Your Diabetic Child at School

Diabetes is a 24-hour condition. When your child attends school or day-care, you must help teachers or day-care providers understand the condition and the importance of caring for your child's special needs. Each school and day care provider reacts differently to children who need extra attention. If your child is going to be entering day care, or school for the first time, you will have to do your homework before entrusting her well-being to someone else.

While some schools may have a full-time nurse on staff, many do not. If your school does not have a nurse, this should not be cause for alarm. If your child's teacher has the information he or she will need beforehand, and understands the importance of responding to any warning signs, your child should safely enjoy all the benefits of a school or day care environment as much as any other child.

(1) Meet with your school principal or day care supervisor ahead of time to discuss your child's diabetes and the special needs it requires. Make sure they understand the importance of routine blood testing and, if needed, access to emergency sugar. Some schools will permit testing in the classroom, while others will insist that the testing be done in the clinic or in private.

(2) Find out who will be teaching or caring for your child and make an appointment to see him or her at least a week before your child starts class or day care. Briefly describe diabetes and the extra care that will be involved. The National Institutes of Health publishes "Helping the Student With Diabetes Succeed: A Guide for School Personnel," an excellent resource for both parents and teachers. The American Diabetes Association and the Juvenile Diabetes Foundation both offer excellent booklets that you may find helpful. Particularly recommended is the ADA publication “Caring for Children with Diabetes.” Concise yet thorough, it can be read in less than an hour.
(3) Discuss the school or day care's policy on snacks. Emphasize that mid-morning and mid-afternoon snacks are not optional for your child; they are absolutely critical to her well-being. Regardless of any other activities, you child must have access to these snacks, even if it means packing food to take to an assembly or a class field trip.
(4) Describe what happens when your child becomes hypoglycemic. Explain in as much detail as you can exactly what symptoms to look for and how to respond to them. You might include a one-page description plus instructions (Download “Hypoglycemia Fact Sheet”).
(5) Find out what time your child will be having lunch so that you can schedule her insulin and snacks accordingly.
(6) Provide a supply of emergency snacks and sugar that the teacher or day care provider can keep handy.
(7) Make sure that the teacher or day care provider knows what an insulin reaction is. If she suspects that your child may be having an insulin reaction, she must NOT ignore it or leave the child alone, not even to go to the clinic for a blood test.
(8) If you have a pager or a cell phone, give the number to your child's teacher, school nurse or day care provider with instructions to contact you whenever your child's blood sugar is out of the range you feel is acceptable.
(9) Be sure to include any other teachers or day care workers your child will be in contact with, including music, art or gym teachers as well as the school librarian. Inform them about your child's diabetes and ask them to watch for insulin reactions.
(10) If your child will be taking gym classes or participating in any athletic activities, it is especially important that the teacher knows that the child should never exercise with a blood sugar reading of 240 mg/dl. This reading indicates insufficient insulin, and exercise may actually cause blood sugar to rise.

In some school districts, you may meet with resistance to giving your child the extra attention he or she will need. In the U.S., your child’s right to a public education and any assistance necessary to achieving it is guaranteed by Section 504 of the Rehabilitation Act of 1973. For more information, see the American Diabetes Association.

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