Topic Overview

Federal laws protect children with
diabetes from discrimination in schools and child care
settings. Schools and child care centers must provide reasonable help for the
special needs of children with diabetes while disrupting the usual routine as
little as possible. Also, children should be allowed to take part in
all school activities.footnote 1

If your child has
diabetes, work with your child care center or school to build a care plan
that meets your child’s needs and gives specific instructions for how to handle
the following:footnote 2

  • Blood sugar testing. Include how often and in what
    situations your child’s blood sugar needs testing. For example, your child may
    need routine testing before lunch and special testing if he or she appears to
    have low blood sugar.
  • Insulin, if needed. Include information on
    how to give insulin, how much medicine to give, and how to store
    insulin.
  • Meals and snacks. Make a list of foods that your child can
    eat, how much, and when. Talk with the staff about what to do when there are
    parties at the facility.
  • Symptoms of and treatment for low blood sugar. Give the staff copies
    of symptoms of low blood sugar and treating low blood sugar for later reference. And tell
    them how your child acts when his or her blood sugar level is low.
  • Symptoms of and treatment for high blood sugar. Give the staff copies
    of symptoms of high blood sugar and treating high blood sugar for later reference. And tell them how your child acts when
    his or her blood sugar level is high.
  • Testing

    ketones
    . Include instructions for when and how to
    test your child for ketones and what to do if ketones are
    present.
  • Physical activity and sports. Include information about when your child’s blood sugar should be checked before activity and the desired target range. Provide information about what and how much quick-sugar food to have on hand for your child.
  • Contact persons. Include how to contact both parents
    or another adult who cares for the child as well as the name and phone number
    of the child’s doctor.

You may hear a care plan called a “504” plan. 504
refers to Section 504 of the Rehabilitation Act of 1973, the Individuals with
Disabilities Education Act of 1991, and the Americans with Disabilities Act.
These are laws that protect people who have disabilities. It means that schools
that have federal funding cannot discriminate against children who have
disabilities, and that includes children who have diabetes.footnote 2 You can find a Diabetes Medical Management Plan on the American Diabetes
Association’s website.

You will need to give the staff all of the
materials and equipment they need to care for your child, including supplies to
do a
home blood sugar test, insulin, syringes,
glucagon (if it’s in the care plan), and materials for
testing ketones. And you need to teach the staff how to use these
materials. Remind the staff that your child needs access to the materials and
equipment at all times, even on a field trip. Now and then, check the expiration
dates of supplies your child has at school.

The child care center
or school should provide safe storage for your child’s medicines. Also,
they should provide a private place for your child to receive care, if
desired.

The child care center or school should provide an adult
staff member and a backup person who are:footnote 2

  • Able to test your child’s blood sugar level,
    record the results, and take the correct action for high or low blood sugar
    levels.
  • Trained to give insulin and glucagon, if
    needed.
  • Able to test your child’s urine or blood for ketones and
    know what to do if the results are not normal.
  • Aware of your
    child’s meal and snack schedule and can remind your child when it is time to
    eat again.

Also, your child should have permission to:

  • Eat a snack anywhere, including the classroom and
    school bus. Make sure this is in the diabetes care plan.
  • Use the
    restroom and drink liquids as needed.
  • See school health personnel
    whenever he or she asks.
  • Miss school (without consequences) for
    medical appointments.

If your child can do a blood sugar test, let the staff
know that your child may need help when his or her blood sugar level is low and
may need to be reminded to eat or drink something during these times.

A child should never be left alone when his or her blood sugar level is
low.

Contact the American Diabetes Association for a sample
diabetes care plan and other information for teachers and child care
providers.

For older children who take their own insulin to
school, check the school rules for kids carrying their own medicine, needles,
and blood sugar meters. Many schools do not allow kids to carry any kind of
medicine without special permission.

References

Citations

  1. Siminerio LM, et al. (2014). Care of young children with diabetes in the child care setting: A position statement of the American Diabetes Association. Diabetes Care, 37(10): 2834-2842. DOI: 10.2337/dc14-1676. Accessed October 9. 2014.
  2. Jackson CC, et al. (2015). Diabetes care in the school setting: A position statement of the American Diabetes Association. Diabetes Care, 38(1): 1958-1963. DOI: 10.2337/dc15-1418. Accessed January 11, 2016.

Other Works Consulted

  • Siminerio LM, et al. (2014). Care of young children with diabetes in the child care setting: A position statement of the American Diabetes Association. Diabetes Care, 37(10): 2834-2842. DOI: 10.2337/dc14-1676. Accessed October 9. 2014.

Credits

ByHealthwise Staff
Primary Medical Reviewer John Pope, MD – Pediatrics
Kathleen Romito, MD – Family Medicine
Specialist Medical Reviewer Stephen LaFranchi, MD – Pediatrics, Pediatric Endocrinology

Current as ofMarch 13, 2017