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Posted by on Aug 10, 2017 in Diabetes Management, School

Making the Grade: Back to School with Diabetes

Making the Grade: Back to School with Diabetes

As a parent or caregiver of a child with diabetes, your back-to-school checklist includes more than a backpack, notebooks and writing tools. You also have to add visits to your child’s healthcare providers, forms to complete, supplies to provide, and connecting with the school personnel to your list.

Each child and each school year is different. It’s influenced by your child’s characteristics, age, how long they’ve had diabetes and their abilities to manage their diabetes at school. The school and school personnel, from teachers to school health providers, factor in, too. One year your child may be in a familiar school; the next year they may be in a new school or in a completely new district. What’s always the same is that you know your child and their needs best.

While we cannot provide you with legal advice, we’ve compiled a few details about certain federal and state laws and regulations that may be helpful in managing your child’s diabetes during the school day, along with some practical pointers.

Select U.S. Laws and Regulations Help Schools Ace Diabetes Management

As a parent or caregiver, consider developing written plans under two key federal laws that protect children with diabetes. Be familiar with these plans and know what services your child might receive:

  • The 504 Plan: Based on Section 504 of the Rehabilitation Act of 1973, which prohibits discrimination by any entity receiving federal funds including public, private and religious schools and any program offered by a public school system, this is the plan in which your child’s required accommodations in school are documented. Each school-age student with diabetes should have an annually updated 504 plan to establish how the school will meet their needs. Another law, the Americans with Disabilities Act (ADA) prohibits discrimination on the basis of disability by places of public accommodations, including public and private schools.
  • Individualized Education Program (IEP): The IEP is developed for students qualifying for services under the Individuals with Disabilities Education Act (IDEA), another federal law. Under IDEA, the federal government gives money to state and local education agencies to provide special education to children with disabilities, including some with diabetes if their diabetes or another disability adversely impacts learning. Students who qualify for these services should have an IEP developed by school personnel which includes diabetes-related accommodations.

Collectively these laws require schools to ensure safe, fair and equal access to education and school-sponsored activities. Schools must meet the requirements of these federal laws regardless of state laws. State regulations, which vary state to state, may provide guidance on the skill level and training of school personnel, the individuals who can administer insulin, give a bolus, and/or treat severe hypoglycemia. Many state laws provide additional protections to children with diabetes.

At the Head of the Class: Your Child’s School Health Personnel

The number of school health providers required in your child’s school is based on the laws in your state. In some states, the direct care of a child with diabetes may be provided by a registered nurse (RNs), a licensed practical nurse (LPNs), a health assistant and/or other school personnel. The “school nurse,” which may or may not be a RN, typically provides direct care to students and may delegate diabetes care tasks to other trained non-clinical school staff. The school nurse provides training, ongoing supervision, evaluation of the trained school staff, and evaluation of the student’s health. The school nurse is typically a member of your child’s 504 or IEP team.

ABCs and 123s: Document Your Child’s Diabetes Management Plan

To provide your child with diabetes care during the school day, at the start of each school year you’ll need to provide the school nurse with your child’s current Diabetes Medical Management Plan (DMMP). The DMMP contains directions from your child’s healthcare provider on diabetes care at school and school-sponsored events. To implement the DMMP, the school nurse should combine the school health provider’s orders with information from their nursing assessment of the student and family. From the DMMP, the school nurse develops an Individualized Healthcare Plan (IHP) which should include emergency care plans for diabetes-related issues that can occur during school hours, such as hypoglycemia and hyperglycemia.

The Diabetes Learning Curve: Be the Teacher

As you and your child with diabetes start a new school year, keep in mind that you and your child (depending on their age) may have more expertise in managing your child’s day-to-day care with diabetes and the technologies they use than the school health providers. Recognize that these individuals may be relatively new to working with a child with diabetes and may have concerns and fears. Work with them early in the year to increase their knowledge and allay their fears. Try to establish a positive working relationship to make sure your child receives the best possible care all school year long.

Tips for Success:
• Be familiar with the relevant federal and state laws.
• Ask about the training and credentials of the person who has direct contact with your child and their supervisor.
• Work with your child’s care providers and school personnel to update their 504 plan, IEP or other written accommodation plan annually.
• Ask your child’s diabetes educator to assist in answering questions and training school healthcare personnel on new technologies.
• Have a back-up plan in place for situations where your child may require assistance (e.g., such as a Pod being pulled off on the playground).
• Make sure that adequate diabetes supplies are on hand at school.
• Tap reliable resources available at your fingertips (see recommendations below).

For more information about keeping children safe at school refer to the American Diabetes Association, the National Diabetes Education Program within the National Institutes of Health and the National Association of School Nurses.

– Hope Warshaw, MMSc, RD, CDE, BC-ADM

Thanks to our expert contributors: Crystal Woodward, Director of the American Diabetes Association’s (ADA) Safe-at -School program. Jade Bland-Slaffey, MSHCA, BSN, RN, Nurse Education and Practice Specialist, National Association of School Nurses.


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Posted by on Jul 24, 2017 in Lifestyle, Relationships

Managing Diabetes Together: What Parents Want Most Out of Their Partners

Managing Diabetes Together: What Parents Want Most Out of Their Partners

As many people know, I am very active with the Friends for Life (FFL) conference organized by the organization Children with Diabetes (CWD), which takes place each July in Orlando.  I have been involved since the beginning of FFL and it has been nothing less than an absolute honor and joy.

Years ago, during the conference, I took a poll. Now in fair disclosure, this was by no means a scientific study, just a survey question.  But the response was startling nonetheless.

I asked parents, what was the #1 thing, dealing with diabetes, they would want from their spouse?
The number one answer given by moms was that they wished their husbands would help more with their child’s diabetes management care. What was the number one answer given by the dads? It was that they wished their spouse would allow them to do more with their child’s diabetes management.

I kid you not.

There is no blame here.  It is, and was, just an interesting tidbit in the ongoing discussion of diabetes under one roof.  But even when I work with just the dads at FFL (I regularly coordinate the Dad’s Discussion Group), I get the feeling that they are still trying to find their own pathway in their child’s diabetes world.

My advice to them, and to parents like them everywhere? First thing, relax.  We have all been there.  Moms and dads have been trying to figure the way to navigate this world together forever and in the words of my late, and wonderful friend, Dr. Richard Rubin, “…….it’s about balance and communication.”

Diabetes is a tough world in and of itself.  Whether you are new, or have been at this a while, there are a two basic rules for communicating effectively and managing diabetes together.

  1. Figure out which way is up, together. Whether it is a husband and wife, wife and wife, or husband and husband, there is usually one person who handles most of the day-to-day management in their child’s diabetes management. Don’t assume who that person will be. Have a discussion together, even if from the onset one of you is leaning toward taking control. Know why one person is better suited for the job and make sure you come to an agreement.
  1. Do not let the other person rely too heavily on the primary diabetes caregiver. Both parents should know as much as possible about this disease. Those who know me, know that I have stated a million times: education is the equalizer in diabetes. The one person stepping up is not the only one needing to step up.  Partners need to both be able to care for the child at any given time.  There will be times when the person who does most the work will need to leave the child in your care.

If you are reading this and saying to yourself, “crap, that scares me,” guess what?  You do not know enough, so get out there and start learning.  THAT is the first step, and we will discuss more in later articles.

I am a DiabetesDad.

-Tom Karlya, Diabetes Dad and VP of Diabetes Research Institute Foundation


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