Insulin in Schools

A few years ago, we covered a dispute between the California Department of Education and the California School Nurses Association regarding who should be able to administer insulin injections in schools to children with diabetes. At the time, a lawsuit filed by several San Francisco Bay—area parents of children with diabetes had led the Department of Education to relax its rule that only school nurses may deliver insulin to children who cannot deliver it themselves. These new rules, in turn, prompted the California School Nurses Association to sue the state. In the original 2008 trial, a state court judge ruled that under California law, only nurses may deliver medication, including insulin, in schools. Due to the low number of nurses in California schools — in 2007, when the first lawsuit was settled, only 30% of schools had a nurse in the building at any given time — this court ruling meant that many parents had to start coming to their child’s school to administer insulin when a nurse was not available.


Now, many of these parents may be breathing a sigh of relief. Earlier this month, the California Supreme Court ruled on an appeal brought by the state and other groups, including the American Diabetes Association, in favor of allowing other staff members to give insulin injections. According to an article in the San Francisco Chronicle, the court found it too burdensome to require, as California state law did, that only nurses give insulin when, in many cases, parents and even children themselves may be trained to do so. The court thus agreed with the original argument by the parents of children with diabetes that their children’s right to an education was compromised by the requirement that only nurses be allowed to give insulin.

Because this court ruling overturned a state law on the grounds that it violated the federally guaranteed right to an education, the California School Nurses Association may appeal the decision in federal court. According to the group, the latest ruling puts children at greater risk for medical errors, since teachers and other staff members lack the medical expertise and experience of nurses. The American Diabetes Association, on the other hand, stressed that training other staff members meant that there would be a backup plan for when a nurse is not available. Schools, the group noted, will rely on staff members who volunteer to be trained in giving insulin injections, so no teacher or other staff member will have to grudgingly accept this new duty.

What do you think — is it reasonable to let school staff members volunteer to give children insulin injections, or should this task be left to medical professionals? Is it acceptable that, according to the Chronicle article, only 5% of California schools have full-time nurses? If there were a nurse available in every school, would it still be a good idea to educate other staff members about children’s diabetes care? Should parents have veto power over staff members they don’t trust to give injections to their children? Leave a comment below!

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  • John B

    I was diagnosed with Diabetes in 1966 as a 6year old! Form day one I was taught to give my own shots Not a nurse or any other person!! I see no reason the child can’t give their own insulin? There might have to be supervision and maybe even some help in setting the correct dosage!! How hard can it be to read the new pens and dial it in? I personally never wanted anyone to give me my insulin shot so I say let the child give it to themselves!!

  • Bk CDE

    My biases first-I taught many children to give their own insulin working in a peds unit, then was a school nurse for many years, have a niece with type 1 who was told she could not go on a field trip unless her Mom went too, and later became a CDE. But I am not in favor of teaching non-nurse school staff to give insulin. Check a dose maybe with a child who knows how to give it to himself, but I really think what we need to do is make sure more schools have qualified nurses. Even giving oral meds in the schools where I worked was scary at times. It was the secretaries that gave the meds and they were always distracted by phones ringing, someone else needs this or that, a parent or visitor coming to the office. Imagine also trying to remember how to do something you perhaps don’t do very often. Even in the hospital, 2 nurses had to check insulin doses before they were administered. Teachers are no less distracted even if they volunteer to be taught. We definitely need a way to verify their competence. I heard a CDE brag she had taught over 100 school staff in an hour, but when I asked how she verified their competence, she admitted she didn’t. It never occurred to her! I believe every student deserves a school nurse and especially every student with insulin dependent diabetes.

  • Pat S

    As a teacher and a diabetic, I prefer to monitor a child who needs to take insulin. Nine times out of ten, they have to give the shots to themselves at home. With the pens today it is much easier for them than it was several years ago.