Diabetes Forecast

Your Back-to-School Checklist

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Bookbags, folders, calculators, and summer reading assignments: For kids with diabetes and their parents, these typical back-to-school preparations are just the beginning. By now you've probably already met with your child's diabetes care provider and school personnel. But there are other important steps you can take to make sure your child stays safe at school:

Make sure you have a current Diabetes Medical Management Plan (DMMP).

Work with your diabetes care provider to create this plan that spells out your child's school diabetes care regimen, if you haven't already. "What are the child's typical symptoms of hypoglycemia? What snacks does he or she use to treat it? Can the child give his or her own injections?" asks Linda Siminerio, RN, PhD, CDE, cochair of the ADA Safe at School Working Group, and an associate professor at the University of Pittsburgh School of Medicine and Nursing. View a sample plan at www.diabetes.org/schoolsDMMP.

Write up a 504 individualized education program (IEP).

These documents take the information in the DMMP and explain the school's specific responsibilities. They are developed to protect your child's rights under relevant federal laws. One thing the plan addresses is who else should be trained to provide diabetes care tasks for your child when the school nurse is not available. "Who else will your child be in contact with?" says Siminerio. "This is important for all children, although younger children will generally need more help. [Your list should include] the school bus driver, the teacher, anyone responsible at after-school activities or field trips." View a sample 504 plan at www.diabetes.org/schools504.

Don't forget the lows.

Be sure to have a "low box" containing snacks and glucagon with your child, in the classroom, and in the nurse's office, based on what you've outlined in your care plan. Provide your child with sources of glucose, like tabs or gels, that he or she is used to. "I would avoid using things the child would be tempted to snack on if they didn't have hypoglycemia," Siminerio cautions. "I wouldn't put a favorite candy in the bookbag for instance, because the child may be tempted to eat the candy even when he or she doesn't have a low glucose—then it won't be available when the child really needs it."

Build up your child's confidence.

Giving kids a little more independence at home—like teaching them to check their own blood glucose, if they're ready for it—will give them the confidence that they can take care of themselves when you're not with them, too.

Listen—and reassure.

The start of school "is an emotional time for everyone; it's hard to let your child go," Siminerio says. "Anticipate that your child will be nervous. Reassure your child that you've met with the school and they can feel safe."



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