Prepare for Hypoglycemia at School

If you have a child with diabetes, he or she is at risk for low blood sugar, or hypoglycemia. Hypoglycemia is a state where blood glucose (blood sugar) levels fall below a normal range and is defined as blood sugar below 70 milligrams per deciliter (mg/dL). It can occur at any time of the day, so when your child goes off to school in the morning diabetes goes with them. Therefore, it is important to take steps to ensure your child is safe at school.

The more you and those surrounding your child at school – teachers, class mates, nurses, administrators, bus drivers, lunchroom workers – know about diabetes and hypoglycemia, including how to manage blood sugar, symptoms of low blood sugar and how to correct it, the more help they can offer your child, if necessary. Planning ahead and always being prepared can help minimize complications with diabetes at school.

Low blood sugar may occur during the school day just like it can at home. Hypoglycemia may occur due to changes in activity level, food intake or medication. Common symptoms are shakiness, sweating, tingling, hunger, dizziness and trouble thinking clearly. Low blood sugar in a more severe and dangerous state may lead to irritability, change in personality, seizures and loss of consciousness.

Naturally, parents want the people who are around their child at school to be able to recognize low blood sugar and know the proper steps to correct it. This is especially important for younger children who may not be able to tell that they are experiencing low blood sugar symptoms.

Low blood sugar may occur during or after physical activity. If your child participates in physical activity and/or gym class at school or after school sports, make sure teachers and coaches (and maybe even team mates) are aware of diabetes and know what to do to identify and correct hypoglycemia.

On a yearly basis, or whenever your child’s self-management regimen or school circumstances change, you, your child’s healthcare professional, your child and school staff should work on developing and implementing a Diabetes Medical Management Plan. This can be done using a form provided by the school or a healthcare professional. Samples of Diabetes Medical Management Plan forms are also available online.

Having a child with diabetes has its challenges and there is much to learn about managing hypoglycemia. The more you, your child and school staff know about low blood sugar and how to recognize and help correct it, the more everyone can do to help your child keep safe and in control of his or her diabetes.

Creating a Diabetes Care Plan

Developing a Diabetes Medical Management Plan for your child is an important way to help your child manage his or her diabetes while at school.

This plan forms the basis from which to manage your child’s diabetes and includes your child’s:

  • Date of diabetes diagnosis
  • Personal, medical and emergency contact information and plans
  • Medication plan
  • Self blood sugar monitoring schedule
  • Assessed self-care skills for performing diabetes care tasks
  • Typical signs and symptoms and recommended treatment for both hypoglycemia and hyperglycemia
  • Meal and snack plan
  • Physical activity requirements

Having a Diabetes Medical Management Plan for your student child is important for his or her well-being and safety while attending school or school-related activities. Remember, after the school year begins, if your child’s diabetes care plan changes, the Diabetes Medical Management Plan will also need to be updated.

How to Create Your Plan

The National Diabetes Education Program (NDEP), a federally-funded program sponsored by the U.S. Department of Health and Human Services’ National Institutes of Health and the Centers for Disease Control and Prevention, has created the document Helping the Student with Diabetes Succeed: A Guide for School Personnel. The guide offers information about the different types of plans that may benefit your student child and can be used to create a Diabetes Medical Management Plan. Sample forms and resources are also included in the guide.

Source:

National Diabetes Education Program. Helping the Student with Diabetes Succeed: A Guide for School Personnel (2010): http://ndep.nih.gov/media/Youth_NDEPSchoolGuide.pdf.

Tips and Tools for Parents

Help School Staff Who Interact With Your Child

  • Notify appropriate school staff, such as the principal, school nurse or teacher, that your child has diabetes.
  • Work with your child’s healthcare professional and appropriate school staff to develop a Diabetes Medical Management Plan. Review the plan on an annual basis or whenever your child’s self-management regimen or school circumstances change.
  • Provide current and accurate emergency contact information to the school. Notify the school of any changes to this information, if necessary.
  • Provide equipment and supplies that are needed for managing and correcting low blood sugar. This includes, but is not limited to: blood glucose testing supplies, insulin and syringes, snacks, fast-acting carbohydrates and a glucagon kit.
  • Be proactive with communicating any changes to your child’s needs to the appropriate school staff.
Tips and Tools for School Staff

Helping a Child with Diabetes: Recognizing and Correcting Low Blood Sugar

  • Be prepared to recognize and respond to signs and symptoms of low blood sugar. Use the student’s Hypoglycemia Emergency Care Plan and understand when and how to use a glucagon kit, or contact emergency medical assistance.
  • Be mindful that eating meals and snacks on time is very important to diabetes management.
  • Communicate any changes in the schedule that may affect activity level and meals/snacks, such as field trips and class parties.
  • Make sure that fast-acting carbohydrates, such as glucose tablets, liquid or gel, are readily available at all activity locations.
  • Understand that low blood sugar can occur during and after physical activity. Allow students with diabetes to wear a medical ID during physical activity.
What Your Child Should Pack Every Day

It is important to make sure that your child is always prepared to manage his or her diabetes while in school, including preventing and correcting low blood sugar. Pack the following items in your child’s school bag to help him or her be prepared to manage hypoglycemia (this is not an all-inclusive list):

  • Fast-Acting Carbohydrates
    • Glucose tablets, liquid and/or gel
    • Juice boxes that do not require refrigeration
    • Any other food item that your child’s healthcare professional recommends
  • Diabetes Supplies
    • Blood glucose testing supplies
    • Ketone testing strips
    • Insulin and syringes
    • Extra insulin pump supplies, if child uses pump
    • Snacks such as crackers and peanut butter
  • Contact Information
    • Emergency numbers, including yours and the name of your child’s healthcare professional.

Source:

National Diabetes Education Program. Helping the Student with Diabetes Succeed: A Guide for School Personnel (2010): http://ndep.nih.gov/media/Youth_NDEPSchoolGuide.pdf.

Tips for Creating a Hypoglycemia Readiness Pack

Teachers and other school staff and coaches should learn to recognize and know how to manage low blood sugar episodes.

A hypoglycemia readiness pack may contain:

  • Hypoglycemia Emergency Care Plan
  • Insulin
  • Syringes
  • Blood glucose testing supplies
  • Ketone testing strips
  • Glucagon
  • Fast-acting glucose tablets, liquids and/or gels
  • Snacks such as juice boxes and small boxes of raisins

The Hypoglycemia Emergency Care Plan is a form that summarizes how to recognize and correct low blood sugar. The development of this plan should be coordinated by the school nurse and it should be distributed to all appropriate school staff.

Source:

National Diabetes Education Program. Helping the Student with Diabetes Succeed: A Guide for School Personnel (2010): http://ndep.nih.gov/media/Youth_NDEPSchoolGuide.pdf.