Here’s a rundown of the areas in which you’ll need to plan ahead, whether that means educating the camp staff or packing extra supplies. Make sure you cover each one of these following areas, even if your child is quite independent.
Blood glucose and ketone testing. To make sure your child’s blood glucose level is checked as often as it should be while he’s at camp, the following questions need to be answered before camp starts: Who will be responsible for monitoring and recording if he cannot do it himself? If the camper does monitor himself, who will make sure it’s done on time? If you determine that a check needs to be done at midnight or 3 AM, who will be responsible for that? Where will the meter and strips be kept? (They must be available at all times.) How will used strips and lancets be disposed of?
Make sure the camp staff knows when to check for ketones. If urine or blood ketones are positive, direct that you or the child’s physician be called immediately.
Low blood glucose. All camp staff in contact with your camper must be able to recognize hypoglycemia and know what to do if he has a low. Make a list of the symptoms of low blood glucose that your camper usually gets. List more unusual symptoms as well, just in case. Include “seizure” on your list even if your child has never had one. Include a list of the situations in which low blood glucose is more likely to occur.
List the appropriate treatments for lows that occur just before a meal and lows that occur between meals. Make sure glucose tablets and other treatment for lows are carried by either your child or the counselor who is with him at all times. Explain what to do if your child resists treatment, and give direction for rechecking blood glucose after a low. Make sure you and the camp staff answer the following questions before check-in: How will treatment be recorded? Whom will it be reported to? When will it be reported? Is there someone at camp who can give glucagon, if necessary? Where will it be kept? In an emergency, who will call an ambulance? How far is it to the nearest hospital?
Insulin administration and adjustment. Make a plan for insulin storage, injections, and dose adjustments. At camp, insulin should be stored in a refrigerator, even if you normally store opened vials at room temperature at home. Temperatures in cabins, tents, or backpacks can get very high, causing insulin to lose potency. Most camp infirmaries or health centers should have a refrigerator.
If your child cannot draw up insulin or give himself an injection, designate a camp staff member to take care of it. (Again, do not assume the nurse will be available at all times.) An older teen experienced with giving himself injections or using an insulin pump may have confidence to administer and adjust insulin on his own. However, all campers, even independent ones, should have some staff oversight to make sure that injections or boluses are given; it’s too easy to forget in the excitement of camp activities. Ask that a staff member keep an eye on your child’s insulin administration, and make sure your child understands that this will be the procedure while at camp.
A word of caution to the experienced and the inexperienced: With the increased physical activity at camp, the insulin dose may need to be reduced by about 10% (if this reduction is too much, the dose can be increased the next day). If your camper can’t make insulin dose changes by himself, you need to answer the following questions: Do you want the staff to follow your camper’s home dose schedule? Do you use a scale for raising and lowering doses that depends on your child’s premeal blood glucose level? How will decisions about insulin doses be communicated to you? You may want to designate a time that camp staff can call you at home.