School and Daycare Issues

Each school reacts differently to children that need a little extra attention. And children with diabetes do need a little extra attention, especially when they are very young. If you are approaching your first school year with diabetes, here's a list of things you should do before school starts:

  1. Meet with the school principal and determine the school's specific policies regarding blood testing and access to emergency sugar. Some schools allow the children to test in the classroom, while others require them to test in the clinic.

  2. Find out the name of your child's teacher and make an appointment to see her at least one week before school starts. At that meeting, you should:

    1. Tell her that your child has diabetes.

    2. Briefly describe what it means to have diabetes. Both the ADA and the JDF have excellent booklets and pamphlets to assist you. Particularly good is the ADA publication, Caring for Children with Diabetes. It cover the basics about diabetes and, at only 14 pages, is short enough to read in about an hour.

    3. Tell her that your child must eat mid-morning and mid-afternoon snacks, and tell her at what time you expect the snacks to be eaten. For most kids, these snacks are not optional! Regardless of the day's activities, your child must be allowed to eat these snacks. That might mean bringing food to an assembly or field trip.

    4. Find out at what time your child will be having lunch so you can plan your insulin accordingly. Some kids have lunch at 11:00 while others have lunch at 12:45. That can make a big difference on insulin and morning snack makeup.

    5. Describe what happens when your child is hypoglycemic. Since every child reacts differently, tell her exactly what to look for and how to respond. You might want to provide a one-page instruction sheet.

    6. Give the teacher a supply of sugar and extra snack foods to keep in her desk in case they are needed. In some schools, you might have to keep these in the clinic.

    7. Impress upon the teacher in no uncertain terms that if she suspects that your child is having an insulin reaction that your child is not to be left alone. If your child must go to the clinic to perform a blood test, make sure the teacher understands that someone must go with your child.

  3. If you can, obtain a numeric pager. Give your pager number to your child's teacher and clinic nurse, if there is one. Have then send a page with your child's blood sugar value whenever it is out of the range that you feel is acceptable.

  4. Meet with any other teacher that your child will see, including gym teachers, music teachers, art teachers and the librarian. Let them know that your child has diabetes and ask them to be on the lookout for an insulin reaction. This is especially important for gym teachers.

  5. An extra note for the gym teachers: Make sure that they know that your child should not exercise with a blood sugar over 240 mg/dl, since such a high sugar can indicate insufficient insulin and, in this case, exercise can actually cause the blood sugar to rise. One parent reported that her child's gym teacher said that exercise lowered blood sugar and made a ketonic child run a mile!

If You're Faced with an Uncooperative School

First, be sure that you are realistic in your expectations. If your school doesn't have a full-time nurse, they aren't likely to get one just for your child. A full-time nurse isn't necessary for kids with diabetes. With proper education, your child's teacher can provide an environment suitable for in-classroom blood testing and be alert to your child's signs of low blood sugar.

For parents faced with less than accommodating school districts, however, mention of Section 504 of the Rehabilitation Act of 1973 can help show you're serious. Section 504 deals with discrimination, and is the basis for accommodating the special needs of children with diabetes. The following resources will help:

For More Information


  1. Managing Your Child's Diabetes by Robert Wood Johnson, IV, Sale Johnson, Casey Johnson and Susan Kleinman
  2. A Child with Diabetes is in Your Care by the Juvenile Diabetes Foundation
  3. Caring for Children with Diabetes by the American Diabetes Associtation


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Last Updated: Tue Oct 21 07:28:27 2003
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