In people with diabetes, either the pancreas doesn’t make insulin (type 1) or the body cannot use insulin properly (type 2). Without insulin, glucose– the body’s main energy source– builds up in the blood and causes severe damage.

Children with diabetes usually have Type 1 diabetes, in which the pancreas doesn’t make insulin. They need daily injections or wear an insulin pump to enable their bodies to use food properly.

When the body doesn’t make insulin, there are two types of problems that occur.

Hyperglycemia occurs when the blood-glucose level gets
too high–for example, when the body gets too little insulin or too much food. Blood glucose also rises when a person with diabetes is ill or under extreme stress. The body produces ketones, harmful acids that poison the body and its organs. Untreated, hyperglycemia may result in ketoacidosis, a very serious condition that requires hospitalization. Treatment includes extra fluids and insulin.

Insulin injections today are nearly painless, thanks to smaller needles. Insulin pumps, which deliver insulin through a small tube that is placed just under the skin, cut down on the numbers of injections necessary. Insulin is usually injected into the fatty layer under the skin of the abdomen, hips and buttocks, or thighs. Parents are instructed on when and how to give the child insulin, as well as the best sites to inject it based on the his or her weight, age, and activity patterns.

Hypoglycemia is the exact opposite of hyperglycemia.
It occurs when the blood-glucose level gets too low–for example, when the body gets too much insulin, too little
food, or too much acitivity or stress. Hypoglycemia is the most common problem in children with diabetes. Usually
it is mild and can be easily treated by giving the child a
sweet food or drink.

Type 1 diabetes is not contagious. You cannot “catch”
it from someone who has it. Type 1 diabetes can run
in families. Researchers are still studying how and why
Type 1 diabetes occurs in certain children and families. Children cannot outgrow it. Although there isn’t a cure
for Type 1 diabetes, it can be controlled. Research has shown that maintaining good control of blood-glucose level scan possibly prevent or at least postpone some of the long-term complications of diabetes.

Type 1 diabetes is more flexible today than it used to be. With good medical care and support from other children and adults, kids with type 1 diabetes can lead healthy, active, fulfilled lives.

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AccoMOMdate88 Omaha, NE
#whatisdiabetes It is so frustrating for me when my son comes home upset about not being able to participate in activities. I never know what to say to his teachers. The suggestions about making accommodations is super helpful!

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Worrieddad92 Denver, CO
#whatisdiabetes My son is entering fourth grade in September, and he was just diagnosed with T1D this summer. How can I empower him to not be afraid of speaking up for himself?

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Worriedteacher88 Cleveland, OH
#whatisdiabetes Any suggestions on activity substitutions if my student isn't feeling well on a day where recess is outside?

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AnonymousUser856>Worrieddad92
Tell him that health is more important than school! And that nobody knows his body better than he does. If he doesn't feel well, he MUST speak up!

TeacherfromNY>Worrieddad92
The teacher will learn to understand if he or she does not! There is a huge learning curve, and they are equipped to deal with every situation.

This is an anonymous forum where parents and teachers can ask and/or answer questions, yet still maintain confidentiality. Your information will not be disclosed elsewhere.We only ask
for your email to notify you of a response to your question.

When a student is diagnosed with T1D, his whole life changes in an instant. All of a sudden he can't eat or drink
all of the things his friends are eating and drinking. After
the baseball game, everyone runs to get a soda, but he
has to find diet soda. He may be looking forward to a class
or activity all day, but then his blood glucose acts up and
he has to miss it. As if these challenges were not enough,
the student also has to deal with prejudice and teasing
from other students and sometimes even adults, who
don't understand the disease.

Once again, the age when T1D onset occurs, and the age, maturity level, personality, and emotional state of the student all affect how
he will adjust to life with T1D. Creating a support network requires discussions between the parent(s), student, nurse, administrator, guidance counselor, and teachers; these should always include consideration of emotional and social issues. Some emotional and social issues to consider are

Where will the testing of blood-glucose levels take place?

Where will snacks be eaten?

Will the student simply tell the teacher that he needs to see
the nurse, or does a signal need to be established between the student and teacher for the student to communicate this need?

Will the classmates be told/educated about T1D and the student with T1D? If so, who will do the talking and educating, and how?

How will parties and food be handled so that the student is not left out or put in an embarrassing situation?

Will the student wear an insulin pump during PE class? If not, where will it be stored?

Will the student wear a medical ID bracelet?

How will the school and/or parent deal with the student if the resists care, does not take his insulin, refuses to check blood-glucose levels, reports false glucose levels, etc?

How will depression or anger issues be handled?

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Worriedteacher88 Cleveland, OH
#whatisdiabetes Any suggestions on activity substitutions if my student isn't feeling well on a day where recess is outside?

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AnonymousUser856>Worrieddad92
Tell him that health is more important than school! And that nobody knows his body better than he does. If he doesn't feel well, he MUST speak up!

TeacherfromNY>Worrieddad92
The teacher will learn to understand if he or she does not! There is a huge learning curve, and they are equipped to deal with every situation.

It is essential to establish a partnership with your child’s school in order to create a supportive environment in which he or she can learn and thrive. The parents’, students’, and school’s needs must be mutually communicated, heard, and understood. From the first day your child returns to school post-diagnosis, you should make every attempt to establish
a positive partnership with the school. Be sure on the first day to explain the vast differences between type 1 and type 2 diabetes to your child’s teacher. While most people know
of diabetes, much of their knowledge is usually about type
2 diabetes. The teacher may or may not have had previous experience with other children with type 1 diabetes, but it is important to understand and emphasize that each person’s experience with the disease is different.

Effective type 1 diabetes management at school has numerous positive outcomes. It can

promote a healthy, productive learning environment
for students with T1D

reduce the number of absences of students with T1D

reduce classroom disruptions and disturbances

help ensure an effective response in case of a T1D
related emergency

This responsibility is similar to school staff being prepared to give an Epipen to a child who is allergic to bees.

The closest adult in the school, usually your child’s teacher, can be designated as the “go-to person” for him or her.
The teacher needs to learn all he or she can about your
child’s specific type 1 diabetes-management routine in
order ot support your child throughout the school day. Ideally, there would also be a “backup” adult trained to
check your child’s glucose as well as recognize and/or
treat hypoglycemia or hyperglycemia. If the child is mature enough to treat him or herself, he or she should be allowed
to do so under supervision. It could also be beneficial to request that the school provide a location in which the child can check his or her blood glucose or take insulin privately.
Two adults need to be trained to give a glucagon injection
in case of emergency.

As a parent in the parent to teacher relationship, it is important to keep the lines of communication open and
show that you appreciate the partnership, email the teacher and whomever is helping to care for your child thanking them for working with you and include your complete

contact information and any other useful information,
letting them know that they can contact you with questions any time. Check in regularly with the teacher about your child’s type 1 diabetes regimen, as well as with the school nurse. Check in about replenishing supplies when necessary, and form good relationship with the lunch and staff monitors. Some additional parent responsibilities are to very clearly communicate your permission for the teacher to call 911 and to administer glucagon whenever they deem it to be necessary. Also, that the school has your permission to share the needed medical information about your child
with everybody who needs to know, and provide multiple emergancy contacts. It is important to keep the teacher notified if there are changes in your child’s management.

It would also be beneficial to provide necessary equipment (supplies, snacks and emergency items) needed. The teacher can contact you when supplies are running low. A school
kit might include: vials of your child’s insulin (clearly labeled with the child’s name), syringes, a second glucose meter to keep at school (with batteries and test strips), glucagon kits, glucose tablets, juiceboxes, or other forms of fast-acting sugar, cake icing or glucose gel, snacks containing protein (such as peanut butter crackers), and a mini carbohydrate-counting guide.

Be an advocate for that student with
less-accommodating school staff!

If you are a teacher reading this and the parent you are working with is not following these guidelines, you can suggest they use them, (adapted from the Junior Diabetes Research Foundation) to ensure that their child is getting the best in school care possible! If the student says he or
she doesn’t feel well, never send the student to the nurse’s office without another student or adult accompany him or her. Genuinely welcome the student into your classroom
and create a supportive environment for him or her. Assure the parent that you will do everything in your power to keep the child safe.

Create a system for a regular reminder to yourself to be vigilant and observant concerning the student with Type
1 diabetes. Use the same system to remind yourself of
low- or high-blood-glucose symptoms and emergency responses. Create a system to make sure that when field trips or other special and different kinds of activities are planned, the healthcare needs of the child with Type 1 diabetes are remembered and addressed. Try to provide
any agreed upon modifications and accommodations to the student. Do not make the student and parents jump through hoops if another modification needs to be added to the agreed-upon list.

Find ways to help the student feel less “different.” Use
the students' parents as a resource. Communicate with them, and partner with them to provide the best learning environment possible! Let parents know when snacks and other supplies need to be replaced. Respect the student’s confidentiality and right to privacy. Also, work with both the parent and child to determine the best ways to address any T1D-related issues that may arise in the classroom.

Substitute Teachers:

When you are out of the classroom, make sure that the substitute knows what to look for, what to do, and what modifications or accomomodations are necessary. Have
a Substitute Teacher Folder in an obvious place and include
the appropriate emergency information about the student
with Type 1 diabetes.

It is important for both the Parent and Teacher to encourage the child to take some responsibility as well because only the child knows how he or she is feeling. It would be helpful for the child to clearly communicate with the teacher how he or she is feeling, understand what to do if for some reason, an adult at the school does not give the child premission
to do something he or she must do (i.e. doesn’t test blood sugar or go to the nurse for school), learning what to say when a fellow student says something inappropriate or mean about the child having type 1 diabetes, and to know how to handle a situation if food that is not good for the
child is passed out during class time. The child should try
to work to become as independent as possible in his or her own diabetes care and management. The child shouldn’t be afraid to let good friends know about the disease and how they can help if he or she is ever in need of assistance.

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Worriedteacher88 Cleveland, OH
#whatisdiabetes Any suggestions on activity substitutions if my student isn't feeling well on a day where recess is outside?

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AnonymousUser856>Worrieddad92
Tell him that health is more important than school! And that nobody knows his body better than he does. If he doesn't feel well, he MUST speak up!

TeacherfromNY>Worrieddad92
The teacher will learn to understand if he or she does not! There is a huge learning curve, and they are equipped to deal with every situation.