Anxious about sending 6 year old to school for 1st time with Diabetes

Type 1 and LADA Parents of Children with Type 1 Diabetes
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My son was diagnosed 2 months ago, since then we have moved from Arizona to Bangkok, Thailand. We have been adjusting, we have our ups and downs, emotionally and physically but for the most part things are going well. School starts in a week. I have spoke with my sons Dr., the Nurses at the school, as well as the cafeteria worker. There are a few other kids at the school with diabetes so they have some experience. I am very anxious and nervous about how this will go for him. ANY help/experience is greatly appreciated. From what I have gathered, my son will go to the nurses office prior to lunch to test, go eat, and return to the nurses office for his insulin.

A few concerns:
1) The cafeteria here is more like a buffet. The kids can choose from a variety of foods everyday. There is a menu posted at the beginning of the week, BUT nutrition facts are not available like they would be in the U.S. I COULD pack him a lunch everyday, but I would really like to avoid that if at all possible. I know that we can make this work, just need to figure out how. I will join him at school the first week during lunch times to help the nurses and my son.
2) Testing at other times: I am considering keeping a testing kit in the nurses office as well as one in my sons backpack so he has it in the classroom. He can test himself, but doesn't always know how to appropriately treat highs & lows. Training the teacher as well as nurses will of course be mandatory so that they can tell my son what to do after he has tested.
3) Putting the control in someone elses hands. This is my son and his life that I am allowing someone else to be in control of. This freaks me out. I have not left him with anyone other than my husband since his diagnosis. Although it is scary, I am also looking forward to a break.

How did some of you deal with everything that goes along with sending your children to school for the first time after diagnosis?? What did you send your kids to school with supply / snack wise? What was their daily schedule like? P.E.? Lunches etc.

- Guess I should say that he is using Humalog / Lantus via injections. We are going to start looking into the pump at some point so I would like to hear how those on pump managed as well.

Thanks for reading my long post!! I look forward to hearing feedback.

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Hi, i am the father of a young five year old girl who was diagnosed with T1DM about eight months back. she has been going to school regularly ever since. Dont worry everything will be just fine. You can always say "easier said than done" but not to some one who is in the same situation as yours. So relax and just take it easy.
we are in India and here the schools dont have that many facilities or awareness even about how to handle children with Diabetes.
We send our daughter to school at 8 am and she is back by noon. during this time we just ensure that there are no Hypos.
Once this starts you will get to know exactly what to do. And controlling sugar levels with kids in school is very difficult. Especially so when you say there is a buffet out there.
I wud go with you packing a lunch for your son and then educating him about what he can take from the buffet.
The role of the teachers is very very important and they need to be reminded time and again to watch out what the kid is doing.
Everything will turn out fine. best of luck
Piyush

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I definitely recommend that you pack him a lunch every day. It's the only way you'll know how many carbs he's eating. Label each container with carb counts and then teach him to keep anything he hasn't eaten in the containers, so anyone can see how much he had. I use these labels and they work great: http://www.amazon.com/Jokari-47826-Erasable-Labels-Markers/dp/B002MPH4OG/ref=sr_1_1?ie=UTF8&qid=1375633474&sr=8-1&keywords=label+once

I would also have a meeting with the school administrator, teacher, and nurse to come up with a regular schedule for checking his blood sugar. Although he can test himself, he likely won't keep track of when to test and do it without being reminded. I also think that's too much responsibility for a newly diagnosed 6 year old to have to test himself every time. Our daughter is 7 and was diagnosed almost 3 years ago and we still don't require her to test herself if she doesn't feel like it. Sometimes she'd rather just hold her hand out and let us do it.

In our case, we have a Dex CGM (which I highly recommend getting before you get a pump). If the Dex alerts, then of course our daughter needs to test. If it doesn't, we have a set schedule for checks just to confirm that she's doing well. Often, this just means a quick glance at her Dex if we know that we have a good sensor. This is especially helpful to do about an hour before lunch, just in case a correction is needed to get her BG down from a high in time to eat. You may not be doing too much of that yet since he is newly dx and still honeymooning, but it's always good to test when you can.

We have sugar (juice, glucose tabs, glucose gel) in every classroom that our daughter ever goes into, including the library and gym. I have them in little plastic containers with simple instructions on a card attached to them. I made ID cards with her photo on the front along with a medical symbol, her name, condition, and teacher's name. On the back are the basic instructions telling what to do if she shows signs of a low or is unconscious, etc. I'm happy to share the file I use for the card if you are interested.

I'm concerned about the idea of having teachers responsible for making choices about treatment of highs and lows. Yes, they need to be trained to understand the basics and know how to handle emergency hypos. However, his hour-to-hour care is far too complex for a teacher to track when they have so many other kids to look after and teach. Also, you'll want to have everything logged in one place so that two different teachers don't do the same thing an hour apart. I assume he would only receive insulin at the nurse's office and that would be logged. If he is high, I would want him to go to the nurse's office, wash hands, re-check, and then calculate and give any needed correction. If he is low, I'd want an adult (not another student) walk him to the nurse's office (or have the nurse come to him) to re-check and give glucose as needed.

Hopefully, if they have other students with type 1, they have alot of this already worked out. I think you should have a meeting with them as soon as possible. Preferably, before school starts.

This is our third year in school with our daughter and we've had to work out lots of things, so please ask if you have any other questions. I'd love to help.

Sandi

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Looks like you have gotten great advice so far and I am probably going to sound like a broken record but I think that packing his lunch so that you know what he is eating. My daughter goes to the nurse and checks herself and then does her pump WITH the nurse's supervision. I do not give her a blood glucose machine to keep with her because I know that she would forget to check and not only that when she hits a low there was no way she could (I call it Jekel and Hyde time) Her teacher should be aware of how he acts when he is feeling low or high so that if they think there might be an issue then they could send an adult with him to the nurses office to have them check him. He should also know that if he does feel his highs or lows (some don't) then he needs to feel comfortable speaking up and telling an adult listen I don't feel good. Also watch recess and gym class sometimes they are close together (my daughters was last year) and if he just had lunch and then is going right into an activity such as those they may need to watch him. Also make sure they test him before he gets on the bus if there is a long ride be sure to pack him an extra juice box and let the bus driver know that if he isn't feeling good he must drink that. There is a lot to think about but you will get into the groove soon enough. Just take it one day at a time.

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I feel your pain. My 7 year old was diagnosed on July 23rd and school started Aug 9th. We had the week of diagnosis in the hospital, a week of couch potatoing, a week at the beach and then school started. Her BG is still all over the place and until today (at school), she had not had a low that she recognized. We will not get into a regular extra curricular schedule with soccer and dance for another 3 or 4 weeks so everything is so up in the air.

I am follwing the school nurses suggestions about having sugar to treat lows in every room she will be in. We have a schedule for checking and going to lunch early so that she has extra time to finish. I have been packing her lunch, even though she has always been a school lunch eater. The school employee charged with assisting her and checking on her is my other daughters one on one aide. My other daughter is completely disabled so has an employee dedicated to just her. This is good because the aide is already like part of our family and she has pretty free reign to take my older daugher with her and go check on the younger one at any time. That does not mean I'm still not nervous about the situation. She is in an academic gifted class at school for most of the day with only 5 children. I see that as a postive because the teacher has far less little ones to keep up with.

I am trying to take a breath and trust that everyone will settle into a routine that works best for everyone. I am so glad to have found forums like this for support and suggestions.

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Sending you big e-hugs, Jovigil.

I know it's very stressful, but it sounds like you are in a great situation with the aide you already know. I think that will help so much.

Are you able to be at school some of the time for the next few weeks? I practically lived at our school for the first 3 weeks when my daughter started kindergarten. It helped my daughter and the health aide who was learning how to care for her - just to have another adult to talk through what to do with various BG numbers. It is an awful lot to ask of parents to teach others how to care for our T1 kids when we are just barely understanding ourselves yet, but it seems easier if you are kind of in it together with her aide at school. It also helped me to be there and to know exactly how everything was going through the day.

I'm finally feeling like I (mostly) know how to handle school and this is her 3rd year. Please ask questions because I'd love to help you if I can.

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I wanted to thank everyone for their comments and suggestions. Today is my son's first day of school. I am nervous to say the least. I am going to return to the school around lunch time to help with his testing and insulin. I decided to pack his lunch for now at least and maybe ease into eating the school lunches later. I am trying to just go with the flow, with the understanding that there are going to be ups, downs, and stresses the first couple of weeks.

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Hi,
My 12 year old was diagnosed 7/13/13 and I was wondering all of the same things! I have a meeting with the school nurse today.

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This website has great resources for you: http://www.coloradokidswithdiabetes.org/ It's written by the Colorado Kids with Diabetes Care and Prevention Collaborative, but of course it is applicable and helpful for kids anywhere.

You can order a free copy of this publication, which has excellent info and resources in it. I ordered a hard copy for myself and for my school. You can also read the entire document online and print out whatever pages you want. http://ndep.nih.gov/publications/PublicationDetail.aspx?PubId=97#main

Here you'll find a sample 504 plan. It can be downloaded as an editable document so you can change it to suit your child. This is the one I'm using this year. http://www.diabetes.org/living-with-diabetes/parents-and-kids/diabetes-care-at-school/written-care-plans/section-504-plan.html

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This is how I've edited the sample 504 for my daughter for this year.

1548-Clara5042013__.pdf (336 KB)