabetes supplies for back to school
- How to prepare for an IEP, 504 plan or care plan meeting
Make sure you have everything you need for back to school
Grab the AMAZING back to school bundle! It includes a checklist, high and low blood sugar images, tips for meeting with the school, and sample letters to send to your child’s teacher!
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