The approach of September signals the start of a new school year, filled with new adventures and challenges. For parents of children living with diabetes, a significant challenge each academic year is managing their children's diabetes care in the classroom.

Sarah Avveduto is a Stouffville, Ont.-based high school teacher. Her daughter, Grace, age 12, was diagnosed with type 1 diabetes at age 8. “It was incredibly hard to send her back [to school] knowing that one moment she could be fine, and the next not,” says Avveduto.

What is diabetes?

Type 1 diabetes is a condition where the body stops creating insulin – a hormone that controls blood sugar (glucose) levels. Without insulin, your body will store glucose in your blood, rather than let your cells use that glucose produce energy. This causes fatigue, blurred vision, increased thirst and other symptoms. Type 1 diabetes is the most prevalent type of diabetes among kids. According to the Canadian Pediatric Society, “Children under the age of 5 years are the fastest-growing group of newly diagnosed cases of type 1 diabetes.”

Children can also have type 2 diabetes, a condition in which the body doesn’t make enough insulin or doesn't use the insulin it does make properly.

Creating a diabetes care plan

When a child's blood sugar is extremely low (referred to as hypoglycemia), it can cause seizures or loss of consciousness. That’s why it’s important that your child living with diabetes has an emergency kit containing insulin and medical tools at school.

In addition, you need to create a written care plan for school staff that outlines how to care for your child’s specific needs. The Canadian Pediatric Society offers an individual care plan template that recommends the information to include in your written plan. As well as printing the plan, you should email a digital version to all your child’s teachers and have a copy available for the office and substitute teachers.

The care plan should include:

  • When your child’s blood sugar should be checked
  • The location of emergency snacks
  • Special care notes about physical activity
  • Emergency contact information (doctor, parents, nurse, etc.)
  • The location of any emergency kits
  • The emergency procedures for low blood sugar and high blood sugar
  • Notes on insulin management

Diabetes care tips at school

Here are 5 ways you can improve your child’s diabetes care at school:

  1. Connect with teachers in person and early. “I always recommend that parents schedule an appointment with teachers outside of class time,” says Diana Mancuso, an elementary school teacher with the Toronto District School Board and a parent blogger at Toronto Teacher Mom. “Especially during back-to-school season, if things come in on paper they can get misplaced.”
  2. Educate your child’s peers and school staff on what the signs of a diabetic episode look like, both informally (through posters and conversations) and formally, through presentations.
  3. Ensure there’s always a snack in your child’s bag and in the classroom (in elementary school, ask the teacher for a space to store snacks).
  4. Encourage your child to test blood sugar levels after gym class.
  5. Let the teacher know your child may need to write tests at a later time if very high or low blood sugar is affecting your child’s ability to concentrate.

Note: The Hospital for Sick Children provides an excellent resource centre for caregivers who wish to learn more about supporting those who live with diabetes.

Don’t let diabetes deter you

16-year-old Connor Doherty has been living with diabetes since he was 8 months old. But diabetes hasn’t stopped him from excelling at sports. He’s on the school swim, basketball and baseball teams and he’s been a hockey goalie since age 4. Before a workout, he makes sure to eat a granola bar to prevent his blood sugar levels from dropping in response to the increased activity. In addition, since sometimes physical activity can make his blood sugar spike, he monitors his blood sugar after a game closely. He says living with diabetes takes adjustments, but it shouldn’t stop students from pursuing their passions. “Diabetes shouldn't stop you from doing the things you love,” says Doherty. “And if you're scared of people treating you differently, most don't, and real friends understand and support you.”

The bottom line

The best way to cope with back-to-school anxiety about a child living with diabetes is to establish clear lines of communication with the school and to educate your child’s caregivers. The more you educate yourself and encourage your child to be an advocate, the smoother the school routine will become. Sometimes out-of-the-ordinary events will crop up, but once you’ve successfully met that challenge, both you and your child will feel more at ease. "Once they've been on the first field trip, or the first track meet successfully, it gets better,” says Avveduto. “You don't stop them from going on the field trip, you just prepare them as much as you can.”