The demands of diabetes management cannot help but have an impact on school life. School personnel must be aware of the student
with diabetes. By understanding the important aspects of diabetes management, the teacher can ensure the student’s healthy
adjustment to the classroom setting and peer interactions. Teachers also play an important part in ensuring the safety of
the student with diabetes, not only in the classroom but in the playground, on school trips, and in sports activities. A knowledgeable
and supportive teacher will help relieve parental anxiety, and will prevent minor crises from getting out of hand. A poorly
informed or misinformed teacher who has great anxiety about having a student with diabetes in the classroom can add to the
adjustment and management difficulties encountered by the child and the family.
To avert potential problems, arrange a meeting with the child’s teachers and other school personnel at the beginning of the
school year, or soon after diagnosis if it happens during the school year, to discuss the child’s individual needs. Give them
the appropriate information about your child’s diabetes. If you complete an information form, it may help them remember important
facts about your child’s needs.
General health care is the responsibility of the family, with the help of the diabetes team. Teachers and other school personnel,
excluding the school nurse, are not health care professionals, but they do have a role to play in supporting students and
ensuring their safety. It is unrealistic to expect the majority of teachers to be well informed about every disorder that
a student may some day show up with. However, when a student with a disorder does arrive in their classroom, teachers, and
school personnel should gain the necessary know-how to provide support. How much participation is expected from teachers will
depend on the child’s age, stage of development, and diabetes routines.
The most important thing for teachers to know about diabetes is how to recognize hypoglycemia and prevent a mild insulin reaction
from escalating into a more severe one. Teachers of younger children need to be especially observant during gym periods, and
remind the child with diabetes to take a snack. Teachers should also understand that meal plans are an important element of
diabetes care, and that it’s hard for children with diabetes to participate in surprise pizza parties or snacks. Teachers
should inform parents of any such events so the child’s meal plan and insulin dose can be adjusted accordingly. They should
be aware of the need for between-meal snacks. Similarly, they should become familiar with the signs of hyperglycemia, and
notify parents if the child has to leave the classroom to go to the bathroom more frequently than usual.
In general, teachers should not be expected or required to perform blood sugar checks or inject insulin. However, school personnel
should understand enough about the procedures that they will allow the child privacy to do injections and blood glucose testing,
and supply any necessary supervision. The school should have a plan of action in place in case the child has a severe insulin
reaction -- administer sugar or juice if the child is conscious; if unconscious, call an ambulance. If the child vomits, the
parents or some other designated, responsible adult should be notified. If they are unavailable, the teacher must get the
child to the nearest emergency room.
Field trips
Children with diabetes should be encouraged to participate in as many school activities as they choose, and should not be
excluded from school trips. However, planning ahead is essential. If they are participating in physical activities beyond
those they do on a daily basis, extra food should be packed in their knapsack or lunch box. Include a mix of fast-acting carbohydrate
snacks, such as juice boxes and dried fruit to stave off low sugar reactions, and complex carbohydrate snacks such as crackers,
breakfast bars, and cookies.
Careful preparation for overnight trips or special events will help prevent problems. If the event -- for example, a field
trip to the zoo --overlaps an insulin injection or blood test time, ensure that one of the teachers or chaperoning parents
is taking responsibility for either performing or supervising the task. Children and accompanying adults should always have
supplies to treat low blood sugar, such as hard candies, glucose gels -- even a glucagon kit for overnight or longer trips,
if a responsible adult is taught how to use it. Children should know how to recognize symptoms of low blood sugar before
they are permitted to go on overnight field trips. Before that, considering volunteering as a chaperone yourself.
What to pack on a field trip
On field trips of any type, the child with diabetes must have:
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a source of quick-fix concentrated carbohydrate to treat hypoglycemia (i.e. juice boxes, glucose tablets, hard candies)
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visible identification that indicates that the student has diabetes, such as a MedicAlert bracelet
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insulin, syringes, and blood testing equipment, if the trip overlaps a testing or injection time
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an informed adult companion
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the phone number of parents or an alternate, well-informed responsible adult
