University of Illinois Extension

Diabetes at School

Section 504 of the Rehabilitation Act of 1973 (the Individuals with Disabilities Education Act) protects children with diabetes. Under these laws, diabetes is considered to be a disability. This makes it illegal for schools or day care centers to discriminate against kids with diabetes. Any school that receives federal funding or any facility considered open to the public must reasonably accommodate the special needs of kids with diabetes. The needs of the student with diabetes must be provided for within the child's usual school setting with as little disruption to the child or school as possible.

Diabetes Medical Management Plans (DMMPs)

The individualized diabetes medical management plan (DMMP) helps protect the child at school. The DMMP should be developed by the student's personal diabetes health care team with input from the parent or guardian.

The DMMP includes specific instructions for:

  • Blood glucose monitoring
  • Insulin administration
  • Meals and snacks
  • Symptoms and treatment of hypoglycemia
  • Symptoms and treatment of high blood glucose
  • Checking for ketones
  • Participating in physical activity
  • Emergency situations/school evacuations

Parent Responsibilities

The parent or guardian is responsible for providing the school or day care provider with everything the child needs to take care of their diabetes:

  • Blood glucose monitoring machines
  • Insulin if needed and administration tools
  • Urine or ketone testing materials
  • Supplies to treat hypoglycemia
  • Students' meal and snack schedule (worked out at the beginning of the year with the school to make sure it can be maintained as closely as possible)
  • Emergency phone numbers

The parent is responsible for maintaining blood glucose monitoring equipment. For example, making sure it's cleaned and calibrated. They also have to ensure that materials are disposed of properly.

School Responsibilities

  • Staff training
  • Immediate accessibility to hypoglycemia treatment materials
  • Ensuring insulin availability at the time set out by the students' DMMP
  • Providing privacy for student when monitoring blood glucose or taking insulin
  • Storage space for blood glucose monitoring equipment, insulin, and glucagon
  • Giving student permission to:
    • Carry equipment, supplies, snacks
    • Eat a snack anywhere to prevent hypoglycemia
    • Miss school without consequences for illness and doctor’s appointments
    • Use the restroom and have access to fluids if necessary

Optimally, the school nurse helps check blood glucose and ketones. The nurse may also administer the insulin, glucagon, or other medications. More often, though, it's backup trained school personnel who's responsible for these aspects of the child's care.

Student Responsibilities

  • Younger children should know who the responsible adult is at their school for when they have problems with low or high blood glucose
  • Students' confidence and capabilities of performing self-care tasks should be identified in their DMMP. This will have to be adapted each year.

Paperwork

It's helpful to have a separate log book at school to keep track of blood glucose and ketone readings. It’s also useful to log when the blood glucose monitoring device is calibrated.

The DMMP should be completed and signed by the students' diabetes health care team to make sure both the parents and the school are on the right track.

Usually, a signed release of confidentiality from the legal guardian or parent is required so the health care team can communicate with the school. Copies of these should be maintained at the school, at the health care professional's office, and with the parent.