Managing diabetes in school is important to make sure a child with diabetes has the same education and experience at school. It’s just as important to manage their diabetes at school as well as it is managed at home.
Testing a child’s blood sugar
Children with diabetes will need to check their blood sugar levels regularly throughout the day. Blood sugar tests tell you, and the child, exactly what their blood sugar levels are and what treatment they need to keep them in range of their target levels.
Blood sugar tests will usually need to be done before meals, if they’re feeling unwell, before, after and during PE and any time you or they think they might be going too low or high.
The child’s PDSN will give you advice on when to test a child’s blood sugars and also how to do it properly and safely.
Insulin in school
Injecting insulin at school
Children who inject insulin to treat their diabetes will use an insulin pen. There are two types of insulin pen:
- disposable which comes pre-filled and is thrown away when empty
- reusable which have a replaceable cartridge of insulin.
Using cold insulin can make the injection more painful, so the insulin a child is currently using should be stored at room temperature. Spare insulin should be stored in the fridge, although extreme temperatures stop insulin from working so it should never be put in a freezer or near a heat source.
When you take space insulin out of the fridge, it can last for a month before you should dispose of it.
The amount of insulin a child needs to keep at school will depend on how much insulin they are prescribed.
Some children might want a private area where they can take their injections if this is the case this should be allowed and should never be a toilet. Others children might be happy to inject in public which should also be allowed. Children might need help with injecting, especially if they’re younger or newly diagnosed.
Insulin pumps at school
Insulin pumps are small devices that give someone a small, varying amount of insulin all the time. This is pre-set to meet the needs of each child individually and is done by their PDSN. This dose of insulin is called background insulin.
As well as the background dose of insulin that is continuously delivered by the pump, children who use an insulin pump will need to give extra insulin through the pump when they eat or if their blood sugar levels are high. This is done by pressing a combination of buttons which some children might need help with.
Their PDSN will train school staff on how to give insulin through the pump and how to look after the pump at school.
Hypos and hypers
People with diabetes can cause high and low blood sugar levels which are known as hypos and hypers.
It’s important to remember that both hypos and hypers can affect a child’s behaviour. If a child is behaving out of character, it’s always worth checking their blood sugar levels.
Hypos are when a child’s blood sugar levels go really too low, it’s really important that you treat a hypo as quickly as possible.
Hypos are usually treated with something sugary to eat and drink. These amounts will be different depending on how serious the hypo is and how old the child is too. During your training with their PDSN, the diabetes nurse will go through how to treat a hypo and what causes them.
Some children know when they’re having a hypo and can treat it themselves, but some children won’t be able to and will need your help.
All school staff should know the signs of a hypo in each individual child and what to do if they’re having one.
Hyperglycaemia happens when a child’s blood sugar goes too high.
This might be because they’ve missed an insulin dose, not taken enough insulin, of stress, sugary or starchy food and sometimes there isn’t an obvious cause.
Symptoms of a hyper can be the child being really thirst, needing the toilet a lot, feeling sick, blurred vision and having a tummy ache. If any of these symptoms happen, test their blood sugar and treat the hyper with insulin.
The child’s PDSN will tell you how to treat a hyper and when it should also be written on their IHP.
Eating at school
There is no special diet for children with diabetes, they should follow the same healthy balanced diet recommended for every child.
Children with diabetes can enjoy foods such as sweets and chocolate just like other children in moderation, so they shouldn’t be excluded from class treats unless advised by their parent or PDSN.
All children will match their insulin exactly to the amount of carbohydrate in the food they’re about to eat. This is called 'carbohydrate (or carb) counting'.
Children might need help with carb counting, especially if they’re younger or newly diagnosed. Their parents and PDSN will discuss the support they need, explain exactly how it works, and give you all the information you need to carb count.
We also have more information in our Carbohydrate counting section.
The majority of children with diabetes should be able to enjoy all kinds of physical activity, and diabetes shouldn’t stop them from taking part or being selected to represent school and other teams.
Children will need to plan for physical activity because all forms of exercise (such as swimming, football, running and athletics) use up glucose. This can mean that their blood sugar levels fall too low and they’ll have a hypo.
On the other hand, if their blood glucose is high before getting active, physical activity may make it rise even higher.
- The way a child prepares for an activity will vary depending on:
- when they last injected their insulin
- the type of physical activity they’ll be doing
- how long they're being active for
- when they last ate
- their blood glucose level.
Because of this, they might need to have an extra snack before, during and after physical activity, alter their insulin dose and check their blood glucose more regularly.
If a child uses an insulin pump, they’ll need to be disconnected if the child is taking part in contact sports and water sports.
Generally, pumps should not be disconnected for more than one hour because they use rapid acting insulin and while they are disconnected no more insulin will be getting into the body. This means that the blood glucose will start to rise.
To make sure that blood glucose levels stay as stable as possible, the pump must be reconnected as soon as the activity is over and the child’s blood glucose level should be checked. They might need some extra insulin as well.
School staff should talk to the child’s parent or PDSN who will advise on how they should prepare and look after diabetes while doing physical activity.
Our Good Care in Schools pack
To find out more about helping a child with Type 1 diabetes at school, order our schools pack.