Back to School with Diabetes

For parents of children with diabetes, getting ready for a new school year includes a lot more than buying new clothes, backpacks, notebooks, and pencils. It means buying diabetes supplies to keep at school and most importantly, preparing school staff to help your children stay safe at school and at school-sponsored activities.

“Nobody knows your child’s day-to-day needs and how to respond to a diabetes emergency better than the parents,” said Natasha Leibel, head of the pediatric endocrinology program at the Naomi Berrie Diabetes Center. “That’s why it is so important to start the school year in contact with the school health team and to keep open the lines of communication throughout the school year.”

Step One: in the back to school process is to fill out the sheet called, “Parent Request for School Forms” which can be accessed on the Berrie Center website. If you are a parent or guardian of a school-bound child with diabetes and you haven’t received this sheet, please contact Kindra Matthews (ksm2111@cumc.columbia.edu) who is the point person at the Berrie Center for back-to-school forms.

For children with diabetes, there are two important documents that must be completed before the start of school—the 504 Plan and the Diabetes Medical Management Plan. The 504 plan was developed to meet the requirements of a federal law that prohibits discrimination against people with disabilities including people with insulin-dependent diabetes. It sets out the actions the school will take to make sure students with diabetes are medically safe, have the same access to education as other children, and are treated fairly. It is a tool that can be used to make sure that students, parents/guardians and school staff understand their responsibilities.

A comprehensive Diabetes Medical Management Plan (DMMP) is a document that contains the medical orders for your child such as target blood sugar levels, insulin-to-carb ratios, pump settings or long-acting insulin regimens and symptoms of hypoglycemia and hyperglycemia. It must be signed by the healthcare team at the Berrie Center annually. New York City public school officials refer to this as the Diabetes Medication Administration Form (DMAF).

Step Two: Once Kindra receives the Parent’s Request for School Forms, she will work with the pediatric diabetes educators, who in turn work with your child’s endocrinologists to update or fill out the DMMP/DMAF and 504 Plan. And Kindra will even fax forms to your child’s school if you provide the phone numbers. Kindra will also be mailing home each child’s DMMP/DMAF and 504 Plan, so be on the look-out.

Step Three: The healthcare team at the Berrie Center suggests that parents meet with the school nurse and other important school personnel to go over your child’s DMMP/DMAF and 504 Plan. The school nurse will use the medical orders to prepare your child’s routine and emergency diabetes care plans at school. But parents can help make sure that teachers, physical education teachers and coaches understand the signs of low and high blood glucose and know what to do if either occurs—a requirement or “accommodation” in the 504 Plan. Give examples of some of your child’s symptoms to help his or her school team quickly recognize and be able to handle highs and lows.

Step Four: Provide the school with all diabetes supplies, medicines, and items needed to carry out your child’s healthcare and emergency plans. This includes items to check your child’s blood sugar, ketone strips, extra insulin, quick-acting glucose products and a glucagon kit. Make sure your child has plenty of healthy snacks on hand like yogurt, fruit and crackers. Don’t forget to buy the standard school supplies!

Step Five: Know your rights. This year, for the first time in the state of New York, parents and guardians will be taken into account when making insulin dose adjustment determinations. In the past, New York parents were met with resistance when wanting to get involved in their child’s dosing adjustments. But thanks to changes in the law (spearheaded by clinicians and parents from the Berrie Center) parents will play a role in the treatment of their child during school, if necessary, which should greatly impact the school year for the better. This accommodation is now part of the 504 Plan for New York families.

Step Six: Keep us in the loop. Stay in touch with your care team at the Berrie Center who can always address your concerns and answer your questions. And remember to have a great year.