One week into this Type 1 diabetic thing and my kids school nurse (i.e. clinic aid) made a major mistake

Hi everyone,
I am one week into this diabetic thing with my (almost) 6 year old and we seem to have hit the ‘honeymoon’. My first question is about the honeymoon…is it possible to be in the honeymoon stage so soon after diagnosis–we were diagnosed 10 days ago?

In addition, we knew my daughter hit a low yesterday and was probably going into this “honeymoon stage”. This morning I discussed the honeymoon stage with the school nurse/clinic aid as well as her teachers and explained that their is a chance my child would be in the clinic and they would need to check her sugar level and probably give her 4oz oj then call me. I found out at one point this morning that my daughter was in the clinic and the nurse gave her orange juice … HOWEVER, the nurse did not check her sugar level before the oj was given, then the nurse did not wait 15 minutes to recheck her, nor did the nurse call me. I found all of this out because one hour later my daughter was back in the clinic, this time the nurse checked her sugar (it was 47) and then gave her more juice and called me. I was LIVID that there was no sugar level an hour prior, yet she gave her juice, and that I was not called. I did call the Public Health Administrator and explained the situation. She followed up with the nurse (who is not a registered RN, she’s a clinic aid). I had no idea that Fairfax County Public Schools in Virginia does not have to provide registered nurses in their clinics. I have no idea if I should talk to the principal about this. I have no idea how else to make sure the school is notifying me the minute my child comes into the clinic. Luckily I live about 10 houses up from the school so I ran to the school the minute the nurse called me with the 47 sugar level. I did type up a step by step of what needs to happen if my daughter walks into the clinic and gave it to the nurse this afternoon. It still doesn’t guarantee my child is getting the best care. Oh, and lastly, my daughter is the only diabetic in the school so I assume this clinic aid doesn’t have a lot of experience with diabetics.

Thanks for letting me vent.

You would actually be in the honeymoon stage when diagnosed. The honeymoon stage is when the pancreas is still working, just not 100%. A child can remain in the honeymoon stage for a year or even longer after being diagnosed.

When the honeymoon stage ends…you wont see lows…the blood glucose will go higher due to the fact that more insulin is needed because of the pancreas no longer producing any.

Also wanted to add…if she was given 4 ounces of juice and an hour later 47…when you are treating a low, the juice is to get the blood glucose back up to a safe level…but you need to give a complex carb to keep it up there, otherwise it will go up and shoot right back down. Treating a low you should give a 10-15 complex carb and either glucose tablets, juice, even some soda pop. Without a complex carb the chance of a low shortly thereafter is pretty good.

We actually saw more lows when the honeymoon ended because her body could no longer regulate insulin or glucagon. Our d that is still making insulin hardly ever goes low.

That makes sense but I would think typically the highs would be a sign of the honeymoon stage ending.

I am sorry about your rough day. As if learning to treat and fit diabetes into your life, trying to educate others at the same time can be very scary and frustrating. If being notified about blood glucose issues continues to be a problem you may want to consider getting your daughter a cell phone so she can call you herself. I know that we added the cell phone into our girls health plans. Also, as far as health aid vs nurse goes it probably doesn’t matter. Unless it is an endo nurse they most likely will know very little about d. School nurses are taught only a little about a lot of things with little emphasis on d. Meeting with your principal, as well as your daughters teachers is probably a good idea. The more people you can include and educate the better it will be for you and your daughter. Half our job as parents of d kids it caring for our kids, the other half is advocating and educating.

Going high more often is a sign that more insulin is needed, which also means less insulin is being made naturally (the honeymoon ). The flip side is that the hormone that tells the liver to release glucagon is also being shut off, so it is easier to overdose and lows can happen more easily.

Please follow up with the school board. In Florida the doctors fill out a form for the schools. By law the school has to provide a nurse, even of there is only one diabetic child in the school. I think it’s called a 504 plan. Refer to the webpage It’s a great website for parents.

Can you give me suggestions for snacks that are complex carbs? I have no idea about this stuff.

Also my daughter was diagnosed at 6 years old. She is now 11 years old. The honeymoon phase was difficult. I know her doctors would blame everything on the honeymoon phase, which to me was they really didn’t have the answers to m questions. Only you will eventually figure out how your own child’s diabetes works. After a few years, you will be an expert at regulating her. A few tips I taught my daughter are:

When she checks herself I would have her tell me out load what she was on. When she bolused I would tell her to say out load how much insulin she was giving herself or I would tell her how much I was giving her… This helps because she will begin to establish a norm. If everyday she normally gives herself 10 units for breakfast, then one day she gets 15 units, it should bring up a red flag. Thats just a form of double checking that I used.

Another tip is when she was low I would tell her what she was on, for example 50. I would tell her to remember how she is feeling at that moment. I explained to her when you feel this way, check your self right away. My daughter at first would tell me when she was low her stomach hurt like if she was extremely hungry. Now she feels shaky when she is low.
You might think she is to young to handle all this but they grow up fast once they have diabetes. If you have any questions, feel free to contact me.

504 Plan! It is what can protect your child, and ensure every instruction you and the school agree on, must be followed or the school can be held liable should something happen from neglecting to do so. Even the teacher/nurse/aid can be held personally liable should they decide not to adhere to what is outlined in the plan. Because your child is diabetic, he would qualify and it would protect him! You can spell out exactly how you think his care should be done.

There is a lot of good information on these, and children with diabetes website has several samples on it.
BTW- I’m in VA also! (and my mother-in-law works for Rockingham County Schools, and part of her job is to assist with writing these, so let me know if you need any additional information or help with preparing one).

She must have been very low to continue being so low an our later.

1/2 peanut butter sandwich, soy milk ( because it has protein), crackers with cheese.

Also make sure she has a juice box and glucose tabs in her book bag.

Very scary. Though I have not been there, I am soon to leave my recently diagnosed 4 year old at Preschool. I have chosen to stay at PS until I met with our Dr. to see exactly what I should train staff on. Monday is the day. Its so hard to try and educate people when we are still learning ourselves. If you contact the JDRA they have a pamphlet to provide to schools that may be helpful. I have also heard of professional presentations about diabetes that have taken place at schools . . . another idea. So glad you were able to vent here, those of us who have children with diabetes are definately not a majority . . . . I feel alone most of the time. I am so happy to have found this website to find support.

Hi.Sorry to hear about your problems.I found that some nurses and GP’s are not really good with the little details about Type 1 diabetes.I have been talking my tongue off to erase a lot of inaccuracies about diabetes.What I would tell you though,there are two very good books that helped me a whole lot.Gary Scheiner’s"Ultimate Guide to Carb Counting" and Ragnar Hanas’ "Type 1 Diabetse’ Dr. Hanas explains honeymoon phase,dawn phenomenon everything in a clear and simple way.When you get this book and really study it you will be teaching some health practicioners about diabetes.

A couple peanut butter crackers would be a perfect complex carb to pair with some juice for a low. Graham crackers. I handful of whole grain cereal (trying to think what a 6 year old would be okay with)…

.My son actually eats a spoonful of peanut butter every night before going to bed. I read an article when he was first diagnosed written by a type 1 diabetic who did this since she was first diagnosed 20 some years ago. The peanut butter helped prevent night time lows. Night time lows are my biggest fear.

Contact your local JDRF and see if they can guide you to someone who can help you get a 504 plan in place with the school. Diabetes is frustrating enough that as parents we should not have to be dealing with additional worries every time we send our children off to school. The 504 plan can seem overwhelming which is why I suggest seeing if JDRF can suggest someone who can help you with it.

Alice hit the nail on the head. As parents of children with diabetes our job is to advocate and educate. When my son was first diagnosed I felt lost and confused. I could not see being to the point we are today. I felt like life as I knew it was over and that my days were going to be filled with stress and fear. It does get easier. Each child is different. So while something works for one child, it wont necessarily work for another. For instance I know parents whose children cant eat cereal for breakfast because it causes them to go extremely high. Cereal doesnt effect my son that way. For the first 6 months to a year, testing frequently (more than recommended) to understand what effects blood glucose levels is so important. You eventually learn what effects your childs blood glucose. Pizza can shoot some kids high…my son it does not. Children each have different levels of being active. Keep a log of her meals. This can help to show you if any foods are causing spikes in her blood glucose.

After my son returned to school after being diagnosed, I called every day to see what his lunchtime blood glucose was. Fortunately for me, my son was 12 and I am sure with a 6 year old its more difficult to get them to take control of their diabetes on their own. But Marcelas advice was excellent. Have your daughter start testing herself if she doesnt already. When she gives you her number, ask her if she thinks it needs attention (correcting a high or treating a low). Have her start counting carbs at meal time with you. It is so important that these kids understand how to manage their diabetes. Once you feel you have a grasp on the carb counting and managing of diabetes, push for the insulin pump. Many doctors want to wait until the honeymoon stage is over and I totally disagree with this. The pump helps get so much tighter control of their numbers. It also eliminates over 100 injections a month. My son is reaching his one year anniversary of being diagnosed and if we waited until the honeymoon phase was over to get the pump, he would still be without it as he is still honeymooning.

Be careful of what message boards you frequent. Until I found this message board, all the boards I found were nothing but doom and gloom. Diabetes is controlable. It is manageable. The people who you hear complaining and that have tons of medical problems due to their diabetes are generally people who didnt take care of themselves through the years of being diagnosed.

A little early to do anything about it. But consider diabetes camp for next summer. My son went and it was an awesome experience for him. I cant say enough good things about it. He had so much fun and on top of it, it gave my husband and I a week off from diabetes. We knew that the people at camp were taking care of him and his diabetes.

Heather where are you located?

Okay I will stop babbling for now lol!

Think Like A Pancreas by Gary Scheiner is also a wonderful book. it really helped me make sense of everything that is involved with T1 daily regimen.
(Was trying to post under Hebrews comment…)

Thank you. I also agree regarding the pump. My daughter was diagnosed in October 2006 and by April 2007 she was on the pump. The doctor wanted me to wait and I insisted. Do not think you daughter is to young for the pump, kids are really good with electronics.

I seriously think that so many of these doctors are old school (became doctors before the insulin pump existed) and they just cant move forward with technology. The pump is an awesome invention and has brought so much more normalcy to my sons life. His blood glucose numbers, even though were good before the pump are that much better. Tonight we have CMG training.

The doctors can say they want to wait, but it is up to you. When we went in to my sons appointment I knew that I was either getting approval for us to get the pump, or finding a new doctor. I read to much regarding the pump to know how much of an improvement this could make to my sons life.