By Nicole Sherry, MD
Director, MassGeneral for Children Diabetes Center
One of the first things to consider before sending a child to school for the first time after they’ve been diagnosed with Diabetes is how much information to share and with whom. Generally a big support system is best, but the decision of how much to disclose varies from family to family; some children still need time to adjust and cope so keeping their diagnosis private is preferred, while others are comfortable enough to share with some or all of their classmates.
However, parents should contact the school nurse ahead of time to discuss their child’s needs. These can change depending on the age of the student (adolescents for example need to balance Diabetes management with finding time to socialize), but a really important one is establishing a safe, private place to check their blood sugar—not having such a place can be a barrier to taking care of their Diabetes. It may also be helpful for parents to talk to their child’s teachers and alert them to signs that the student may need to check their blood sugar. For instance if the student seems tired, looks like they’re not paying attention or starts acting up, these can all be signs that the child has high or low blood sugar.
Another topic we discuss with families is whether to buy lunch at school or bring it from home. If the child brings their own lunch, we recommend identifying and labeling the carb content for each individual piece. For picky eaters, it may be best for the child to eat their lunch first and bring what’s left to the school nurse who can administer insulin based on what was eaten.
When they return to school, students can bring a set of supplies—lancets, meters and test strips as well as glucagon and ketone strips—to leave at the nurse’s office. They’ll also need to bring the doctor’s orders which outline when to check blood sugar, what to do for a high or a low, contact information for the child’s care team and insulin orders. In Massachusetts, these orders can be written on paper from the doctor’s office and don’t need to be printed on a special form from the school. Students who can test on their own should have a set of testing supplies to keep with them, along with a rapid acting glucose such as juice, jelly beans or Skittles®.