Diabetes Forecast

Diabetes at School: 504 Plan Essentials

Important aspects of your student's school care plan

By Lindsey Wahowiak , , , ,
children in classroom facing blackboard


The 504 plan is a legal document that lays out precisely your child’s diabetes needs and modifications and how the school will address those items. It’s important to have a 504 plan for your student, whether your state has Safe at School laws in place or not. “Parents should proactively work with the school to put a 504 plan in place,” says Crystal Jackson, director of the ADA’s Safe at School campaign. Here she clarifies some school situations that are often misunderstood:

Field Trips and Extracurricular Activities

Students must be permitted to participate in all school-sponsored field trips and extracurricular activities (such as sports, clubs, and enrichment programs) without restriction and with needed accommodations. Routine and emergency care during such activities—as outlined by the Diabetes Medical Management Plan (DMMP), or physician’s order—must be provided. The school nurse or other supervisory school personnel should make sure students’ diabetes supplies are accessible and available. Parents or guardians cannot be required to accompany students on field trips or any other school activity as a condition of students’ participation.

Alternate Exam Times

Students should not be required to take an exam when affected by high or low blood glucose levels. Students should be permitted to take the exam at another time without penalty. Extra time to finish an exam or classroom work should be provided without penalty if students need to take breaks to use the bathroom, get a drink of water, or to treat hypoglycemia or hyperglycemia.

Diabetes-Related Absences

It is important for students to attend school regularly. Absences do happen, however, and students should not be penalized for missing school because of medical appointments and/or illness. Parents or guardians should provide documentation from a student’s health care provider if required by school policy.  Communication is key. If a student is absent, immediately follow up with the attendance office to confirm the absence is properly documented and contact the teachers to create a plan for making up missed work and exams.

When the School Nurse Isn’t Available

The school should train school staff members to provide routine (insulin delivery, blood glucose monitoring, assistance with meals and snacks) and emergency (glucagon administration) care when a school nurse is not available to do so. This includes the times when students are on school campus as well as during all school-sponsored activities. The provided care should be in accordance with a student’s DMMP. In addition, any school staff member who has supervisory responsibility for students should be trained with a general overview of diabetes and in how to recognize and treat hypoglycemia and hyperglycemia, plus how and when to get help. Bus drivers should also be informed about students’ diabetes and be prepared to take needed actions.

A guide to writing a 504 plan.


Safe at School in Texas



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