Navigating Diabetes Management in School

Kids with diabetes should be able to focus on learning, having fun and participating in all that childhood has to offer. We talked with Colleen Buggs-Saxton, MD, PhD, a pediatric endocrinologist with Wayne Pediatrics to learn about diabetes management.

There’s nothing more important for your child than a successful school experience where they can concentrate on learning, engage with teachers and friends and have fun. For the child with Type 1 or Type 2 diabetes, effective diabetes management will help them do all of this and more. With help and support from parents and caregivers, children with diabetes can participate in all of the activities they enjoy, says Colleen Buggs-Saxton, MD, PhD, a pediatric endocrinologist with Wayne Pediatrics.

“The most important thing is for parents to support their child, especially if the child is wondering why diabetes is happening to them,” says Dr. Buggs-Saxton, who leads a highly skilled diabetes care team at Wayne Pediatrics. “Parents can let their child know that even though we may know what can trigger diabetes, there is nothing they did to cause it, and they shouldn’t feel bad about it. Help them understand that having diabetes does not mean they can’t do the activities they enjoy doing.”

While Type 1 diabetes is the most common form in children, there is a rise in Type 2 diabetes and patients are getting younger, Dr. Buggs-Saxton says, adding that obesity along with race and ethnicity and having a parent or grandparent with Type 2 diabetes are all risk factors for the disease.

At first, diabetes management can be overwhelming for families. But with education and attention to routine, parents and caregivers can help children learn to live with diabetes and even thrive, says Dr. Buggs-Saxton.

“The wonderful thing about pediatric diabetes care is that we really highlight the importance of education for the child and family. At Wayne Pediatrics, we offer a lot of team support to the parents. There are amazing tools that can make life with diabetes so much better and can help kids do well in school and participate in sports and live life and enjoy it,” she says.

General pediatricians aren’t always fully conversant with the changing research and technologies involved in pediatric diabetes, so it makes sense to visit a health care practice that has that expertise built in. In addition to pediatric endocrinology, Wayne Pediatrics has a diabetes care team that includes a diabetes nurse, a certified diabetes care and education specialist, a dietitian, a social worker and a psychologist all dedicated to assisting with the care of children with diabetes.

Dr. Buggs-Saxton shares tips on what parents need to know about managing their child’s diabetes as they return to school this year.

Diabetes management issues to consider

Success with helping your child manage diabetes will come with knowing what your child is capable of doing, which varies depending on age. What they are doing at home to manage their diabetes, they should also be doing at school, says Dr. Buggs-Saxton.

Preparation is key, she says. “Getting into a school year routine is important, so prepare to follow a schedule. Get up earlier or prepare the night before to make sure your child has the supplies they need.” Creating a backpack list of what your child needs and referring to it daily can help both of you know what you need.

“We have suggestions for a school kit that you can put together with your child. In it should be a blood glucose meter and test strips that are not expired. If your child wears a continuous glucose monitor, you will still need a backup plan. Make sure to have a meter with new batteries and a lancet or poker,” she suggests.

Talk with your child about what they will do if their blood sugar gets too low or too high. How will they know and how will they treat it? Because each child responds differently to the sensation of dropping blood sugar levels, talk with your child and diabetes care team to learn to recognize the symptoms. “Your continuous glucose monitor will also give your child a warning or ‘alert’ if glucose level is too high or too low and a glucose monitor app can also be loaded onto your phone to see your child’s glucose levels.”

Keep juice boxes or glucose tablets for a quick increase in blood sugar, plus a granola bar or cheese and crackers for sustained blood sugar in the kit at all times. Emergency treatment for low blood sugars comes in several forms now, even an easy-to-administer nasal spray. Special urine ketone test strips for high blood sugars should also be in the kit. “Plus, at Wayne Pediatrics we give our patients an ID card with our contact information that the child can keep in the kit,” Dr. Buggs-Saxton says.

What to share with the school

“The No. 1 thing is communication,” Dr. Buggs-Saxton says. “Clearly communicate with your child’s school and provide a diabetes medical management plan from your child’s diabetes team. Students are in school to learn but the school also needs to create a safe environment especially for students with diabetes. Your child will be more successful in school when there is good communication about their health.”

Make an appointment with your child’s diabetes team to get a “diabetes medical management plan of care” before school starts. Within the state of Michigan, Dr. Buggs-Saxton and other care providers are working to develop a standardized diabetes medical management plan for students.

The federal government, through Section 504 of the Individuals with Disabilities Education Act, provides additional support for students with diabetes. The 504 Plan is a written document outlining an agreement between parent and the school so the child can, with accommodations, receive their education.

“The family should meet with the school to create a 504 Plan and update it regularly,” she says, adding that the need for continual updates is critical, as different accommodations are needed as the child gets older. It’s also a good idea to find out if school nurses and other administrators are up to date with new diabetes technologies and protocols.

Staying healthy is important

Certainly, COVID-19 has created a new normal for schools, and it’s important for parents to keep their child with diabetes as healthy as possible. Be sure your child is current on all immunizations, including flu and now COVID-19, and that they know how to wash their hands thoroughly and regularly. Practice how to wear a face mask to cover both their mouth and nose.

“This is not the time to be in the hospital, so be sure to have your child take their medications, check their blood sugar, and get their vaccines. Remember to put some extra masks and hand sanitizer into their diabetes school kit — they will need extras!” Dr. Buggs-Saxton says.

Because there is a correlation between obesity and Type 2 diabetes, if your diabetes team includes a dietitian and a certified diabetes care and education specialist, be sure to tap into their resources for support in maintaining a healthy weight for your child.

Create healthy habits at home by eating an apple or an orange instead of drinking sugar-laden fruit juice, drink more water, shop for brightly colored fruits and vegetables rather than processed foods. “Parents can be great role models for their children because kids will eat what they see you eating,” she says.

Wayne Pediatrics, home to Wayne State University Department of Pediatrics faculty physicians, provides a wealth of resources dedicated to children’s care at one location. This includes pediatric generalists and specialists as well as dietitians, psychologists, social workers and a diabetes educator. Visit waynepediatrics.org or call 313-448-4600 to make an appointment.

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