I used to work in my local public schools, and I have had experience working with children with diabetes. One child in particular stands out in my mind, since he actually required insulin shots sometimes. of course we were trained in medication administration, CPR and First Aid, so if an emergency arose, we were more than qualified to handle it while we called for medical help.
Sending your child back to school can be a stressful time for any parent. After a type 1 diabetes diagnosis, this event can heighten anxiety: will your child remember to check his or her blood sugar or take insulin? How can you help make sure your child’s teachers know the symptoms of hypoglycemia (low blood sugar)
or hyperglycemia (high blood sugar) and know what to do? Who can help your child with his or her lunchtime insulin and is prepared to help in the event of a serious low? How can you best support the management of your child’s diabetes at school?
The awesome folks at Disney recognize this growing issue that affects our children, and they have created the first ever character with Diabetes. Coco the Monkey is a playful, friendly gal who just happens to have Type 1 Diabetes. A great resource, from a collaboration between Disney and Lilly Diabetes, is a family friendly type 1 website, www.family.com/type1, where families can find inspiration, education and practical advice about type 1 diabetes. The collaboration also provides a resourceful book, Coco Goes Back to School, which is available through local Endocrinologists’ offices nationwide. This book focuses on a fun-loving monkey with type 1 diabetes, who is returning to school after her type 1 diagnosis and goes through how she deals with a variety of situations.
With careful planning and preparation, you and your child can have a happy return to school. These tips
were created with the personal insights and help of Crystal Jackson, Director, Safe at School, American Diabetes
Association, to help make the transition from summer to school a little less stressful.
orders for your child’s school—sometimes referred to as a Diabetes Medical Management Plan (DMMP). This
plan should spell out your child’s school diabetes care regimen and may help you and your child feel less anxious
about managing diabetes in school and during extracurricular activities. It should also verify what your child can
do independently and when he or she requires more help from a school nurse or other trained school staff
2. Know your rights. Federal and state laws protect students with diabetes against discrimination and require
your child’s school to meet his or her needs. Section 504 of the Rehabilitation Act of 1973 prohibits organizations
that receive federal funds from discriminating against children with diabetes. A 504 Plan or Individualized
Education Program (IEP) details in writing your child’s rights while at school and should identify who has been
trained to provide care to your child when the school nurse is not available. Contact your school principal or 504
coordinator about putting a written 504 Plan or IEP in place for your child to help ensure that your child’s needs
can be met and he or she will be treated fairly at school.
3. Be part of a team. Establish a partnership between you, your child, and the school to help manage your child’s
diabetes. Meet and work with the school nurse, principal and teachers to help ensure each team member knows
and understands their responsibilities, helping everyone feel more prepared in managing your child’s diabetes--
especially if hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) occurs during the day. Be a
resource for your school nurse in helping to identify people or programs that can help train school personnel. If
your child and his or her teacher agree, explain diabetes to your child's classmates.
4. Create emergency care plans for hypo- and hyperglycemia. Your child encounters several different adults
throughout the day—teachers, the bus driver, lunch staff, and others—who should be prepared to recognize and
treat diabetes emergencies. Work with the school nurse to develop easily accessible emergency care plans to
help ensure staff members recognize and know what to do if your child experiences low or high blood sugar.
5. Pack ahead. Work together with your child to create a diabetes kit that can be carried in his or her backpack
or is easily accessible throughout the school day. Supplies may include:
• blood glucose meter, testing strips, lancets, and extra batteries for the meter
• ketone testing supplies
• insulin and syringes/pens
• treatment for severe low blood sugar
• glucose tablets or other fast-acting glucose and snacks
• for children with an insulin pump, spare infusion sets, batteries, backup insulin
and syringes/pens in case of pump failure
6. Create “low” kits. Even with careful management, blood sugar swings can happen. In order to be prepared,
it may be helpful to create a “low” kit for your child’s classrooms and other common areas (e.g. library, office,
bus, cafeteria, and playground) that might include snacks, glucose tablets, and treatment for severe low blood
sugar. This kit should also include emergency care plans reminding adults what needs to be done, along with
emergency phone numbers. If your child is comfortable managing his or her diabetes, he or she should be
allowed to carry a low kit and other supplies throughout the day. Remember to provide kits to those who care
for your child before and after school.
7. Recognize responsibility. When your child is ready to monitor his or her blood sugar or give his or her own
insulin, ensure that he or she feels comfortable and has the needed skills to do so. For example, if your child
is independent, make sure he or she can do self-management anywhere, anytime. Make sure he or she knows
who to contact if help is needed.
8. Eat well-balanced meals. There are no forbidden foods for children with diabetes. However, all children
should be encouraged to eat healthy foods. It’s important to provide your child with foods that keep them alert
and ready to learn. If you send a lunch with your child, pack a healthy meal that contains whole grains and fresh
fruits and vegetables. If your child buys meals at school, look at the cafeteria menus together to help him or her
make healthy choices and calculate the carbohydrate amounts. Many schools post their menus online with
nutrition information, or you can request this information from school workers.
9. Exercise daily. Encourage your child to be active throughout the day. Remember: having diabetes does not
mean that your child cannot be physically active or participate in physical education classes. In fact, being active
can help your child improve his or her blood sugar control. Make sure the adult in charge knows how to
recognize and treat a low.
10. Stay healthy. As with all aspects of type 1 diabetes management, it’s important to be proactive about your
child’s overall health. Remember to stay up-to-date on recommended check-ups and vaccinations, including the
WHERE TO GO FOR ADDITIONAL INFORMATION
Academy of Nutrition and Dietetics, “Making the Grade at Lunchtime”,
American Association of Diabetes Educators, “Management of Children with Diabetes in the School Setting”,
American Diabetes Association, “Diabetes Care in the School and Day Care Setting”, Diabetes Care, Volume 35, Supplement
1, January 2012
American Diabetes Association, Safe at School Campaign
Children with Diabetes, Diabetes at School resource guide
Disney Family parenting website
JDRF School Advisory Toolkit
Lilly Diabetes, downloadable pediatric resources
National Diabetes Education Program: “Helping the Student with Diabetes Succeed: A Guide for School Personnel” (2010),