Returning to School After a Diabetes Diagnosis

A diagnosis of diabetes is a life-changing event for the whole family, and while your child's medical care team is there to guide you, one of the biggest challenges is figuring out how to manage their care when they're away from home. Returning to school requires careful planning, communication, and teamwork. 

Dr. Naomi R. Fogel, director of Lurie Children's Pediatric Diabetes Program, offers essential tips to help make the transition back to the classroom smooth, safe and stress-free for your child. 

Establish Your Diabetes Care Team at School 

Your child's school isn't just a place for learning; it's where they'll spend the majority of their day, making the staff crucial members of their diabetes management team. Create the 504 Plan, which is a legally binding document that outlines how the school will accommodate your child’s health needs. It should detail: 

• Where and when your child can test blood sugar and take insulin  
• Access to snacks and water, even outside of normal break times
• Permission to carry necessary supplies (meter, insulin pen, juice box) with them
• Training for staff on recognizing and treating hypoglycemia (low blood sugar) 

Be sure to designate one or two staff members (usually the school nurse) who will be the main point of contact for routine care and emergencies. Before the first day, meet with the principal, school nurse, your child's primary teacher and any after-school program supervisors to ensure everyone has the proper information and plan of care. 

Prepare Essential Supplies and Paperwork 

Organization is key to managing diabetes at school. Prepare two separate kits to ensure your child is covered wherever they go, including:

• The main school kit: This should be kept in the nurse's office. It needs a full month's supply of everything: insulin, syringes/pens, glucose meter, testing strips, glucagon, spare pump supplies, ketone testing supplies and contact information.
• The go-bag: This is a small, portable kit your child can take to the cafeteria, recess, gym class and field trips. It must include their meter, a source of fast-acting carbohydrate (like glucose tabs or juice) and a quick snack. 

The more prepared you are, the easier it can be for your child to manage their diabetes while at school. 

Focus on Low Blood Sugar Preparedness 

Hypoglycemia (low blood sugar) is the most immediate threat in a school setting, and every adult supervising your child should know how to spot and treat it. Help your child identify their own low symptoms (shakiness, headache, dizziness) and teach the staff to watch for them too. Ensure the nurse and teacher understand the “rule of 15” treatment: give 15 grams of fast-acting carbs, wait 15 minutes, re-test blood sugar and repeat if necessary. 

Make sure the emergency glucagon injection kit is easily accessible and known to all key personnel. Ensure the school nurse has the most current written orders from your child’s endocrinologist, including all dosing ratios, correction factors, and treatment instructions for high and low blood sugar. 

Empower Your Child 

A new diagnosis can make a child feel different or embarrassed. Your emotional support is just as important as the medical support. Keep an open dialogue and talk with your child about their feelings about their diabetes at school. Let them decide who they want to tell and how. 

Empower your child to take ownership of their care as much as possible by letting them test their own blood sugar or choose their own snack.  While you must advocate for their rights and safety, try to step back once the plan is in place. Show your child that you trust the school staff to keep them safe, which in turn helps them feel more confident. 

Prioritize Communication and Consistency

A consistent routine minimizes stress and helps stabilize blood sugar levels. Clearly document the exact times your child eats lunch and snacks and try to keep mealtimes consistent every day. Be sure to schedule regular (monthly or quarterly) check-in meetings with the school nurse and teacher to discuss any challenges, like playground activity or stress, that might be affecting your child's numbers.

Returning to school is a big step, but with collaboration and communication between your family, your medical team and the school staff, your child can continue to thrive both academically and medically. 

Learn more about Lurie Children's Pediatric Diabetes Program

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