Keeping kids with Type 1 diabetes medically safe in school requires a team effort among families, health care providers and school staff. Here's one mother's story of how she's been prepping her son to start kindergarten with a lunch box and diabetes kit in hand.
When Stacey Simms sends her 5-year-old son, Benny, off to school, she's confident he'll be in good hands. And yet she worries, too. Benny has been dealing with diabetes since he was age 2. "Now he's a pro," says Simms, a radio talk-show host in Charlotte.
The little boy can check his own blood sugar and use his insulin pump, both with adult supervision. He can't count carbs, however, which is how his parents measure out how much insulin he needs.
Simms has been pleased with the response from her son's public school, and has worked hard to get several legal forms and doctor's orders organized.
"I'm pleased that most of Benny's care will happen in the classroom," she says. Most of the help he needs will come from his teacher and her assistant, not the school's part-time nurse. "He won't have to leave the room every time he needs to be checked. That's not the case in every state."
In some states, state law restricts who can provide diabetes care in the school setting and whether a student with diabetes is permitted to self-manage his or her disease. In California, for example, an appeals court recently ruled that state law prohibits school employees who are not nurses from volunteering to help children with diabetes by administering needed insulin. However, a new law in Florida allows kids to help manage their diabetes and carry their own supplies. Go to www.diabetes.org, the American Diabetes Organization website, and click on "Safe at School" to learn about your state's laws.
Type 1 diabetes, usually diagnosed in children and young adults, was previously known as juvenile diabetes. In type 1 diabetes, the body does not produce insulin.
Insulin is a hormone needed to convert glucose, starches and other food into energy, according to the American Diabetes Association.
Like most children with type 1 diabetes, Benny's care is intense, Simms says:
"We check his blood sugar with a finger prick six to eight times a day. He needs to be checked before he eats, before exercise and before he gets on the bus. He'll also need to be checked anytime he just doesn't feel right. He'll need insulin anytime he eats and anytime his blood sugar is too high. He'll need sugar, usually from a juice box, anytime his blood glucose number is too low."
She's hopeful that what is routine to the family will soon become routine at school.
Here's the plan: Benny will bring his diabetes kit to school every day. It includes a meter, with lancet and test strips, extra insulin, pump supplies, juice boxes and snacks with protein, an emergency glucose shot, and syringes in case something goes wrong with the pump. There will be a duplicate of everything in the school's front office. Benny's lunch will be labeled with the carb count of each item.
And a plus: Big sister Lea will be on the bus with Benny and has had a great experience at their school.
A week before school starts, he's "super-excited" about finally getting to start school. He mainly wants to make sure his mom will come to his class to read one of his books about diabetes.
"Benny wants his new friends to know why he wears a pump and may get some snacks when they don't," Simms says. "Other than that, he's just excited to finally head off to kindergarten."
Resources the mom suggests:
--"Taking Diabetes to School" (JayJo Books, 2004, $11.95) by Kim Gosselin, first in a series of Special Kids in Schools books.
--The Juvenile Diabetes Research Foundation website at www.JDRF.org. Simms is on the board and donates proceeds from her book, "I Can't Cook, But I Know Someone Who Can" (Spark Publications, 2008) to the foundation. Her website is www.staceysimms.com.
--An online community for kids, families and adults with diabetes is www.childrenwithdiabetes.com.
Parenting tip: Through a national call center at 800-DIABETES, legal advocates for the American Diabetes Association assist families with school discrimination concerns.
Betsy Flagler, a journalist based in Davidson, N.C., is a mother and teaches preschool. Reach her at firstname.lastname@example.org.