Navigating School with Type 1 Diabetes: Essential Guide for Parents and Teachers (2024)

Did you know that approximately 1 in 400 children in the United States has Type 1 Diabetes? For these young warriors and their families, school isn't just about ABCs and 123s – it's a daily balancing act of blood sugar management, learning, and growing up. 

But here’s the good news:

With the right knowledge and support, children with T1D can thrive in any classroom.

Let’s dive into how we can make that happen!

Understanding Type 1 Diabetes in the School Setting

Type 1 Diabetes isn't just a medical condition; it's a daily companion for students who live with it. In the classroom, it means balancing blood sugar levels with learning fractions and studying history. It's crucial for everyone in the school environment to understand that T1D doesn't define a student, but it does require attention and care throughout the school day.

In the Diabetic Ninja world, we are transitioning from elementary school to middle school (junior high for some people). So this means new teachers, new staff, new day, and a new school nurse. So we are enacting this same plan to get all teachers and administration on board with what our doctor requires and our lil blue ninja needs.

So let’s begin together!

Creating a Comprehensive Diabetes Management Plan

A solid diabetes management plan is like a roadmap for success in school. It outlines everything from blood sugar checking schedules to insulin doses, ensuring everyone knows their role in keeping the student healthy and ready to learn. Remember, this plan is a living document – it should grow and change as the student does, adapting to new routines, growth spurts, and the ever-changing nature of T1D.

Before dropping a bunch of paperwork on the school nurse desk, call and ask what they specifically require from you as well as your doctor. There might be specific paperwork involved. Also ask if that school nurse already manages other kids with type 1 diabetes. This may save time and streamline your coordination practice.

Essential Diabetes Supplies for School

Think of a diabetes kit as a student's superhero utility belt – it's got all the tools needed to tackle T1D challenges during the school day. Stocking and storing these supplies properly ensures that help is always at hand, whether it's a routine blood sugar check or managing an unexpected low. It's not just about having the supplies; it's about knowing where they are and how to use them effectively.

This is where working specifically with your child’s teacher or teachers and the school nurse is imperative. In elementary school, the teacher had a small refrigerator that held low snacks in the classroom. The teacher’s aide sent notes home requesting more when they ran out.

The nurse only held quick emergency glucose and some shelf stable snacks; as well as a finger stick kit and urinalysis strips.

Middle school and High Schoolers are in a different situation with changing classes and rooms all day. They typically will require a more robust kit that is essentially with them at all time.

Blood Glucose Monitoring at School

Blood glucose monitoring is like checking the fuel gauge on a car – it tells you exactly where you're at and what you need. Setting up a testing routine that fits seamlessly into the school day helps minimize disruptions while keeping the student's health in check. With a little creativity and planning, blood sugar checks can become as routine as sharpening a pencil.

In our school system, Dexcom seems to have a monopoly with blood glucose monitors, as that’s what all diabetics there seemed to use. (for good reason). That made it easy for the diabetic ninja twins to integrate quickly back to school after diagnosis.

It was super easy and stress free to coordinate with school nurses and integrate into the monitoring they already did with other children. The School Nurse has an IPAD that monitors each dexcom account and they can set alerts for highs and lows (blood sugar) according to your doctors instructions.

It is stressful at first to give up control and monitoring to another individual, but parents need the break as well.

Insulin Administration During School Hours

Insulin is the MVP in the T1D management game, and administering it at school requires teamwork and precision. Whether it's via injections or an insulin pump, having a clear plan for insulin delivery ensures the student gets the right dose at the right time. It's not just about the mechanics of giving insulin; it's about integrating this crucial task into the school day smoothly and safely.

Often times school rules consider insulin a prescription drug and won’t let your t1d child administer it themselves. Having an omnipod (or other insulin pump) sort of negates this, but our elementary age ninja was required to talk to the nurse before entering his carb count and pressing go on his insulin delivery.

Our high school age ninja showed the school nurse what she was doing for the first few weeks, and was then left to fend for herself.

Your experiences may vary. How does it work at your school? let us know here.

Managing Hypoglycemia in the Classroom

Low blood sugar can sneak up quickly, making swift action crucial. Having a clear, easy-to-follow protocol for treating lows ensures that everyone, from the teacher to the student, knows exactly what to do. It's about being prepared, staying calm, and turning a potential emergency into a manageable situation that gets the student back to learning as quickly as possible.

BGM alarms and understanding your child’s response to food and activity are what’s best to communicate and understand with school staff.

As an example, our son would go “Low” nearly every day after lunch because he’d run around like a crazy ninja on the playground. The school nurse and I would make a plan to cut carb count, or cut insulin count, or put his omnipod on “activity”. All of these things would work in part, but then a rain day would keep him inside for rec and then he would go high. Ultimately it seemed best to NOT adjust anything for lunch and then provide extra carbs as needed for the activity. Best to consult with medical professionals since every kid is different, but you know your child best.

Constant adjustment and monitoring is the name of the game here.

Understanding low symptoms and knowing if a child can “feel” the low blood sugar are important as well.

Handling Hyperglycemia During School

High blood sugar might not be as immediately urgent as a low, but it still needs attention. The key is balancing diabetes management with minimizing classroom disruptions. By having strategies in place, students can address high blood sugars without missing out on important learning time. It's all about finding that sweet spot (pun intended!) between health management and academic engagement.

Similar to the HYPOglycemia (low blood sugar) conversation above, you will find that adjustments for high blood sugar one day don’t meet the reality of the next day. Kids are more labile (meaning they bounce around and respond quicker to insulin and carbs) than older diabetics. Mostly 😉

Here’s important considerations when blood sugar is HIGH:

• Do they have insulin on board?
• Is their pump working correctly or due to change?
• Is their BGM working correctly or due to change?
• Are they sick?
• Are ketones high?

The child’s doctor, school nurse, and parents should have a protocol for each of these. Normally it starts with a check of urine for ketones with a ketone stick. If you’re interested in more information on how the Diabetic Ninjas approach this, let us know here.

Nutrition and Meal Planning for T1D Students

Food at school isn't just about satisfying hunger – for students with T1D, it's a key part of their health management. Working with school cafeterias on carb counting and planning for special events ensures that students can enjoy meals and treats while staying on top of their diabetes. It's about making food fun and safe, not a source of stress or exclusion.

The option always exists to send a child to school with their own packed lunch and snacks. This way you and the child know exactly what’s in the lunch, what the carb count is, and know that its something the child will actually eat and finish. Most schools have carb counts available for lunches, but not always for snacks or treats for special occasions like birthdays and holidays.

There are a few options for special occasion treats:

• Keep a snack/treat in classroom just for your child
• Send a snack/treat for special occasions that you know carbs for
• Allow your child to enjoy the special treat and adjust insulin accordingly

There’s no right or wrong answer here. None of us need any extra refined sugar at all, so having this stuff at school isn’t necessary; But socially it might be nice to fit in for a child.

Physical Education and Extracurricular Activities

Being active is great for all kids, including those with T1D, but it does require some extra planning. The goal is to ensure students can participate fully and safely in PE and after-school activities. With the right strategies in place, sports and physical activities become opportunities for fun and learning, not obstacles to be feared.

Protocols worked out with a diabetic student’s doctor, school nurse, parents, coaches, and teachers are necessary here. Prior planning of how intense an activity is coupled with hydration and a pre-activity snack is what we all do.

Most endocrinologists can give you a chart that outlines your specific carb needs vs blood sugar protocol.

If you need to see an example, let us know here.

Supporting Academic Performance with T1D

Blood sugar ups and downs can affect more than just physical health – they can impact learning too. Understanding this connection is key to supporting students' academic success. With the right accommodations and support, students with T1D can excel in their studies, proving that diabetes is just a part of their life, not a barrier to achievement.

Teachers absolutely need to know the signs associated with type 1 diabetes. When our blue ninja went hot for td1, we later had a meeting with the school principle, teacher, and school nurse. The teacher mentioned how he would put his head down every afternoon after lunch. For weeks. This affected his school work in the afternoon, but she never told us until after the fact.

Similarily, our pink ninja went to math class after lunch. Pre-diagnosis she was failing math and getting nothing but grief from the teacher. Turns out she was freaking diabetic and going super high everyday after lunch… so cognitively she wasn’t capable of doing math. This “gentleman” was a complete moron after diagnosis too. After a few choice conversations with the principle and time with a tutor, the Pink Ninja was back on track.

We use these example to illustrate that some teacher just don’t get it. They need to be taught how to recognize signs and adjust for this disabling condition.

And sometimes you just have to force it with IEP’s and 504 plans. More on that later.

Emotional and Social Aspects of T1D at School

Managing T1D at school isn't just about blood sugars and insulin – it's also about navigating the social and emotional landscape of growing up. Helping students feel confident and supported in managing their diabetes can have a huge impact on their overall school experience. It's about creating an environment where T1D is understood, accepted, and never a source of shame or isolation.

Communication Between Home and School

When it comes to managing T1D at school, good communication is everything. Keeping all parties in the loop ensures that everyone is on the same page about the student's needs and progress. In today's digital age, there are more ways than ever to stay connected, making it easier to provide seamless care from home to classroom.

Texting with school nurses, teacher’s aides, and sometimes teachers or staff throughout the day seems to be the norm. It’s best to talk about communication protocols before things happen. There have definetly been times where I see a diabetic ninja with a lower blood sugar with arrows double down (on the dexcom) and have called the school nurse to make sure she is on it with carbs. Sometimes she appreciates the reminder!

Legal Rights and Accommodations for T1D Students

Knowledge is power, especially when it comes to the legal rights of students with T1D. Understanding and implementing the appropriate accommodations ensures that students have equal access to education while safely managing their diabetes. It’s not about special treatment; it’s about leveling the playing field so that T1D doesn’t hold any student back from reaching their full potential.

Training School Staff on Diabetes Management

Empowering school staff with diabetes knowledge is like giving them a superpower to support students with T1D. Comprehensive training ensures that everyone, from teachers to administrators, feels confident in their ability to assist with diabetes management. Remember, this isn’t a one-and-done deal – regular refreshers keep everyone’s skills sharp and up-to-date.

Emergency Preparedness for T1D at School

While we hope for the best, it’s crucial to be prepared for the worst. Having a clear, well-practiced plan for diabetes emergencies ensures that everyone knows exactly what to do if the need arises. It’s like a fire drill for diabetes – a bit of preparation can make a huge difference in a critical moment.

Thriving with Diabetes at School

With the right preparation, communication, and support, students with Type 1 Diabetes can have a safe, healthy, and successful school experience. By working together, parents, teachers, and school staff can create an environment where T1D management becomes a seamless part of the school day, allowing students to focus on learning, growing, and enjoying their educational journey.