Diabetes in Children: Preparing a Care Plan for School

Overview

A diabetes care plan for school is a document that includes information to help the school or daycare staff know how to manage your child's diabetes. The goal of a care plan is to meet your child's daily needs and prepare ahead of time for any problems.

For example, if your child needs to eat shortly after taking insulin or to have a snack in class, then a staff member can make sure that this happens. The care plan can also cover how to handle special occasions, such as a school party or field trip.

Your child may feel better knowing that the staff can help when needed. And the plan lets the staff know how to help your child safely take part in all events and activities.

Meet with the school staff at the start of each school year. Discuss the care plan with your child's teachers, school nurse, gym teacher, and school leaders.

Update the care plan each year. Make sure to tell the school staff about any changes to the plan during the year.

How do you make 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.^{footnote 1, footnote 2} 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.