School staff will need to be informed about diabetes and what is involved in managing it daily. If the school has never before had a pupil with diabetes there is a lot that staff will need to know. Even if the pupil has been attending the school and staff are familiar with diabetes, they will still need an update after the summer as things may have changed. This is especially important if the pupil is moving on to a new class teacher. The recommendations below are based on 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 school should arrange a meeting with the parents, the class teacher, principal and SNA (if applicable) so parents can explain diabetes and what is involved in its daily management. Ensure (chosen) staff (Teachers and SNAs) undertake specific diabetes training as necessary (e.g. insulin injection administration or supervision, insulin pump, glucagon administration etc.)
• It is important to agree a written Personal Pupil’s Plan for diabetes care during school hours in consultation with the parents and the pupil’s diabetes team.
• This Personal Pupil Plan 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), the level of supervision that is required during snack/lunchtime, the plan for insulin administration and in what situations should parents be contacted.
• Such a plan is age-sensitive and should be regularly updated. It has been created and published by the HSE National Clinical Programme for Paediatric Diabetes guideline: Meeting the Care Needs of Primary School Children with Type 1 Diabetes during School Hours and is fully supported and co-authored by Diabetes Ireland.
• Parents / guardians of the pupil should consult the Personal Pupil’s Plan with their diabetes team, and bring it to the school, so all concerned have the same understanding of the goals of diabetes management, the minimum safety requirements and describes when teachers/SNA’s interventions are necessary.
• School staff responsibility is to provide sufficient resources to implement the Personal Pupil’s Plan.
• Provide immediate access to treatment of a low blood glucose when needed. See more about low blood sugar levels here  https://www.diabetes.ie/hypoglycaemia-low-blood-glucose-level-what-you-need-to-know/. See the guidelines on the Hypoglycaemia treatment prepared by the HSE.
• Ensure all school staff are diabetes aware. Talk to all staff, it is not only the class teacher that needs to be aware of the needs of a pupil with diabetes. Teachers on yard supervision, SNAs and learning support teachers should all be informed of who the pupil with diabetes is, what the signs of a low blood glucose are and how to treat it.
• 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. Sharp disposal unit and disposable gloves and information about the safe disposal of needles/syringes in a sharps container should be made available at school (provided by parents/carers). See more information here.
• Treat the child normally and help other children do the same.
• If requested, provide a room where the child can have privacy (if they wish) when testing their blood glucose or administering insulin, and where they can store their diabetes equipment.
• For younger children a designated staff member should observe that the pupil finishes their snack/lunch.
• Ensure all staff are given the opportunity to attend any diabetes education sessions that may be provided by the pupil’s diabetes team.
• Develop a healthy eating policy in the school. The presence of a healthy eating policy ensures that all children eat well at school, and this makes it easier for the pupil with diabetes to do the same. Healthy Eating and lots of activity should be encouraged for all school children as it prevents the development of childhood obesity.
• Ensure good communication between home and school i.e. in a form of a notebook which documents food eaten, activity done, episodes of low blood glucose and how they were treated. This can then also be used at home so that parents can inform the school of anything that might affect the pupil while they are in school.
• Inform 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.

As per the HSE guidelines, the parents/guardians of a child with diabetes have responsibility to:

• Inform the Board of Management, school principal and the teacher that their child has diabetes
• Attend and participate in school meetings to provide sufficient/additional information so that the care needs of the pupil are defined based on the Personal Pupil’s Plan supplied by the diabetes team
• Inform school staff of any changes in their child’s health status or diabetes regimen
• Ensure their child’s insulin (if administration is required during the school day) and glucose meter is labelled with the child’s full name. Ensure insulin and all necessary equipment (blood glucose meter, lancet device, strips, insulin pump consumables, sharps disposal etc.) are within the expiry date and that the child has a hypo remedy with them each day to treat low blood glucose (hypoglycaemia)
• Parents/guardians 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 appendix 4 of the full document for more information)
• Provide information about their child’s meal/snack schedule which should be tailored to fit into the daily school timetable (where possible)
• Provide the school with appropriate treats for their child for special events such as parties
• 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
• 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

How non-teaching support and SNA’s could help? click here.