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Question:

From Wisconsin, USA:

My daughter is 5 years old and was diagnosed with diabetes at 20 months. She just started kindergarten today and the school is having trouble determining who can legally care for her needs. She needs at least 2 people that can do glucagon and insulin as well as blood sugar checks when needed. Also, we do live in a rural town of 2000 population and only have a school nurse on duty 1 day a week. Can anyone who is trained by me be okay? Really need some help or direction as how to solve this problem. As it stands now, I will be going to school with her every day until we can figure this out.

Answer:

Federal law [see below] requires that the needs of children with diabetes be accommodated by the school. Someone at the school needs to assume responsibility for checking blood glucose levels and treating low blood sugar reactions as needed. Either you or the school nurse (most likely you as you know your daughter's meter) should do the training (with the school nurse in attendance so she can learn too).

I would advise against keeping glucagon at school, as the likelihood of that kind of severe insulin reaction is remote.

Speak with your diabetes team about rearranging her insulin program to avoid giving insulin shots at school.

SS

Additional comments from Dr. Quick:

Also, see:

WWQ

Additional Comments from Heather Valdes Speer, Research Coordinator and mother of a child with diabetes:

Any person who is trained by the parent or school nurse should be capable of assisting a kindergartener in blood testing. If there is concern about liability, the only grey area seems to be the actual pricking of the finger. A 5 year old is quite capable of doing the fingerpoke themselves, but may need help getting the blood on the strip and reading the results.

Look for a couple of volunteers at your school, and then give them training, lots of praise and presents. You can get a lot of cooperation from school personnel with a positive approach rather that the "law says you have to take care of my kid" approach. Good candidates for helpers would be the school office staff and teaching assistants. The teacher should have knowledge of diabetes, but is often occupied with 20+ other children in the classroom.

The most important focus at school should be prevention of hypoglycemia, so everyone who is with a kid with diabetes should be well versed in low blood sugar treatments: don't forget the Physical Education coach, recess monitor, lunch monitor, bus driver.

Never send a child with low blood sugar to the nurses office alone: use the buddy system. Perhaps the child can pick a different buddy each day to go to the office for pre-lunch blood testing. This also gives the entire class a close up lesson in diabetes management. We used colored stickers to designate blood sugars: red for low, yellow for high and green for normal. My kid would put the sticker on her hand or shirt and show it to the teacher (who could be prepared to observe the child for the rest of the school day). After school, if my kid couldn't remember the exact blood sugar at lunch, she could always remember the color of the sticker.

HVS

Original posting 9 Sep 1998
Additional comment added 26 Sep 1998
Posted to Social Issues: School and Daycare

  
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Last Updated: Tuesday April 06, 2010 15:09:00
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