You're confident in your child's ability to manage her diabetes 1. She knows how to count carbs, measure her blood sugar levels and give herself insulin injections. But you're always around to back her up. Are you just as confident when she walks out the door to school? You can be, if you, your child and your child's school have a plan and work as a team.

Overview of Diabetes Care

Managing diabetes is an all-day, every-day job requiring constant vigilance. It involves limiting the daily intake of carbohydrates, monitoring blood sugar levels via glucose meters and urine test strips throughout the day, giving insulin injections as prescribed by your child's pediatrician or endocrinologist, getting appropriate exercise, and knowing how to quickly treat any high or low blood sugar problems. It's a good idea to keep a health diary to monitor diet, medications, blood glucose fluctuations and physical symptoms. This is especially important when your child is newly diagnosed to help your doctor determine an appropriate management regimen.

Managing diabetes at home is a family affair, requiring the help and understanding of everyone. But when your child is in the classroom, school staff must take the place of your family.

Things to Consider

Sending your child with diabetes to school requires more than sending along diabetic supplies and a note for the teacher. For example:

• Who will monitor your child's lunch?
• Will my child be allowed to test and inject on her own? Or will the school require a medical professional?
• Will someone be responsible for educating classmates?
• Will someone make sure she gets enough exercise?
• Are there emergency protocols in place?

Legal Responsibilities

Under the Americans with Disabilities Act, diabetes is considered a disability. Any federally funded or public organization cannot discriminate against people with diabetes and must provide reasonable accommodations for their needs.  This includes a complete assessment of an individual's needs, provision of those needs with little disruption in the child's routine and permitting participation in all school activities. To adequately provide for the health and safety of a child with diabetes, school personnel must understand diabetes, be trained in managing it and be prepared for emergencies.

Your Child, the Team and the Plan

Managing your child's diabetes at school requires a team effort. That team will consist of you, your child's healthcare team and school staff. It's important to meet with your team at the beginning of each school year to develop a diabetes healthcare plan for your child.

Healthcare team responsibilities: Your doctors should develop a written schedule for glucose testing and insulin injections for your child as well as diet instructions. They need to educate school staff about diabetes treatment and correct techniques for testing and administering insulin. School personnel should also be schooled in emergency protocols.

Parental responsibilities: You, as the parent or guardian, need to provide all the necessary items for blood and urine testing as well as insulin, needles and any other supplies your child requires. You will need to discuss appropriate diet at lunchtime and snacks during the day, and determine who will have responsibility for monitoring your child's diet. It is also a parent's duty to provide emergency contact information for parents and healthcare providers as well as written permission for your child to seek medical help from school medical staff.

School staff responsibilities: School staff need to receive training in all phases of diabetes treatment, including testing, insulin administration and hypoglycemia treatment. School personnel should monitor your child's diet and notify the parents of any problems they encounter. School staff should accommodate your child's request for privacy when testing or administering insulin, and a trained school staff member should be present if the child is too young to perform the tasks alone.

Sending your diabetic child off to school can be scary, as you are putting your child's welfare in the hands of others. However, through careful consultation and planning with school staff and your family practice doctors, you should be able to rest assured that your child is in good hands.