School staff will need to be informed about diabetes and what is involved in managing it daily. The school may never before have had a pupil with diabetes so there is a lot they will need to know. Even if they are familiar with diabetes and your child they will still need an update after the summer as things may have changed. This is especially important if the child is moving on to a new class teacher. The newly released HSE document ‘Meeting the Care Needs of Primary School Children with Type 1 Diabetes during School Hours’ might be very helpful to educate the school staff, and discuss the responsibilities of the staff and parents. The tips below are based on the guidelines listed as part of this document.
As per the HSE guidelines, the parents/guardians of a child with diabetes…
- Should inform the Board of Management, school principal and the teacher that their child has diabetes.
- Should arrange a meeting with the class teacher, principal and SNA (if applicable) to explain diabetes and its daily management. In some cases, diabetes nurse specialist can join the team and educate, however, this is not a standardised solution across the country and in the majority of cases parents educate the school staff. It is important to agree a written Personal Pupil’s Plan for diabetes care during school hours in consultation with your child’s diabetes team. It should outline when to test glucose levels, how to recognise and treat a low blood glucose level (hypo), how to recognise and treat a high blood glucose level (hyper), supervision that is required during snack/lunchtime, the plan for insulin administration and in what situations should parents be contacted. The Personal Pupil’s Plan should be updated at least once a year or if any changes are necessary.
- Inform the school staff if the child’s health status or diabetes regimen has changed.
- Ensure that the child’s insulin and glucose meter is labelled with their full name. Ensure insulin and all necessary equipment (i.e. blood glucose meter, CGM meter, lancet device, strips, insulin pump consumables, sharps disposal etc.) is within the expiry date and ensure that your child has a hypo remedy with them each day to treat low blood glucose leves (hypos).
- Provide the school with a sharps disposal unit and dispose of it when it is full. Disposable gloves and information about the safe disposal of needles/syringes in a sharps container should also be made available. See more information here.
- Provide the school with the daily medical kit and be responsible for restocking any used items and ensuring items with expiration dates are in date. The kit might include:
- Blood glucose meter, testing strips, and lancets, CGM sensor/device
- Blood ketone test strips and meter
- Insulin and appropriate supplies (if the pupil requires insulin during school hours)
- Quick-acting source of glucose for Hypoglycaemia treatment for the classroom, office and other places that the pupil may spend time e.g. carbohydrate-containing snacks.
- In addition, the school should be provided with an emergency supply kit for use parents/guardians should be responsible for restocking any used items and ensuring items with expiration dates are in date. The kit should include:
- Water wipes for cleaning fingers
- Quick-acting source of glucose for Hypoglycaemia treatment such as Glucogel
- Glucagon emergency kit
- Provide contact details for you and other carers in case of emergency. Also provide contact details of the diabetes team (included in the Personal Pupil’s Plan).
- Ensure good communication between home and school. You might consider having a notebook which documents food eaten, activity done, episodes of high/low blood glucose and how they were treated. This can then also be used at home so that you can inform school of changes or relevant information that may affect diabetes management during that school day.
- If your child takes part in a lot of activities or sports after school, remember to include an extra sandwich or snack on those days. You may need to discuss this further with your dietitian. Ensure they have some quick-acting carbohydrate to hand in case of a hypo. It is also a good idea to leave an emergency pack with the teacher containing a blood glucose monitor and glucose tablets, a sweet drink and snacks.
- The best way to ensure that school is a happy and safe place for your child with diabetes is by talking to the relevant parties and preventing problems before they arise. The more the school staff know and understand about diabetes, the less likely it is that fear will prevent the right response and misunderstandings are less likely if there is regular communication between school and home.
As per the HSE guidelines, school management should…
- Ensure all school staff are diabetes aware
- Provide sufficient resources to implement the Personal Pupil’s Plan
- Ensure (chosen) staff (Teachers and SNAs) undertake specific diabetes training as necessary (e.g. insulin injection administration or supervision, insulin pump, glucagon administration etc.)
- Provide immediate access to treatment of a low blood glucose when needed.
- Know what to do in an emergency and the order of responsibility for emergency care
- Ensure substitute teachers know when a pupil has diabetes and that they are familiar with classroom procedures
- Ensure diabetes supplies and equipment are accessible and readily available in suitable locations
- Have sufficient knowledge on diabetes to make informed decisions. Action Plan for Blood Glucose Level chart may help to get to know when and how to intervene, and whether the reaction is necessary.
- Have a diabetes care policy including guide to appropriate ‘sharps’ (needle) disposals in place
- Treat the child normally and help other children do the same
- If requested, provide some place in school where your child can have privacy when testing their blood glucose or administering insulin (if they wish), and where they can store their diabetes equipment.
- List a named person (teacher, SNA) to remind young children to finish their snacks and lunch and observe that they are doing so.
- Give permission for your child to miss school, without consequences, for medical appointments.
- Provide opportunity to meet with parents so they can be kept informed of changes to your child’s diabetes care and work with parents updating the personal plan for diabetes care in school.
- Adopt a healthy eating policy in school.
- Provide information for parents in advance when there are games, PE, sports days on in school as they will need to plan for these events and provide the child with extra food or snacks.
