How to prepare your child with diabetes for school

Did you know that diabetes is one of the most common chronic diseases in children? In fact, it’s estimated that 210,000 Americans under 20 years old have diabetes. Managing chronic disease in children is stressful, especially as they head back to school. New teachers, school nurses, classmates, and administrators mean both you and your child may be nervous about the year ahead. Luckily, there are ways to prepare for handling diabetes at school this new academic year.

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1. Create a diabetes action plan for school

One of the most important things parents can do to make the back-to-school transition easier is to create a diabetes management plan. 

“The first thing parents should do is make sure their diabetes school care forms are completed by the pediatric diabetes team,” said Angela Ginn-Meadow, RN, registered dietitian, and certified diabetes educator, based in Baltimore, Maryland.

“These detailed forms provide guidance for the school nurse or supervising adult to provide directions for medication timing and doses,” says Ginn-Meadow. Diabetes school care forms provide other crucial information including:

• Monitoring times
• Carbohydrate goals
• Treatment for high and low blood sugar values
• Contact numbers for diabetes-related emergencies
• Directions for when to check for ketones or administer glucagon

You’ll just have to give your pediatric diabetes care team consent to provide the forms to the school.

If your child’s school or doctor does not have their own forms, the American Diabetes Association offers one that can be used as a template and modified for your child’s needs. It’s a good idea to check in with your child’s diabetes care team, even if your child is returning to the same school, and make sure last year’s diabetes management plan information is still accurate and up to date. Give the diabetes management plan to the school before classes begin so they have time to prepare. Follow up with a phone call to the school nurse to open a dialogue to discuss your child’s health needs. 

2. Plan for medical supplies with school staff

“Parents should also review with school staff how to use any digital devices the child may be using, like an insulin pump or continuous glucose monitor (CGM),” said Toby Smithson, MS, RDN, diabetes lifestyle expert with DiabetesEveryDay and author of Diabetes Meal Planning and Nutrition for Dummies, based in Hilton Head Island, South Carolina. 

It’s recommended that, in addition to the usual school supplies, parents purchase extra diabetes supplies to keep at school, like a glucose meter, any prescription medications, pen needles or syringes, glucose tablets, or glucose gels. If there are certain supplies your child needs to bring daily, make a checklist to avoid forgetting important items.

3. Prepare for blood sugar changes 

Aside from the diabetes action plan for school, being prepared for out-of-target blood sugar treatments is a good starting point when going back to school for kids with diabetes.

“Going back to school means changes in things like activity levels, eating times, and stress levels,” says Smithson. “Each of the changes can affect blood sugar levels, so it’s important that the school has bottled water, medications as prescribed by the child’s doctor, and some quick-acting carbohydrate like juice packs, hard candy, or gummy candy that equals 15 grams of carbohydrates.” These can all be packaged into an easy-to-grab box or bag—for the nurse’s office and the classroom—in case your child starts to experience low blood sugar.

Plan ahead. If your child buys lunch at school, talk to the cafeteria staff to obtain menus in advance so you can know the nutritional content. Meet with the physical education team to determine how the exercise might impact your child’s blood sugar.

4. Talk to teachers about special considerations

When it comes to the classroom, it’s critical that teachers, including gym teachers, are aware of the student’s diabetes. Concessions may need to occur sometimes. 

“The most important thing for them to understand is that students with diabetes may need an extra bathroom break or that you may hear beeps and alarms from diabetes devices,” says Ginn-Meadow. “They should take the time to understand and support the students’ accommodations for diabetes care.” It can also be helpful to inform teachers about the symptoms of low blood sugar, like shakiness or crankiness. A teacher might notice the signs before your child does.

Your child has the right to self-monitor blood sugar or provide treatment in school. Each school district has different policies that students may need to follow, so it’s important to review them. 

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5. Teach children to self-advocate

While it’s important that your child’s teacher and classmates be made aware of their diabetes, you don’t have to be the one to do it. Kids should feel empowered to talk with their teachers and classmates about their diabetes. 

“As diabetes educators, we encourage our young patients to advocate for their self-management of diabetes in school and after school activities,” Ginn-Meadow says. That can include sharing the signs and symptoms of low or high blood sugar and the treatment or, if they wear a device, letting teachers and classmates know that the alarm may ring during class. 

The American Diabetes Association has diabetes training for school staff that may be helpful for parents to share. The training includes informational videos, tips for school nurses, and FAQs about diabetes and school officials.

Give yourself some grace. Having a child with diabetes is difficult on the patient and the family. “It’s important for everyone to practice patience, as the first couple of weeks of school are an adjustment period for everyone—not only children with medical conditions that must be taken care of daily, but also their parents and teachers,” says Ginn-Meadow. Keeping all this in mind, everyone will have a better school year.