How can you make managing diabetes at school easier for your child?

Learning how to manage their diabetes at school can be a big challenge for children. It may also bring changes to their school day as they learn to find time to care for their illness. But it can also be an opportunity for them to start taking more responsibility for their own health.

Part of that means learning how to eat the right foods at the right times and get lots of exercise. It can also mean teaching classmates what diabetes is and what the shots and blood sugar meters are for.

You can help your child by working with the doctor or diabetes educator to create a diabetes care plan for school. And you can keep your child's teachers, coaches, and other school staff informed about how to give diabetes care and manage blood sugar emergencies. A care plan will help you share this information with school staff.

Making a diabetes care plan for school

A diabetes care plan lists all the information that the school staff needs to manage your child's diabetes. Your province may have a care plan template you can use. You can also visit www.diabetesatschool.ca/tools/individual-care-plan to find a template. Here is some important information to put in the plan.

• Include information about insulin or other medicines, if needed.
  • Provide directions on how to give insulin to your child (for example, with an insulin pen), how much insulin to give, and how to store the insulin.
  • If your child takes other medicine for diabetes, make sure to include instructions on how, when, and how much medicine your child should take.
• Provide information about food.
  • Make a list of foods your child can eat, how much, and when. List foods that your child can have during special occasions, such as a class party or field trip. Include information about insulin, if needed, for special-occasion foods.
  • Provide school staff with snacks for your child as needed. Be sure your child's teacher and the school staff know that your child has permission to eat a snack anytime your child needs it. You may want to provide the teacher with glucose tablets or other quick-sugar foods, such as hard candy or fruit juice. The teacher can give it to your child when your child has signs of low blood sugar.
• State how often and when to test your child's blood sugar.

  Work with school staff to create a testing schedule. For example, your child may need their blood sugar tested before lunch and when having symptoms of low blood sugar. The diabetes care plan should also say if an adult needs to test your child's blood sugar or if your child can do it.

• List the symptoms of low or high blood sugar.

  Your child's symptoms may be different from those of other children. Describe your child's symptoms of low or high blood sugar and how to treat them. Make sure the school staff know to never leave your child alone after treatment for low blood sugar.

• Include when and how to test your child for ketones.

  One or more other school staff members should know how to test your child for ketones and know what to do if the results aren't normal.

• Include information about when your child's blood sugar should be checked before physical activity.
  • Include your child's target range.
  • State how many glucose tablets or how much quick-sugar food to have on hand for your child during physical activity.
• Include other important instructions.

  The diabetes plan should also state that your child is allowed to:

  • Eat, drink, and use the washroom when needed.
  • Call a parent, guardian, or caregiver whenever your child asks.
  • Miss school for medical appointments.
• Include contact information.
  • List parent(s), guardian(s), other caregivers, and your child's doctor. You will also want to let school staff know when to call 911 for help in case of an emergency.
  • Include the best way to communicate with you about your child's health. Daily or weekly phone calls, emails, or journal entries can be used to track how things are going at school.
• Include information about privacy.

  Be sure to state that you expect the school to provide a private place to take care of your child's diabetes needs.

Meet with the school staff at the start of each school year. Talk about the care plan with your child's teachers, gym teacher, and school leaders. And update the care plan each year. Make sure to tell the staff about any changes to the plan during the year. Check with your school or province about which tasks require signed consent, a mutual agreement, or training provided by you.

Along with the plan, give the school staff the right supplies to care for your child. These include:

• A home blood sugar test.
• Insulin and syringes.
• Foods that raise blood sugar very fast, such as glucose tablets or juice.
• Glucagon (if it's in the plan).
• Supplies to test for ketones.

Teach the staff how to use these items. Remind the staff that your child needs access to the supplies at all times, even on a field trip. Now and then, check the expiration dates of supplies your child has at school.

For older children who take insulin to school, check with the school. It may have rules about students carrying their own medicines, needles, and blood sugar meters. Many schools require students to get permission or to keep their supplies at the school.

How can you help your child eat right at school?

If your child takes insulin, make sure that the diabetes plan has information about snacks. Teachers and coaches need to know that snacks keep your child's blood sugar at the right level. Tell them that they shouldn't prevent your child from having snacks. And tell them when your child usually needs snacks—for example, before, during, or after exercise.

Your child can eat regular school lunches. Help your child learn to make the best food choices.

Ask the school to let you know ahead of time if meals will be delayed because of special school activities, such as parties or trips. Then you can adjust your child's insulin or snack schedule to prevent a low blood sugar episode.

Have your child carry a quick-acting source of carbohydrate to eat if your child's blood sugar gets too low. These include:

• Foods that raise blood sugar very fast, such as glucose tablets or juice.
• Foods that raise blood sugar more slowly, such as pretzels, snack crackers, or a sandwich.

It's a good idea to ask your child's teacher to keep snacks like these close by.

How can you help your child exercise safely?

Children with diabetes can take part in sports just like children without diabetes. Each child will react differently during physical activity. Children who use insulin are at risk for low blood sugar during and after exercise.

Good planning means checking blood sugar before, during, and after exercise. Keep a record of how exercise affects your child's blood sugar level. Using your records, you can learn to predict how your child will react to being active.