Managing diabetes In school: From pre-school to college

Starting a new school year often involves gathering school supplies and picking out a first-day-of-school outfit, but for parents of children with diabetes, there’s a lot more to it than that. Whether your child has had diabetes for years, is beginning a new school with diabetes, or you’re balancing school and diabetes for the first time, there’s a lot to keep track of. D-Mom x2 Jen Loving provides insights into preparing her children with diabetes for school throughout the years, from pre-school to college. 

In the winter of 2004, I started looking into a half day preschool for my then 4-year-old daughter, Nora. Even though she was my second born, there is a certain thrill yet anxious feeling you get when it’s time to sign your baby up for school. As a mom, you worry if she will find friends, if she will learn easily, and if she will behave. Never did I even think to worry about type 1 diabetes (T1D) and preschool. But there we were in the summer of 2004 with a T1D diagnosis and an impending preschool start date. I was petrified. How was I going to send her to preschool for 2.5 hours without me?! 

We are a very active family and I remember when we were released from the hospital after a week stay learning about how to keep our daughter alive with insulin, log books, test strips, blood glucose (BG) meters, syringes, and a Calorie King book, and just wanting to stay inside our house forever. I forced myself and the rest of my family to accept our new normal and live our lives as we had before diabetes. I never wanted my daughter to feel different or for us to treat her differently. School was no different. By golly, she was going to do this!

Preschool
 

I signed her up and met with her preschool teacher, classroom aide, and school nurse. The staff could not have been more willing to learn about and be reassuring about our Nora’s care. She was on a short and long-acting insulin regime which worked out great for her A.M. preschool routine. I packed low to no-carb snacks, such as a hard-boiled egg, or a few carrots and little bit of ranch dressing (so small the carb counts didn’t equate to her needing any additional insulin) for her to eat so the school staff wouldn’t need to give her insulin, and the classroom and nurses room had plenty of fast acting carbs to treat lows. The school aide was so in tune with my Nora’s BG. Just by looking at her skin coloring, she could tell if she was running low.

Elementary School
 

Each year we would meet with the teacher, aide, and school nurse. I also made a little “Get to Know Me” sheet I handed out to the staff and Nora’s classroom that included Nora’s picture, a brief description of diabetes, and how her behavior may be different than usual due to her BG levels. It was also a plea for parents to send me a heads up for carb counts for birthday treats (back when you were allowed to bring treats into class). The teachers would even have me come into class and read a diabetes book and answer questions. For us, being up front about diabetes made it a non-issue with her classmates. 

As she advanced in grade level, so did her diabetes management. First grade was the year we started her on the MiniMed insulin pump. It was fantastic! However, it was something new to teach the school staff. They were wonderful, supportive, and learned quickly. Second grade we enrolled her in a new school that had four T1D students. The transition was smooth, yet I still met with the teacher, room, and health aide yearly. Third grade was the year we started her on the continuous glucose monitor (CGM). This was great! I think the health aide became the spokesperson for all the T1D kids to get on a CGM! At that time, the school had six T1D students.

Middle School
 

The middle school years for Nora have been tough. Anxiety has become a big issue with her and feeling different, even though these kids have known her since second grade. Her teachers became worried about her, and met with my husband and me to establish an Individual Education Plan (IEP). This gives her extra time on tests and options to take tests outside of the classroom with an educational assistant if necessary. Since we have had the IEP in place, she has done wonderfully!

High School
 

Graduation from middle school is just weeks away. She will be going to a local high school that has no school nurse. I’m not worried though, I know she’s got this! I will alert the school that she has T1D, and establish a routine with her and some staff members in the event she should need assistance. She is able to keep her phone with her at all times so she can text me her blood sugar numbers . I will work with the school to ensure her IEP is able to transfer over, or something similar, should she need it.

College
 

When Nora was in sixth grade, our family received a second T1D diagnosis, our eldest daughter, Evy. She had just graduated high school and was days before her 18^th birthday. Evy had enrolled at our local college, but since she was a college student, and by law an adult, there was little I could do as far as interacting with the school staff, but just support her. However, since she had seen me in action, advocating for her sister, Nora, she was able to go into her first year of college, educate her professors about T1D, and checked in with the College Disability Services at campus to let them know she has T1D. We are fortunate enough that her campus is 5 minutes from our home, and at least the school knows they have a person with diabetes on campus. I recommend if you send your T1D child to college, have them check in with their College Disability Service Department. 

Sometimes new situations can be overwhelming, but we are excited about Nora and Evy’s new adventures. We have been blessed with amazing school staff and understanding teachers along Nora’s almost 10 year diabetes journey. Our family has had to learn, educate, adapt, and be a little flexible along the way. Both of our daughters are amazingly responsible and old souls who I know will go far in this world no matter what they do and no matter if diabetes is along for the ride.