Written in September 2021; updated August 2023.
It’s almost time for your kids to go back to school! As a parent of a child living with type 1 diabetes (T1D), it might be a stressful period as you will have more to do than just run out to buy school supplies. This is especially true if it is the first time your child goes back to school with T1D.
You may need to meet with the school nurse and some of the staff to discuss your child’s needs. It will also be important to prepare small « toolkits » in case of hypoglycemia – low blood sugar level – with quick sugar sources and snacks. An emergency kit to keep at school, with glucagon, insulin and other diabetes-related spare equipment (depending on whether your child is on injections, uses a pump, wears a continuous glucose meter or not) is also recommended.
When you know that each Canadian student spends more than 30 hours per week away from home, leaving your child with T1D in the care of school staff isn’t always easy. In most cases, however, integration goes smoothly, and collaboration with the various stakeholders contributes to this success.
Here are a few key points to consider to ensure a smooth start to the new school year.
Train school staff
Everyone who works with your child (e.g., teachers, daycare providers, bus drivers) should receive information about T1D before school starts. This information can come from you or from your child’s health-care team. Often, a school nurse will be involved to help train school staff. However, not all schools have a full-time nurse available to supervise or administer insulin at lunchtime, for example. With the help of the school administration, you could then identify a person who will become your child’s reference for the management of his condition (e.g., teacher, person in charge of daycare).
You’re probably worried about the risk of hypoglycemia at school. To lessen your fears, make sure that school staff is familiar with :
- your child’s specific symptoms,
- the words your child usually uses to describe his discomfort when his blood sugar level drops,
- the appropriate treatment for your child, depending on the situation (e.g. use of quick sugar for mild to moderate hypoglycemia, glucagon for severe hypoglycemia).
The same guiding rules apply to hyperglycemia (high blood sugar level). Inform the school to notify you immediately if your child experiences nausea or vomiting when his blood sugar is high (above 20 mmol/L), given the risk of diabetic ketoacidosis (build up of acid in blood due to lack of insulin).
Also, keep in mind that some technologies require special training and monitoring by the school team (e.g., risk of hyperglycemia if the insulin pump does not work properly).
Ask for an individual care plan
You want the best for your child and you hope that school staff will manage T1D as well as you do at home. However, the reality of the school environment must be taken into account.
For peace of mind, ask for an individual care plan to be drawn up in collaboration with the school nurse, the school principal and your child’s care team. This will ensure that your child’s diabetes is managed according to your recommendations and those of your child’s medical team (what to do in case of hypoglycemia, for example). The individual care plan should be reviewed annually or when there are changes in your child’s diabetes management (e.g., new technology used, new health concerns).
Don’t define your child by his T1D
Most children want to be accepted for who they are apart from the fact that they live with T1D. They may not wish to be differentiated from others and want to participate, as much as possible, in all activities. For this reason, it’s best not to ask for special privileges and to respect school schedules as much as possible (e.g. meal times, physical education classes, school outings).
Involve your child in raising awareness of T1D
When your child starts a new school year with a new diagnosis of T1D, or if diagnosis is made during the year, it may be a good idea to organize a short presentation on diabetes for the classmates.
You can offer support and encouragement if your child shows interest and is comfortable sharing with others. We recommend to include information about T1D and the equipment your child will be handling in class at times (e.g., blood glucose meter, pen or insulin pump). You will also need to explain what hypoglycemia is and how to treat it (e.g., having to take sugar and snacks outside official snack times). By making other students aware of T1D, they will become understanding and non-judgmental towards your child.
Give your child a sense of responsibility
Depending on your child’s age and level of maturity, teach your youngster to independently monitor blood glucose levels and administer insulin. By becoming more autonomous in managing T1D, your child will be less reliant on the school staff, and less “different” from other students.
Use technology whenever possible
Some technologies, such as continuous glucose monitors (e.g. Dexcom and Freestyle Libre), offer the possibility of remotely monitoring your child’s blood glucose levels. This feature might reassure you as you will get alerts when hypoglycemia, or hyperglycemia, occurs.
Build on collaboration and trust
A climate of cooperation and trust with school staff undoubtedly favors your child’s integration and the establishment of the elements essential to safety.
Accepting that the school can make mistakes, just as you can, will help foster this climate.
Don’t forget to mention to the school staff that a child living with T1D is no different from any other child when the management of blood sugar is optimal. They can therefore expect your child to act and participate in activities like the other students.
- Caroline Boucher, « À l’école » dans Le diabète chez l’enfant et l’adolescent. Édition du CHU Sainte Justine, p 562-574.
- Diabète Québec, Diabetes at schoool, consulted August 6, 2023, https://www.diabete.qc.ca/en/diabetes/living-with-diabetes/for-the-caregivers/daycare-school-and-holiday-camps/diabetes-at-school/
- Gagnon-Le Borgne Danielle, infirmière. (Été 2000). Pour une rentrée scolaire réussie, Plein Soleil, Diabète Québec, p.21.
- Ministère de la Santé et des Services sociaux du Québec. (2011). Protocole d’intervention en milieu scolaire pour les élèves atteints de diabète de type 1. Consulted August 16, 2023, https://publications.msss.gouv.qc.ca/msss/fichiers/2011/11-215-01W.pdf
- Diabetes Canada. Guidelines for the care of students living with diabetes at school. Consulted August 16, 2023. https://diabetes.ca/DiabetesCanadaWebsite/media/Learn-About-Diabetes/Your%20Rights/Diabetes_Canada_KWDIS_Guidelines-(ENG).pdf
Written by: Nathalie Kinnard, scientific writer and research assistant, and Sarah Haag, R.N., BSc.
Linguistic revision by: Marie-Christine Payette