It is that time of the year when families are getting ready for the return to school. For families with young children with diabetes, this time can be very stressful, especially if this is the first time you are sending a child with type 1 diabetes to school. Relinquishing control to manage the child’s care can be anxiety provoking. Preparing for this event can often alleviate some of this concern. Gauging the child’s individual ability to perform self-management is one of the first steps when getting ready for school.
Gathering supplies for everyday use should include a care box left with the school nurse. It should include glucometer and test strips with supplies or continuous glucose monitor supplies, syringes or pump supplies with insulin, urine ketone strips, treatment for hypoglycemia including a fast-acting glucose source, such as juice boxes plus glucose tablets with follow up snacks such as peanut butter crackers. A glucagon kit should be in the box too.
Working closely with the school nurse and teachers is an important to establish goals for treatment of the child. Setting up a meeting with the teacher and nurse is helpful. Express concerns and offer education related to diabetes care. Keeping lines of communication are important to maintain objectives established initially and to discuss changes in diabetes regimen. Handouts that offer information concerning care of patients with type 1 diabetes are often helpful. This may include sheets the teacher can refer to that describe signs and symptoms of hyper and hypoglycemia. The teacher can keep on desk to refer to when and if needed. A quick run down on type of insulin action and side effects can be helpful.
If acceptable to the child, sharing with the class some diabetes basics may reduce curiosity and reduce anxiety on everyone’s part. Include the need for medication like many children need including asthma medications and antibiotics. Discuss the need to monitor glucose regularly and to eat healthy like we all should eat.
Parent and child should discuss meal planning that may include breakfast, lunch and snacks at school. Will meals be brown bagged or bought in the school cafeteria? This should be an ongoing topic. Planning ahead takes some of the anxiety out of day to day diabetes care. If the child decides to purchase lunch, knowing the nutritional content of the lunch can often reduce risk of hyperglycemia and hypoglycemia. Many school systems can provide nutritional content for common meals served in the cafeteria. Some schools bring in hot lunches on various days of the week from national restaurant chains such as Subway. Access to nutritional content is often online. There is also a phone app called T1D1 that can help with carbohydrate counting. As the child gets older and becomes more independent this may provide a level of comfort for parents and school employees.
Class parties are often challenging. If possible consider being a room parent and present during the parties to insure foods provided are accounted for. No child wants to be singled out but adjustments in insulin can prevent out of range glucose control.
Field trips are another consideration for the family and school faculty to consider with a child with diabetes. Parents are often encouraged to chaperone. It is a great to spend time with your child outside the family unit along with the child’s friends. Teachers often open up and this is a good time to answer any concerns. Bringing along supplies needed on a daily basis is important to maintain safety and avoid hypo- and hyperglycemia. Extra snacks should be included, as many field trips include walking and usually much more than an average day of classroom education, and this can result in hypoglycemia.
Education of all involved along with planning ahead can reduce stress and anxiety when sending children to school young and newly diagnosed. Being proactive can prevent miscommunication and preventable mishaps.
