School-Time Tips for Children with Diabetes
Help Ensure That Your Child Receives the Best Diabetes Care at School
The transition from summer to the new school year is a busy and sometimes stressful time for many families. And for about a quarter of a million U.S. students with type 1 diabetes—and the growing number of children with type 2 diabetes—extra planning and unique concerns are a big part of hitting the books again. Joslin's Pediatric, Adolescent and Young Adult Section provides guidance to help parents and their children with diabetes have a safe, healthy and fun school year—whether kids have been living with diabetes a long time or are newly diagnosed.
Planning is crucial for parents of children with diabetes, and communicating that plan with school personnel will help things go more smoothly for children while they are away from home. And, as approaches to diabetes care advance with the introduction of novel treatments, including new insulins, advanced blood glucose monitoring devices and insulin pumps, it becomes more crucial to work with the child’s healthcare team and communicate orally and in writing with the child’s school team. Tips from Joslin's pediatric staff include:
Make a plan and write it down: Parents should develop a detailed diabetes school safety plan that outlines all aspects of their child’s disease, how monitoring and blood glucose management will be handled during school hours and extra curricular activities, and what symptoms to look for and steps to take in the case of an emergency. This Diabetes Medical Management Plan (DMMP) should be developed before the school year starts with the child’s healthcare team and should be discussed in a formal meeting between the parents and appropriate school personnel to ensure expectations, roles and responsibilities are mutually understood and agreed upon. The plan should also be revisited throughout the school year to ensure that it continues to address the child’s individual needs, which may change.
Cast a wide communications net: When deciding whom to communicate with regularly at school, parents need to cast a wide net. It’s important to think about not only specific teachers, school nurses or select administrators, but all the people who will interact with the child throughout the day, including bus drivers, cafeteria workers, coaches, after-school volunteers, field trip chaperones, classroom monitors, close friends and other parents. Communicating with people who are with the child prior to meals, in mid-afternoon and following exercise is especially crucial as this is when blood glucose levels tend to drop, requiring special attention.
Be prepared: Plan to bring the child’s diabetes supplies to school on or before the first day of class. These supplies may include a blood glucose meter, strips and lancets; insulin along with syringes, insulin pens, or insulin pump supplies; and a glucagon kit, rapid acting carbohydrates and other snack items. And make a note on your calendar to check on supplies at the start of each month during the school year. Check that the child with diabetes has not outgrown his or her diabetes ID bracelet or necklace.
Get and keep the child involved: Depending on age and how long the child has had the disease, a child with diabetes is generally happier and healthier the more s/he is involved with the diabetes care. It is key to engage the child in the school plan and let him or her help choose when and how classmates will learn about diabetes. Keep the lines of communication open about managing diabetes at school and while the child can help in the care, diabetes is not a do-it-yourself disease, so the adults at school need to remain involved.
Strive for balance between food, exercise and insulin: As parents educate themselves and others about diabetes, it is essential to leverage three elements for their child’s health with type 1 diabetes—food, exercise and insulin. Kids with type 1 diabetes can generally eat any food in moderation, but a school menu high in carbohydrates will need to be counteracted with an appropriate amount of insulin. When packing lunch for a child with diabetes, be sure to take into consideration their activities throughout the day, as any change in routine can impact blood glucose levels. As for exercise, there is no doubt that it is great for all kids, but because it can lower blood glucose levels, it is important to ensure an extra eye is kept on a child with diabetes after finishing gym class, recess or sports practice.
