Updated August 31, 2006

School Planning 101

by Margaret T. Lawlor, M.S., C.D.E., and Cindy Pasquarello, B.S.N., R.N., C.D.E.

High blood glucose. High blood glucose levels do not cause the immediate threat that low blood glucose does. The signs of high blood glucose include being very thirsty, having to use the bathroom often, or becoming very tired. The child’s individual symptoms should be written on the diabetes plan. The plan should state that the student is allowed to go to the bathroom as well as to get water to drink. How and when blood or urine ketones are measured should also be recorded. It should be specified whether the parents and diabetes health-care team are to be notified when blood glucose or ketone levels are high.

Emergencies. Until recently, little attention was paid to the development of a disaster plan for the student with diabetes. A disaster might be a natural one, such as a blizzard, hurricane, or tornado, or a manmade one. A lockdown of the school building could be necessary. Many schools are now asking for a diabetes management plan that covers a span of 48–72 hours, including a supply of insulin to cover that time period, in the event that a child is unable to be reunited with a parent.

An emergency situation is not the only time that a child could be separated from his insulin and snack supply for an extended period of time. A fire drill could also keep him from his diabetes supplies, so a plan should be made for fire drills in the event that the student has low blood glucose during the time outside the school building.

Field trips. Students with diabetes should never be excluded from field trips, which are not just learning experiences but also social ones. Requiring a parent to go on a field trip is often not reasonable, possible, or age-appropriate for the student. A DMMP should specify what accommodations are necessary to allow a child with diabetes to participate in outings with the rest of the class while still receiving the medical care he needs. According to the specific circumstances of the child, a DMMP should state who, if anyone, needs to accompany him, and what guidelines, such as permission to eat snacks on the bus, need to be followed.

Letting kids be kids
All children deserve a level playing field. A DMMP, 504 plan, or IEP can help ensure just that. With the aid of the information and instructions laid out in one of these written plans, and the legal recourse provided by a 504 plan or IEP, neither parent nor child will have to worry about lost opportunities or unfair treatment. Which means there will be plenty of time for the excitement that accompanies just being a kid in school.

Also in this article:
School Plan Resources

Margaret Lawlor is the Coordinator of Pediatric Research and Education and Cindy Pasquarello is a Pediatric and Adolescent Diabetes Nurse Specialist at the Joslin Diabetes Center in Boston, Massachusetts.

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