Going to School with Diabetes: A New Routine

Beth McNamara Health Guide

  • Our school district starts school the Tuesday after Labor Day, which is later than many. But wherever you are, the routine typically is the same: the mad rush to gather new clothes, haircuts, school supplies. Once that's been done, parents evaluate schedules, determine who needs to be where and when, and then assess what the routine should be.

    Those that are ultra-organized even do a run through of what a typical morning will be like, right down to where backpacks should be laid out. In all honesty, the first day of school in my house usually is smooth sailing, since no one sleeps a wink the previous night. But the second day of school, and, honestly, the next three weeks of school days, are sheer utter mayhem. We may have done "good" that first day, but then we can't quite seem to get it back together until the first week of October.

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    If your child has diabetes, there is an extra layer (and a very thick one at that) of planning that both the child, and more specifically his parents, need to do. Attention to detail is a must when it comes to the "D" Back-To-School List.

    To make the routine smoother, it helps to enlist the help of the team of people that you and the child will encounter during the school year, including: Dia

    • The school nurse and nurses aides: Set up a meeting with this team either before school, which is preferable but often difficult with reduced work schedules and vacation plans. At this meeting, review plans and paper work that your child currently has on file to determine if any updating may need to be done. Review who has been trained and on what (glucagons? administering insulin? checking blood sugar? etc.)
    • Administrators and administrative staff: An email and even a meeting with the school's principal, assistant principal and administrative staff is a good idea to reconnect with them after the summer hiatus or to introduce yourself and your child if it is a new school (even if your child has stayed in the same school district but has graduated, for instance, from elementary to middle school).
    • Counselors: It doesn't hurt to touch base with all of the school's counselors via email to reconnect or introduce yourself. More specifically, you should consider meeting with the school counselor who is responsible for your child in person to ask them to be on the look out for additional issues that can plague diabetic children: isolation, depression, feelings of being overwhelmed.
    • Teachers: If your child is younger and not yet able to manage his diabetes on his own, you will want to meet with any and all teachers that will come in touch with the child during the day to review routines and what to look out for when it comes to BG lows and highs. Once a child enters middle and high school, these one-on-one meetings can be more difficult to come by, but can be very helpful. In the very least, connect with each teachers via email to alert the teacher of your child's diabetes and how BG lows and highs can impact his learning. Including an overview or cheat sheet (see below) of these symptoms is a good idea. Ask the teacher not to single the child out or draw special attention to the child's condition when possible.
    • After-school childcare and/or activities staff, including sports coaches: Like teachers list above, it is a good idea to meet with after-school staff/coaches one-on-one. They should be made aware of your child's individual BG low and high symptoms and work with the child to address the issue. Cheat sheets (see below) are helpful for this group. Coaches will need to be very cognizant of how increased activity will impact the child's BG levels. Encourage the coach not to isolate the child because of his condition.
    • Bus drivers: Touch base with the bus driver directly once you know which bus your child will be taking. You can either personally talk to the driver at the stop, or, to avoid the mortification of an older child, call the driver ahead of time to alert him that your child is a diabetic and inform him on which of his routes/stops the child rides. The driver should be made aware of symptoms of BG lows particularly, and BG highs. Too, your child should have the ability to eat a snack and take water to work through lows and highs.
    • Safety patrols/staff: In addition to the bus drivers, alert the team of safety patrols at your school of your child's condition and needs. This includes those that monitor kids who walk to school.


    • Room parent volunteers and activity coordinators: This group is particularly applicable for the elementary-school age set of kids. Once room parent volunteers have been designated, you may want to let them know of your child's condition and work with them on snacks for classroom parties and activities. The same is true for activity/field trip coordinators.

    Here is a list of items you will want to ensure you have at school:

    1. Any and all school forms, including those that will need to be secured from your endocrinologist. Check with you school nurse to ensure that your forms are up to date.

    2. Back up supplies: Just like when you travel, Make sure that you keep track of the expiration date on these.

    3. Back-up supplies of fast-acting glucose, including glucose tablets, juices/juice boxes, GatoradeTM, SkittlesTM, jelly beans.

    4. Update your IEP/504: If you do not have a 504 Plan in place, seriously consider putting one in place - even if things have been smooth sailing to this point in time. Things change, including administrators, teachers, nursing staff, school district procedures; and what was once smooth sailing may become very rough seas.

    5. Extra snacks, back-up lunches: These can be left at the clinic and should be clearly marked. Don't forget to include a few dollars in change for the Coke and snack machines. I've actually left snacks and some money with one of the administrative assistant for when my child has an activity after school and needs something extra to eat.

    6. Cheat sheets: Some parents and practitioners put together "cheat sheets" that let teachers and nursing staff know of what specifically to look for when it comes to their child's diabetes routine, individual symptoms for hypo- and hyperglycemia, and how the child manages his diabetes (with a pump? Syringes? An insulin pen?). These sheets are great to take with you when you meet with teachers, after-school child care, coaches, and the nursing staff. Often your required school forms for the nursing staff will have much of this information included. If you choose to correspond via email, consider including a bulleted synopsis.

    If your school year has already started, then I hope your beginning was smooth and easy. And if you start late like we do here in Northern Virginia, I hope you get more sleep than we will in my house on Labor Day night

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Published On: August 27, 2009