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The Sweet Life: Back to School with Diabetes

Pencils, notebooks, backpacks, and school clothes are items that typically cross your mind when you think about back to school. Your back-to-school list will look a little different when your child has diabetes. You will also need to have a glucometer, insulin, and a plan for highs and lows ready. Plus, you need to take other steps to make sure your child stays safe at school. Here are some tips and tricks to get you ready to tackle that list!

Establish a Diabetes Medical Management Plan (DMMP) for your child

This is the treatment regimen the school staff must follow. Your child’s endocrinologist will supply the school with information and orders to adhere to. This includes:

  • Dosing insulin
  • Checking blood sugars
  • Handling highs and lows
  • Using glucagon
  • Outlining reasons why your child may be excused from school for diabetes-related issues
  • Understanding any other special instructions

Request a meeting before the school year starts

Your child’s school nurse, teachers, principal, and any other staff members who will be with your child on a daily basis (coaches, cafeteria staff, etc.) should be present.


Goals for this meeting:

  • Set up a 504 plan. A 504 plan is a legal document that outlines accommodations that the school must provide for a student with a medical disability. This plan should use the DMMP as a basis. Your plan should include important points, such as:
    • All staff working with students who have diabetes must be trained in recognizing the symptoms of highs and lows.
    • If the student is not feeling well, he or she should NEVER walk to the nurse’s office without another responsible student or adult.
    • The student can have water as needed in class.
    • The student can make a trip to the bathroom at any time.
    • A substitute teacher folder should be in plain site at the teacher’s desk. This should include a student’s DMMP, 504 plan, signs and symptoms of highs and lows, and emergency contacts.
    • Students should be allowed to fully participate in all extracurricular activities—including field trips.
    • Students self-managing their diabetes, should be allowed to do so anywhere—and may always keep their supplies with them.
    • Consider adding a provision stating that students can keep their cell phones out at their desks. This is particularly helpful if they have a Continuous Glucose Monitor that is connected to an app on their phone. (Have a conversation with your child about not abusing this/only using the phone for diabetes-related issues).
    • Establish when the school staff should alert you.
    • Discuss what diabetes means for your child. What is your home routine like? What things make it easier for your child? How is your child handling emotions about having diabetes?
    • Assess the staff’s understanding of type 1 diabetes. Some school staff members may have never met a child with this condition. It may be up to you to teach them basic diabetes care.
    • Discuss excuses from school for diabetes-related appointments and illnesses. Also, come up with a plan to make up work that is missed because of appointments, highs, or lows.


Request carbohydrate counts for school lunches if your child plans to buy lunch 

The cafeteria staff should have a menu with the carbohydrate counts already figured out.


Come up with a plan to handle surprise snacks

  • See if teachers are willing to request that only store-bought snacks with carbohydrate counts readily available are provided.
  • Ask teachers to request that parents let them know what snacks will be brought in a day or two in advance so you can plan insulin dosing accordingly.
  • Request that teachers email or text you in the morning if an outside snack is brought in. Open communication is key.
  • Consider bringing in a snack stash that includes healthier options for your child to choose from.


Pack a “low box”

This should contain a glucagon kit and glucose tablets. Include juice, icing or whatever you usually use to treat low blood sugar.


Empower your child to be their own advocate

Children should know that they will not get into trouble for doing what they need to manage their diabetes—even if an adult in the building is not allowing it. 


Action Items:

UPMC Health Plan Pediatric Case Managers: 1-866-778-6073

We can help with diabetes education, resources and tips.


If your child is being discriminated against at school because of diabetes, call 1-800-DIABETES (1-800-342-2383) for free information and to speak with an Americans with Disabilities Act 

 (ADA) legal advocate.