Back to School with Type 1 Diabetes: What You Need to Know

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As if being a kid isn’t hard enough, adding type 1 diabetes (T1D) to the mix is tough! Even for a child who has embraced and accepted the responsibilities that come with managing diabetes, being a kid or teenager with type 1 can easily affect every part of every day at school.

✔️ Low blood sugars during tests? It’s gonna happen.

✔️ Birthday cupcakes with that tricky-to-bolus-for buttercream frosting? You know it.

✔️ Low blood sugars right before the big soccer game starts? You bet.

✔️ Pump site failure right before your SATs? Uh-huh.

✔️ High blood sugars during that algebra exam? Not very helpful for brain power!

✔️ Being picked on by other students/scolded by teachers for wearing a pager? It’s been done before.

✔️ Being stuck on a blood sugar roller coaster while being a busy, learning student? It’s inevitable.

And let’s not forget about fluctuating blood sugars due to menstruation, growth hormones, dating, being cool, making friends, and just plain trying to fit in. So in an effort to make life just a tiny bit easier, here are a few ways every T1D family can prepare for a new school year.

Establish a 504 Plan.

504 Plans are not the same as an Individualized Education Program (IEP). While an IEP could technically be used to cover the unique needs of a student with type 1 diabetes, the traditional route for this particular student would be a 504 Plan. A 504 Plan to address a student’s needs around diabetes management is actually very simple, but crucial: your student needs to be able to leave the classroom at any time to eat, take insulin, go to the bathroom, visit the nurse, get water, etc. A 504 Plan will also give your child the opportunity to retake a test or wait to take a test if their blood sugar is too low or too high during test time. A 504 Plan will also ensure that your child will never find themselves arguing with a teacher about whether or not they can press buttons on their insulin pump without getting yelled at for using their “cell phone” in class.

Make (very good) friends with the school nurse. 🤝

Reach out to the school nurse and ask if you can go in to talk about what support she/he can provide to your T1D child or teen. It’s crucial that your type 1 student has a place to go when their blood sugar is high or low, and they need somewhere to lie down, get out of the school chaos, and manage their diabetes privately. You can also ask the nurse to store backup supplies like insulin, infusion sets, test strips, and syringes.

Speak with every teacher and coach in your student’s new grade level. 🗣

If your student is old enough (8th grade and above) they may even want to take this on themselves. Have a face-to-face conversation laying out the ins and outs of diabetes, or simply give each of their teachers a printed note that reads, “I have type 1 diabetes. I wear an insulin pump and CGM that may beep sometimes. And I have a 504 Plan in place to help me manage my diabetes safely while also being a student.” And don’t forget about the coaches! You wouldn’t believe how many type 1 kids have been held out of the game because their coach saw them drinking a juice box and assumed that meant they shouldn’t play that day. Educate those coaches!

Be sure to have backup supplies for everything your student might need.

This doesn’t just mean backup infusion sets and CGM sensors. This also goes for: pump batteries, glucose meter batteries, a backup glucose meter, lancets, syringes (even if they’re on a pump), test strips and backup insulin, properly stored in the nurse’s office refrigerator.

Stash plenty of food for lows! 🍭🍬

Perhaps in a lockable container (that growing-kid appetite!), don’t forget about keeping a good stash of fast-acting carbohydrates in your student’s backpack, locker, and pencil case. Remember that juice boxes can rot, squish, and make a big mess. More portable options include Halloween-sized candy packs or glucose tabs, because one package isn’t going to spike their blood sugar to 400 mg/dL, and they don’t melt, rot, or spill.

Establish a blood sugar communication plan between student & parents. 📲

If your type 1 teen is fairly independent with their diabetes management, this may not be as crucial. But younger kids with type 1 diabetes may need help determining insulin doses for new foods, correcting highs, and managing lows. Some parents are texting blood sugar and insulin information with their kids all day long. Other parents might help their type 1 student by coming up with a “If you eat a cafeteria grilled cheese sandwich at lunch, then you need X units of insulin” and so on. Even if you don’t expect to be communicating much, it’s still important to have that discussion with your type 1 student so they know, in the back of their head, that they always have you there to help.

What about that glucagon kit? 🤔

The tricky part of sending your type 1 student to school with a glucagon kit is that it’s only useful if someone around them knows how to use it. Their sports’ coaches definitely need to know how to use a glucagon kit, but you can’t keep a glucagon kit in every classroom, or expect the nurse to always be nearby. Depending on your students’ age, the location of a glucagon kit and who will be taught how to administer it is going to vary. The younger they are, the easier it is – they’ll only have one or two teachers. The older they are, the more teachers they are working with. Pick a trusted teacher, nurse, or coach, and let every other faculty member know that this person has been entrusted with the kit if ever the situation arises.

Being a student at any age with type 1 diabetes isn’t easy.

The more you can support your student through these obstacles rather than expecting them to juggle it all perfectly, the more confident they’ll be in their ability to manage it all. And “manage it all” doesn’t mean they’re going to do it perfectly. They are going to make mistakes. They are to make decisions that might not be the decision you would have chosen for them. Give them the support they need by always remembering that managing type 1 diabetes in school is challenging, and the hope that they can (and will) do it. 💪

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Ginger
Ginger

Ginger Vieira is a writer, author, and speaker living with type 1 diabetes, celiac disease, and fibromyalgia. She is the author of Pregnancy with Type 1 Diabetes, Dealing with Diabetes Burnout, Emotional Eating with Diabetes, and Your Diabetes Science Experiment.