YOUR CHILD AND DIABETES
Type 1 diabetes is the most common form of diabetes in children, although Type 2 diabetes is now on the rise. If your child has been diagnosed with diabetes, you may be feeling overwhelmed and worried, therefore we aim to provide you with information to help you and your child manage their diabetes.
You will find tips on how to encourage your child to eat healthy foods and getting them interested in physical activity. We help you prepare for your child’s diabetes care, by giving you information on testing your child’s blood glucose levels, the different types of insulin and how to manage insulin injections. Many parents may feel worried about their child with diabetes going to school, therefore we aim to reassure you by giving you advice on how to help your child receive good support at school.
Information for children and teenagers
Under-fives with diabetes
Check out our downloadable resource sheet, Teach your Tot about Diabetes, which covers the basic aspects of living with diabetes, there are 10 resource sheets in the set:
- Introduction
- Treatment
- Blood glucose testing
- Fruit and veg bingo game
- Healthy, balanced meal jigsaw
- Hypos - feelings
- Hypos - treatment
- Physical activity - puzzle
- Physical activity - diabetes doesn't hold you back
- Injection sites star chart.
You can use the resource sheets individually, or work through the series. Each sheet has instructions on how to use it, and is designed to be coloured in by your child.
School
Many parents feel anxious about their child going to school with diabetes, and being concerned about whether staff can look after your child is understandable. It takes time to fully understand diabetes, but with support school staff can become competent and confident in looking after your child.
It’s important that you communicate with the school. If it’s difficult to speak to your child’s teacher, keep a diary, which the two of you complete and pass to each other (via your child) at the start and end of each school day. In it, you could include blood glucose results or jot down if your child has had a hypo.
Healthcare plans
A healthcare plan is a record of your child’s medical needs at school and how they are going to be fulfilled. It’s important that everyone is involved in drawing this up. The plan should be reviewed at least annually, as treatment or needs can change.
Note: Teachers aren’t medically trained. So, unless they’ve taught a child with diabetes in the past, or
have experience of diabetes, their knowledge about it might be limited.
Meeting with school
When you meet with your child’s school, make sure you’re talking to the right people. At primary school, it’s vital that the class teacher and the head teacher attend, plus any relevant classroom or welfare assistants. At secondary school, meeting with a form tutor or the head of year will probably be most practical, as your child will have several different teachers for various subjects. They can then pass on any information to the rest of the teachers. Whether your child goes to primary or secondary school, the school nurse should also attend. Depending on their age, your child might want to talk about their diabetes on their own. But do offer for you or their PDSN to go with them.
Possible subjects to cover at the meeting
- If your child takes insulin during school hours what level of help will they need?
- Do they need help with blood tests? When? What levels are you looking for?
- Will your child need snacks/lunch at a particular time? How will that fit into the school day?
- Does your child need help with carb counting? Will your child need an extra snack before/during/after PE? If so, what do they need and when?
- What hypo warning signs should school staff look out for? How should they treat a hypo?
- What should staff do in the event of a high blood glucose level?
- Who’s going to help your child with the practical aspects of diabetes? It’s sensible to have two people trained up in case of sickness. And all staff should know how to recognise and treat a hypo.
- Does your child want to have their injections in a quiet, private place? Where would that be?
- Who should the school contact in case of a problem? Provide contact details of at least two people.
- Stress that your child doesn’t need a special diabetic diet – just the healthy, balanced diet recommended for every child – and that ‘diabetic foods’ are neither necessary nor recommended.
- Tell staff that your child may need to eat snacks in class, either because they need a snack at a certain time, or to treat a hypo.
- Advise school staff on what to do if your child doesn’t eat all of their meal.
Important diabetes equipment for school
- Hypo remedies, eg glucose sweets/sugary drink/GlucoGel, plus a snack if necessary.
- Insulin and insulin pen, plus spares in case of breakage. Insulin not in current use will need to be stored in the fridge – ask staff to keep an eye on the expiry date.
- Blood glucose meter and strips, plus spares in case of breakage/malfunction.
- If your child is on a pump, include spare pump equipment in case the tubing becomes blocked. This will only be worthwhile if your child can change the tubing, or if staff have been trained. If not, they’ll need an insulin pen and insulin.
- Ketone strips (either blood or urine).
Storing supplies
Hypo remedies must be kept with your child at all times. Older children will probably keep them in their school bag. For younger children, it might be easier to have a supply in the classroom, but make sure that it goes with your child if they move class or go out to play.
Other supplies, such as your child’s insulin and blood glucose meter, should be easily accessible. Your child should be allowed to carry these around if they wish. Again, for younger children who will need help with taking insulin and/or blood tests, it may be easier to keep them in a central place. But it’s vital that everybody knows where they are in case they are needed in a hurry.
Blood tests and taking insulin
If your child needs help or supervision with blood tests or taking insulin, make sure that at least two people have been trained in case one person is absent. Your PDSN should be able to provide training. Keep staff informed of dose changes and which injection sites should be used. Let staff know whether your child is happy to inject in front of other children or whether they would like to do it in a private place. Make sure staff know your child’s usual range of blood glucose levels and what to do if levels are outside of that range.
Note: If your child is on a pump, make sure you have a plan for what to do if there is any problem with it, eg a blocked cannula.
Food
- Stress that your child doesn’t need a special diabetic diet – just the healthy, balanced diet recommended for every child – and that 'diabetic foods' are neither necessary nor recommended.
- If your child has any particular dietary needs, explain these to school staff.
- Depending on your child’s insulin regimen, they may need to have meals and snacks at regular times. If so, tell staff that your child will need to be at the same lunch sitting each day, and may also have to be near the front of the queue.
- Tell staff that your child may need to eat snacks in class, either because they need a snack at a certain time or to treat a hypo.
- If your child needs help counting carbohydrates, think about how this can be done. For packed lunches, you can tell staff the amount of carbohydrates in each piece of food, so they can help your child work out how much insulin to have. If your child has school dinners, it may be possible for catering staff to give you menus, which usually have a nutritional breakdown.
- Advise school staff on what to do if your child doesn’t eat all of their meal.
Physical activity
Your child should test their blood glucose levels before and after physical activity and have a snack, if necessary. If the activity is prolonged, they may need to test and/or snack during as well. Glucose tablets or a sugary drink should be kept nearby in case your child feels hypo. Anyone supervising a physical activity must be aware of your child’s diabetes.
Exams
Stress can affect blood glucose levels. Your child may need to do extra blood tests before and during exams. Teachers or invigilators need to be made aware that your child will need to take food or drink into the exam in case they feel hypo. It may be possible for your child to get extra time for an exam, eg if they lost time because of treating a hypo. Talk to staff about this.
Bullying
Some children with diabetes do get bullied about their condition. Lots don’t – but it’s important to be aware of it as a possibility. If your child is being bullied, talk to their teacher or head teacher. Schools take bullying seriously and your child’s school should have a policy on it.
Getting your child to explain about their diabetes through a school project may help. By being upfront about their diabetes, your child may find the bullies soon realise there is very little to tease them about.
Problems
While many schools have an open attitude to children with diabetes, unfortunately some are less keen to provide the level of support that your child needs. This may be down to a lack of understanding, fear of getting something wrong and putting your child in danger, fear of litigation if something does go wrong, or lack of training or support from your paediatric diabetes team. But your child has a right to access all areas of the school curriculum, including extra-curricular activities, so it’s important that you, the school and your paediatric diabetes team work together.
Top school tips
- Give the school as much information as you can about diabetes in general and your own child’s particular needs.
- Involve your paediatric diabetes team right from the start and ask your PDSN to join you at any meetings with school.
- If school seems unwilling to get involved, it may be due to a lack of understanding or worries about things going wrong. Stay calm and offer clear explanations.
- It’s a difficult balance, but try to communicate the importance of looking after diabetes properly at school without frightening staff and putting them off. Your PDSN should be able to help with this.
- Know your rights – under the Equality Act of 2010, schools are not allowed to discriminate against pupils with a disability, and this includes diabetes.
- Find out who will be your main contact at school regarding your child’s diabetes care.
- Talk to your paediatric diabetes team about how they can support the school in looking after your child’s diabetes.
- Who should the school contact in case of a problem? Make sure contact numbers are kept up to date.
- Inform school staff straight away about any changes to your child’s diabetes management.
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