Managing Type 1 Diabetes at School

Work with school staff to safely manage your child’s type 1 diabetes

Type 1 diabetes can be a difficult diagnosis for children and parents. Learning to manage the disease at home and finding what works and what doesn’t can take time. Factor school into the equation, and things can get a little trickier when you, as the parent or guardian, can’t be there to help.

Nevertheless, with some planning and the help of the administration and staff at your child’s school, you will find that managing type 1 diabetes at school is very doable and safe.

A female diabetes healthcare specialist with a young diabetes patient, testing his blood sugar levels

Fertnig / Getty Images

The Law and Your Child’s Rights

There are several laws in place to protect the rights of your child with diabetes at school. 

Both Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1990 (ADA) state that all organizations, including schools, that receive federal funding need to meet the needs of individuals with a disability. Students with diabetes are included in this. 

Schools need to provide reasonable modifications and accommodations for students with diabetes—for example, having school staff members trained and available to check blood glucose levels and administer insulin for a student with diabetes.

The Individuals with Disabilities Education Act (IDEA) is a law that makes available free appropriate public education to eligible children with disabilities throughout the nation and ensures special education and related services to those children. This includes children who have diabetes. 

For the above laws to apply for your child with diabetes, you must show that diabetes can, at times, adversely affect educational performance. The school is then required to develop an Individualized Education Plan (IEP) to accommodate your child’s needs.

Additionally, the Family Education Rights and Privacy Act (FERPA) requires that a school obtain written consent to disclose a student’s education records, including to the student’s own healthcare provider.

Basic Diabetes Self-Care at School

Before your child with diabetes attends school, it’s important that they are aware of and/or can manage basic diabetes self-care. This includes testing blood sugar according to a schedule or having trained diabetes personnel at the school do this. Older students can set testing reminders on their watch or phone to help them remember.

If your child wears a continuous glucose monitoring device, make sure they have access to a smart device or receiver to check and monitor their blood glucose levels throughout the day. Communicate with school staff to let your child know when and where to go for blood sugar testing if they need help.

Another important part of diabetes self-care is knowing when insulin needs to be administered or adjusted. Again, your child might require the assistance of trained diabetes personnel at the school to do this or, if your child is old enough, they might be able to do this on their own. 

It’s also a good idea for your child to wear a medical ID, such as a bracelet or necklace, every day in case of an emergency. Familiarize yourself with your child’s daily school schedule, including any after-school activities your child might attend. This will help you to know when and where you can find them if needed.

Create a School Diabetes Packing List

Make a checklist you and/or your child can look at every day to ensure all necessary supplies are packed to take with them in their backpack to school. This might include:

  • Current diabetes treatment plan, including insulin dosing schedule and amounts
  • Blood sugar meter with extra batteries
  • Test strips
  • Lancets
  • Ketone testing supplies
  • Insulin and syringes/pens (include for backup even if an insulin pump is used)
  • Alcohol wipes
  • Water
  • Glucose tablets or other fast-acting carbs like a juice box or hard candy

Your Child’s Care Team at School

Several people at your child’s school will be involved in your child’s diabetes care. While it may vary from school to school, people that might be on your child’s care team may include the principal, school nurse, teacher, or other trained diabetes personnel. Others that may be included are the bus driver, cafeteria staff, or a school counselor.

The most important person on your child’s care team is your child. Make sure to advocate for your child and teach them to advocate for themself, as well. Depending on your child’s age and level of responsibility, they may be able to participate in their diabetes care to at least some extent.

Be sure to specify in your child’s diabetes medical management plan what level of self-care your child is able to provide and what they will need assistance with.

Be aware of how familiar the staff is with the latest diabetes management technology, especially any diabetes management tools and instruments your child uses as part of their diabetes care.

If your child is with different teachers throughout the day that are not part of their care team, it’s important that a system is set up in case of a diabetes emergency while in their class.

Your Child’s Diabetes Medical Management Plan

A diabetes medical management plan (DMMP) identifies the healthcare needs of your child and provides a written description of their diabetes care regimen.

The DMMP not only specifically states who is on your child’s care team, but also details procedures and protocols for daily diabetes management, as well as special and extracurricular activities for your child.

Managing Diabetes in Class

Since your child will be spending a considerable amount of time in class each day as well as participating in diabetes self-care activities, it’s a good idea to meet their teacher. Ask about classroom rules, such as if students are allowed to leave the room without asking or if they should raise their hand to ask.

Understanding classroom rules and, in turn, letting the teacher know about your child’s needs will help there be a smoother transition in learning how to manage diabetes during class for both your child and their teacher.

You may want to ask the teacher if they could talk to the class about diabetes, including what it is and isn’t, what needs to be done every day, and what can happen when blood sugars get too low—without mentioning that your child has diabetes. 

It’s also important to inform the teacher of specific signs and symptoms to look for when your child’s blood sugar is too low. For example, they may get irritable, nervous, confused, dizzy, or hungry.

The teacher might be able to recognize these symptoms before your child does and can notify the child to eat or drink something to correct it or to get help.

Eating at School 

If your child will be eating school lunch, the school nutrition team can provide menus along with nutrition information to help your child plan for insulin use.

If you feel there is too much variability with school lunch, you can opt to have your child bring their own from home. Some parents and students prefer this option because it’s more predictable and is easier to stick to a meal plan and insulin schedule.

Snacks and treats provided at school that are not part of the regular lunch menu can sometimes offset your child’s normal daily insulin needs. You can either teach your child how to adjust insulin needs during these times or have their teacher or other trained diabetes personnel adjust insulin for any extra carbohydrates eaten. 

You may also opt to have your child receive a previously determined snack during these types of circumstances instead of the other snack or treat if that would make you and your child feel more comfortable.

Physical Activity at School

Children with diabetes need physical activity just like any other child. Physical activity increases insulin sensitivity, which can help lower blood sugar levels.

It’s important to talk with the physical education instructor about what your child needs to fully participate in physical activity safely. They should also be aware of your child’s signs and symptoms when they have low blood sugar.

Keep a “Low Box” Handy at School

Besides your child having their regular daily diabetes supplies with them, it’s a good idea to organize a “low box” with your child’s name on it to keep at school in case of low blood sugar.

This go-to box of supplies can be kept in the classroom, school office, or nurse’s office. Label it with your child’s name, and remember to keep it stocked and up to date. Below are some helpful items to keep handy in a low blood sugar kit:

  • Succinctly written instructions for how to test for and treat a low value
  • Blood sugar meter
  • Test strips
  • Lancets
  • Alcohol wipes
  • Extra batteries for meters and/or pumps
  • Glucose tablets
  • Juice boxes
  • Candies or crackers
  • Glucagon kit, if one isn’t already kept in the school or nurse’s office

Your Child’s Overall Health

In addition to the daily diabetes care of your child, it’s important to care for their overall health, as well.

Vaccines and good hygiene will help decrease the risk of your child getting sick from germs at school. Make sure your child has had all their recommended vaccines, including an annual flu shot. Having an illness can make it more difficult to manage blood sugar levels.

Teach your child the importance of handwashing, especially before eating and after going to the bathroom. It’s also important to have clean hands when checking blood glucose levels and administering insulin via needle and syringe. Washing hands is one of the best ways to avoid spreading germs and becoming sick.

A Word From Verywell

While sending your child with type 1 diabetes to school can be scary, know that it can be a safe and nurturing environment for your child. If your child is worried about going to school after being diagnosed with diabetes, acknowledge any anxiety, fear, or discomfort. Empower them to take charge of and advocate for their health at school.

Collaborate with your child’s administrators, nurse, teachers, and other school staff to build a successful diabetes care team and plan for your child. Keep communication open so everyone can be on the same page regarding your child’s diabetes care at school. Your child will be able to not only survive but thrive at school with type 1 diabetes.

By Brittany Poulson, MDA, RDN, CD, CDCES
Brittany Poulson, MDA, RDN, CDCES, is a registered dietitian and certified diabetes care and education specialist.