Wednesday, July 24, 2013

Back to School Type 1 Diabetes Survival Tips for Parents

Back to school is right around the corner, and school shopping isn’t the only thing that a mom and dad of a type 1 diabetes child needs to plan and prepare for. They also have to make sure the staff at their child’s school is trained and educated on how to take care of their child’s highs and lows; They need to ensure their type 1 child has enough supplies (medical, food and drink) on hand at school; And they need to plan for the unexpected. 

Below are some tips and strategies to help parents of type 1 children get ready for back to school. Please feel free to share any that you have too in the comments section!

  • Get the class and activity schedule before your type 1 diabetes son or daughter starts school. This helped me with trying to set-up my daughter’s insulin pump basal rates during the day. For instance, before she got on the school bus, I lowered her basal enough where her blood sugar wouldn’t drop to where she was at risk of a seizure or passing out. We also worked out a plan for recess where my type 1 daughter would take off her pump and leave it on her desk. This way when recess was finished, she would see her pump on her desk which reminded her to put it back on.
  • Schedule a training with the teacher and nurse prior to school starting. I went in a few days before school started and trained my daughter’s teacher on how to manage my type 1 child's diabetes at school. We discussed lows, highs and the unexpected such as how to handle rain days and substitute teachers.
  • Provide your teacher with a bullet list of what if scenarios. The information I included were things like what if it rains and what if she drops food on the floor during lunch and what if there is a substitute teacher and what if she has a test after lunch. I also included things like how to tell if my daughter was low or high symptoms and how to treat them. 
  • Create a daily log sheet that is sent home every day. Every morning before my daughter goes to school, I fill out the date, what her morning bg was, how many carbs she ate for breakfast and how much insulin I gave her. I also list what her snack carb will be and breakout her lunch items along with carb count. My daughter takes this to school with her and the teacher fills it out every time my daughter checks her blood sugar and administers insulin. The daily log sheet went home with my daughter every day. This helped me in making the necessary basal rate changes to her pump.
  • Exchange cell phone numbers and email addresses if you can. My type 1 daughter’s teacher was awesome! She would text or call me whenever she had a question or wasn’t sure how to handle a situation (and there were many!). The most challenging part during last year’s school year was trying to get my type 1 diabetes daughter’s blood sugar low enough so she could participate in PE. She ate breakfast an hour before PE, which always caused her blood sugar to be right around 300 at that time. Our school will not allow a type 1 diabetic to participate in PE if their blood sugar is over 300. They also will not allow them to get on the school bus if their blood sugar is over 300 or too low.
  • Create a type 1 diabetes at school supplies container. I bought a plastic container with a cover from Target which I filled with sugar tablets, 8 pack of juicy juice boxes, peanut butter crackers (protein), an extra glucose meter and ketone strips. Whenever my type 1 daughters supplies started to run low, the teacher would make note of it on the daily log sheet she sent home.
  • Have your child carry a diabetes bag filled with sugar tablets, a juice box, protein, and meter (and test strips/lancets/finger pricker). They will need to take this everywhere they go.
  • Discuss with your child's teacher and your child where they will check their blood sugar in class. For my daughter, the teacher set-up a table in the room where she could check her blood sugar. This is where my daughter kept her diabetes bag, daily log sheet and whatever else she needed.
  • Determine how and if your type 1 child will share their disease with the students. We had my daughter take one of her type 1 diabetes books in for the teacher to read to the class. Then the teacher opened it up for discussion.
  • Make sure your child's classroom is not an allergy classroom or has peanut allergy restrictions. Protein is a must for keeping a type 1 child's blood sugar stable. And peanuts and peanut butter work great!
  • Fill out proper medical and school paper work, and know your legal rights! We have my type 1 daughters endocrinologist fill out diabetes medical management plan detailing my daughters insulin levels and what range her blood sugar should be kept at. In addition, we completed a 504 Plan which allows my daughter to take an exam at different times if her blood sugar is too low or too high. It also allows her to be excused from class during an exam if she needs to go to the bathroom.
  • Know your legal rights.

Other tips for dealing with seemingly small problems that can depress children about having type 1 diabetes(e.g. all the good cafeteria seats being taken by the time a child returns from the nurse at lunch or having to carry their supplies around with them all the time).
  • Try to invest in a diabetes bag that your child likes. My type 1 daughter picks out everything herself. She likes using a mini backpack. We also got her an insulin pump sports waist band from Pump Wear, Inc. that has cheetah prints on it and some fun things from Pumptastic
  • Have someone reserve a seat at lunch or during a school event for your type 1 child. My daughter’s twin brother tries to hold a seat for her at lunch, while she’s in the classroom checking her blood sugar. I would talk to the teacher about helping make the diabetic child comfortable, where they can ensure the type 1 child gets to sit next to their good friend.

  • Plan ahead for a celebration or party. There have been many occasions where my type 1 daughter hasn’t been able to eat during a celebration because her blood sugar is too high or it’s 30 minutes prior to the bus leaving. When that happens, I have the teacher wrap it up and let her take it home. In fact, there were quite a few times where they wouldn’t allow her to take the bus home because her blood sugar was over 300 bg. I have three kids at the elementary school. When my daughter unexpectedly couldn’t ride the school bus, the school staff would have to frantically run around and get my other two off the bus so I could pick up all three together. After a couple instances like the above, we put a plan in place where if there was a birthday celebration or treat up to one hour before my daughter got on the bus, then she would take the treat home.

  • When a substitute teacher is in her class, my type 1 daughter has to go to the nurse to have her blood sugar checked. There always has to be someone with my daughter when she checks her blood and administers insulin. It’s a protocol her elementary school has. At my daughters school, the nurse is only there three days a week. On the days the nurse is not there, another diabetes trained school staff member sits with my daughter when she checks her blood sugar or administers insulin.

  • Like I mentioned above, my type 1 daughter has missed part of PE or all of PE at least half of last year because of the time it’s held for her specific grade class. I have her color or play a game. I try to have her do things she likes to do during that time because she can’t run around and play.

  • Your type 1 child drops food onto the floor or spills their drink. You’ll find that the teacher will panic more than your child. Try to estimate how many carbs your type 1 child dropped on the floor. Then supplement with something else. We always had extra peanut butter crackers on hand to supplement what fell onto the floor. And this definitely happens!

  • It rained or snowed. If your child doesn’t take their pump off during recess than most likely your child’s blood sugar will be higher. If you are able to send in a note that informs the teacher to give your child a little more insulin at that time, you’ll be able to manage these highs better.

  •  No nurse at the school! The nurse at my daughter’s elementary school is only there three days a week. It is required that a trained diabetes adult has to give, help or observe my type 1 daughter when she check’s her blood glucose and bolus’s herself (bolus means give insulin). For insulin shots, two trained diabetes adults MUST verify dosage and be in the room while administering insulin at my daughter’s school. Mistakes happen. I love that my type 1 daughters school has such strict rules.

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  1. My mother had type 1 diabetes. Great tips :)

    1. Hi Ann, I can't imagine what my daughters life would be like having type 1 diabetes 20, 30 or even 40 years ago. God bless your mom!

  2. Thank you for this great blog on Type 1 back to school. My son Jason was diagnosed on April 27, 2007, at age 11. That year the school published an information poster. The following year, we did a similar training program for the school and information package as in your blog. This was helpful for the teachers and the school, which had no idea (or extremely lack of knowledge) of what Type 1 Diabetes was. Jason was put in charge from the first day (with parent's supervision) of managing his diabetes. He has done extremely well and his endocrinologist stated that Jason was one of the very few in his years of practice who had not returned to hospital for Diabetes emergency. At 15 Jason wanted to go to a Lutheran (LCBI) boarding school for grade 10. He is completing grade 12 there in 2013-2014. Moving to a boarding school and be on your own to manage diabetes was one of the most important decisions we made to help Jason. He has learned to be on his own, but still had some supervision in that someone would know if he didn't make it to class in the morning.

    1. Giving your type 1 child freedom is so important. I'm still working on baby steps, but doing more every day! Jason is an inspiration to other type 1 children.