With safeguards in place, your child can safely learn and develop during the year. Simple steps help make school easier for parents, children and school staff.
Standards of care for students with diabetes in school
This document is approved by the Canadian Diabetes Association. Resources and guidelines for students with diabetes, their parents/caregivers and school staff on how to manage diabetes during school hours.
Arrange a meeting early in the school year. At this meeting, you and your child can discuss diabetes management with teachers and other caregivers. Work together to develop a plan to meet your child’s needs while at school.
The school is responsible for providing a safe environment for all students. Staff in direct contact with your child must know how to oversee any special needs along with emergency care. Talk to the principal about alerting and training other school staff, including the librarian, bus driver, lunchroom staff, and substitute teachers.
It may be helpful to take along a copy of Kids with Diabetes in Your Care. This resource was developed by the Canadian Diabetes Association (CDA) to help families and schools plan for a child’s diabetes needs while at school. You can find it on the CDA website www.diabetes.ca.
You can help teachers and other students understand diabetes in many ways. Some students with diabetes may choose to share this information with only a few very good friends in a very private way. Others are quite comfortable standing up in front of their class to demonstrate how they check blood glucose and take insulin, and how to recognize and treat low blood glucose.
Older children may wish to negotiate credits with their teacher for doing a diabetes presentation for their class. If your child is uncomfortable sharing the diagnosis with a class or school in general, this should be respected and privacy ensured.
Most children with diabetes must check their blood glucose (sugar) at least once during the school day. If so, your child should either bring a blood glucose meter or keep one at school. Most children can perform blood glucose checks by themselves. However, some may need supervision to ensure it is done correctly and that results are recorded accurately. The school should provide a private, clean space to do blood glucose checks.
Talk to school officials about when and how often your child needs to check blood glucose levels. If your child finds it hard to remember when to do blood glucose checks or eat meals and snacks, considering supplying a watch with an alarm, or a cell phone, for this purpose.
Most students with diabetes follow a meal plan to ensure food intake is balanced with insulin. Snacks are often part of this plan and can be eaten in the classroom or at recess. If possible, snacks should be planned for the same time that the other children eat. Some children need supervision to ensure meals and snacks are eaten completely and on time.
Parties or special lunches where food will be served can be lots of fun when well planned. Ask the school to inform you of such events, so that you can decide how to incorporate any new foods in your existing meal plan. If candy is involved, your child should know whether to eat it or take it home. Consider providing a sugar-free selection of candy for these events. Your child will feel included in the celebration, and you can give the candy from class later.
The handling of insulin varies from child to child. Many need insulin before breakfast and not again until the evening. In this case, injections are not necessary during school hours. Others take insulin before each meal or use an insulin pump. These children must be allowed to give insulin at appropriate times.
If the child is young and insulin is needed at noon, a parent may need to meet the child at school. Otherwise, simple supervision by an aide is all that is needed. Parents and school officials should decide together how to support the child in this capacity.
Children who take insulin are at risk for hypoglycemia (low blood glucose), a blood glucose level of less than 4 mmol/L. Signs and symptoms of low blood glucose vary and include shaking, trembling, sweating, and rapid heartbeat. Many young children experience fatigue, sore stomach and misbehaviour. Alert your child’s teacher to the usual signs.
Recognizing and treating low blood glucose as quickly as possible helps prevent severe hypoglycemia, loss of consciousness or seizure. In order to treat quickly, teachers and students should always have supplies for treatment on hand. Parents should supply the school with the rapid-acting carbohydrate (sugar) treatment of choice. Many schools keep treatment supplies in the office and with the gym teacher as well as in the child’s homeroom and locker. Rapid-acting carbohydrate treatments that can be easily stored at school include glucose tablets, juice, Skittles, or jelly beans. Detail how much is needed to treat low blood glucose. Provide a snack for follow-up in case the next meal is more than an hour away.
Written guidelines for treating hypoglycemia are very helpful and ensure your child’s safety while at school. Ask teachers to tell you about any hypoglycemic events, so that you can adjust the diabetes plan accordingly. Your child’s agenda or a separate notebook is ideal for this type of communication.
Not all children with diabetes are comfortable sharing personal information with classmates or teachers. However, for safety reasons teachers must be aware of the condition and know how to treat low blood glucose. Certain trustworthy classmates can be taught to notice and treat low blood glucose.
Blood glucose that is too high is called hyperglycemia. This event can be caused by eating more than usual, doing less activity, being sick or under stress. If blood glucose is high, your child should be allowed to drink plenty of water and go to the bathroom as often as needed.
Good communication between school, parents and child helps ensure success at school. Parents and teachers will also have confidence in the diabetes care while the child is at school. Kids With Diabetes in Your Care (see sidebar on page 28) has easy-to-use pages which can help you organize simple instructions. Early in the year, decide on methods of communication between family and school. Consider using e-mail, the child’s agenda or a special notebook. Provide contact information, including a cell phone number, so that you can be reached easily.
Careful planning and good communication help to ensure a student with diabetes will feel safe and included in classroom activities. By working with the family, schools often find they can effectively support a child with diabetes despite limited resources.