Diabetic Children at School

Beth McNamara Health Guide
  • All parents have a "Do You Have" list of items that we bark to our kids as they rush out the door for school each morning: "Do you have your backpack? Lunch? House key? Shoes? Homework? Gym Clothes? History project requiring 1500 popsicle sticks that we stayed up to 3 a.m. to finish? How about a hug?"


    If your kid has Type 1 Diabetes, the list continues: "Do you have snacks? How many? Glucose tabs? Cell phone? Glucose monitor? Insulin pen? Extra needles? Alcohol wipes? Hall pass for the clinic? Now, how about that hug?"


    Yet when your diabetic child walks out the door, onto the bus and off to school, the real worry begins. You worry about if your kid has gym and if she'll be running the suicide sprints that always dip her blood sugar. Or about the science teacher that asks your child to leave the classroom and go to the clinic to check his blood glucose, meaning he'll miss more of his lab work and fall even further behind. Or that militant hall monitor who won't let your daughter go to her locker for her glucose tabs because she forgot a hall pass at home, even if she's displaying her medic alert tag. The list is endless and makes parents of a diabetic kid weak with apprehension.

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    I can be counted as one of the "luckier" parents: my son was diagnosed at the age of 13 and has been very self-reliant when it comes to managing his condition. I know from talking to parents with younger children with Type 1 that the worries for the younger set are much more fearful, including worrying about a surprise snack at school complete with cupcakes loaded with icing, or a child not being able to be tested in the classroom and needing to leaving the class room three or four times per day to simply to check her blood glucose, or that a kid's cup of applesauce will end up face down on the cafeteria floor and she doesn't have any other food to make up for lost carbs.


    So who do we do we work with to keep your kids safe at school? And what exactly do we have to do?


    I had the good fortune to hear Crystal Jackson, the Associate Director for Legal Advocacy at the American Diabetes Association, present this past weekend on a topic entitled just that: Keeping Your Child Safe at School, which covered the ADA's Safe at School Campaign. The primary goals of this program are to ensure that all diabetic kids are safe, from a medical standpoint, at school and likewise are afforded the same educational opportunities that their classmates have.


    The ADA's Safe at School initiative has three driving principles to ensure that diabetes management at school is effective:

    • Those school staff who are responsible for a diabetic child will have a basic knowledge of diabetes and will know how and who to contact for help.
    • The school nurse is the key provider of diabetes care. However, other personnel must be trained in diabetes care if the school nurse is not present.
    • Students that are able should be permitted to take care of their diabetic needs on their own whether at school or at a school related activity.

    It is assuring to know that someone else is out there helping the parents of diabetic children as we work with our schools, their respective administrations, teachers, and personnel. Many parents will attest that some years are better than others. Too, some teachers, clinicians, and principals are more willing to work with us than others. Success stories abound of parents working with their kids' school for smooth, day-to-day diabetic management. Unfortunately, we hear of horror stories as well.


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    Although we parents sometimes feel as if the deck is stacked against us and no one really wants us, our diabetic child, or our family, to have any semblance of a normal life, including at school, the vast majority of the time, the schools are looking out for what they feel is best for their student body as a whole as well as for each child.


    To ensure a safe and productive educational experience for our child, parents should integrate the key people involved in the child's diabetes management including ourselves, our child, our child's diabetic medical practitioner, the school nurse, a school administrator, school teachers and any additional school personnel that may be involved with our child. 


    Parents, while working with these players, need to ensure that they have all of the necessary pieces of a working school plan in place. According to Jackson and the ADA's Safe at School Campaign, preparing this plan includes parents:

    • Creating a Diabetes Medical Management Plan (DMMP) by working in conjunction with your diabetes management team. The ADA currently is in the process of standardizing these Plans and making them available via their website.
    • Reviewing the Plan with the school nurse and discussing its implementation. It's recommended to do this each school year before the beginning of classes, and not to wait until the last moment.
    • Understanding that the school nurse may develop an Individualized HealthCare Plan (IHP) based on the DMMP, and that the nurse needs to be kept abreast of changes in regiment or equipment in order to update this IHP.
    • Initiating the Section 504/Individualized Education Plan, and keeping these plans updated.
    • Assisting the school nurse to identify any necessary training resources for teachers/school personnel.


    Several laws exist today to help diabetics receive the care they need while at school. This includes the American With Disabilities Act (ADA) enacted in 1990, Section 504 of the Rehabilitation Act of 1973, the Individuals with Disabilities in Education Act, and various state laws.   



    This brings up several more topics to be explored, from 504 Plans and IEPs to the impact on the American with Disabilities Act on potential discrimination of a diabetic child at school.


    But these will need to wait until another day, another post.


Published On: May 21, 2009