Back to School with Type 1 Diabetes 

By: Lauren Dragoni

“You gotta go back, back, back to school again.
It’s bye bye fun, get your homework done, and better be in by ten. I gotta go back, back, back to school again.
Whoa, whoa, I gotta go…Back to School…AGAIN!”

Even though Grease 2 wasn’t quite as iconic as the original cinematic masterpiece, this was one of my favorite films as a little girl. The movie’s song popped into my head every year around the middle of August. Unfortunately, I was preparing to once again return to the halls of academia. The sentiments of these lyrics described how my easy, breezy life was going to end. Ugh.

Now that I am a parent I have very mixed emotions about the “back to school” time of year. On the bright side, my days will be freed up a bit and the word “mom” will fortunately be said 100 times a day versus 10,000. It also means that the warm air and lack of commitments will soon turn to a crisp, chilly breeze and a jam-packed calendar. Ugh.

As we prepare for this glorious day, I can rest easy knowing that my kids have become quite good at adjusting back into the routine of bus riding, homework and extra-curricular activities. For my seven-year-old daughter, Cecilia, this routine involves a few more daily steps. C.C., as we call her, has diabetes.

According to the Mayo Clinic, Type 1 Diabetes is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy. Diabetics have to administer synthetic insulin on their own. Some prefer injections, but C.C. wears an insulin pump. In order to give herself the correct amount of insulin she checks her blood glucose with a finger prick 4-10 times a day.

We are fortunate to live in a wonderful school district that has been very accommodating to C.C.’s needs. We have a nurse as well as a nurse’s aide that we meet with before the school year starts to go over a plan of attack. We then bring her teacher on board and make sure that she/he is aware that C.C. has some special requirements that make it necessary to leave the room at a moment’s notice.

If you are the parent of a newly diagnosed diabetic here are a few things to consider when making arrangements with your school nurse or care provider:

• • Get the proper school medical forms required by your child’s school. Our school will accept a form that is set up by our endocrinologist including carbohydrate ratios, blood glucose target ranges, etc.
  • Have a backup supply of lancets, syringes, alcohol wipes, glucose tablets or carbohydrate snacks to raise blood glucose, infusion sets for pump wearers, extra insulin, a glucagon kit, an additional blood glucose meter, etc.
  • Make sure that your child’s teacher understands the urgency and importance of blood glucose checks and treatment and can allow your child to leave the classroom in a timely and non-disruptive manner.
  • Have a plan with your care provider to alert you if your child is out of target blood glucose range. This may be a phone call, text or end of the day note. We set perimeters to determine what is too high and too low, and warrants a phone call for further instruction.
  • Our endocrinologist suggested a new app called Blue Loop. It allows the school nurse to add information that provides parents with alert notifications for extreme BGs through text or email, documentation of medications and dosages, and access to trends logs among other features. We hope to use the app this year.
  • Our school district has a set menu for the year and can provide us with a copy of the carb counts for each school menu item. It is great to have a copy of this in order to help our nurse come up with carbohydrate counts per meal if C.C. chooses to eat a school lunch. We also provide our nurse with a copy of the Calorie King book (www.calorieking.com) that lists carb information for all types of food including fast food and packaged food products in case we haven’t already provided that info.
  • If C.C. packs her lunch for school I make sure to count her meal carbs and include a post-it note with the number so that she can calculate the correct amount of insulin to give herself based on food and blood sugar level.
  • Some schools allow parents to bring birthday treats. Talk with your school care provider about how to handle this with your diabetic.
  • If your child is a bus rider, talk to your school’s transportation department. Make the bus driver aware that your child has Type 1 Diabetes and must be treated immediately in the event of low or high blood glucose. My daughter carries a package of fruit chews and a glucagon kit in her backpack in case of an emergency. It is also a great idea to inform your child’s bus friends of what to do in case of hypoglycemia (low blood sugar).

We are still learning what works and what does not work for C.C. based on her school day, but I hope that this information will help you make a smooth transition back to your child’s favorite academic institution (that’s an oxymoron, right??)

This “Girl for all Seasons”, another Grease 2 gem, will send everyone back to school, and I will start searching my closets for my wool blankets and heavy sweaters and resign myself to the fact that autumn is coming. Ugh.