Diabetes is a challenge for any child. But when you add in the extra hurdles school presents — monitoring blood sugar, administering insulin, and eating the right foods while away from home — it gets even harder. As a parent of a student with diabetes, you face new challenges at every stage of your child’s life.
The good news? You don’t need to figure it out alone.
We’ve pulled together a roadmap of tips and advice that will help you and your child manage diabetes successfully as they progress through elementary school, middle and high school, and college.
In elementary school, you’re establishing a foundation for your child to manage their own Type I diabetes. This might start small — like letting them choose their own diabetes-friendly snacks.
However, you’ll still need to loop in staff to fill in tasks that your child can’t yet handle by themselves.
To get your young child’s needs met at school, you must communicate them clearly. At this stage, that involves getting things down on paper.
There are some forms you’ll need to fill out and conversations you’ll need to have with school staff. Here are the actions you’ll need to take:
Start by giving a DMMP to your child’s school. This is a document that outlines your child's care needs, including insulin and CGM use. It’s where you can inform school staff about how to recognize symptoms of low and high blood sugar and understand what they need to do during an emergency.
Note: You’ll need to provide a new DMMP every year. The student's health care team, including their physician, should develop the plan before the school year starts, and a parent or guardian will sign it.
You can find a sample DMP here. And get guidance on how to start the DMMP process here.
Work with your school to draft a diabetes 504 plan. This document sets out the accommodations a school will provide to ensure a child with a disability is safe at school and has equal access to educational opportunities. It outlines the self-care tasks your child can complete on their own and lays out the tasks they require help with.
In elementary school, this plan might lay out things like meal and snack schedules, guidelines around physical activity, and when a school nurse will administer insulin and help your child check their blood glucose.
As your child ages, you’ll change this plan to outline the growing number of care tasks they become responsible for. You can find a sample 504 plan here.
Coordinate with the school nurse or trained staff to administer insulin if needed. If your child uses an insulin pump, make sure the nurse and other staff know how it works.
Make sure the school has clear protocols for managing diabetes emergencies and that all staff are educated on how to respond appropriately and safely. Otherwise, misconceptions could put your child in danger: In a recent Reddit thread, one commenter explained how as a child, their school staff were under the impression that diabetic children couldn’t have sugar even when their blood glucose dipped dangerously low. Instead, they were given a glass of water and told to walk home by themselves. Proper education for school staff can help you avoid those situations.
It might also be a good idea to provide a “hypo box,” with supplies like glucagon, glucose tablets, juice boxes, extra insulin, and syringes that can be stored in a refrigerated space at the school that staff can access.
Work with the school to plan physical activity and how to manage blood sugar levels before, during, and after exercise. And educate staff about your child’s ability to participate in physical activities and what might be needed (a snack break after gym class or recess to prevent low blood sugar, for example).
Diabetes is a lifelong disease, so your child will need to keep taking on more and more responsibility for managing it themselves. While you’re communicating with the school, it’s also important to teach your elementary school student some basics about how to manage the disease themselves.
Teach your child how to check their blood sugar levels and recognize the symptoms of high and low blood sugar. A CGM might be a great tool to help them stay on top of it, but younger children may need assistance reading and interpreting the measurements.
Even young children should know what foods are safe for them to eat with diabetes and what to reach for when their blood sugar dips too low.
The years after elementary school are about slowly increasing your child’s level of independence over their diabetes. Little by little, they should be taking more control over tasks like monitoring their blood sugar and choosing foods.
Staff still have a role to play at the middle and high school levels. The keys are to make sure the channels of communication are clear and open and that staff are equipped with the information they need to support your child.
Your child’s needs have changed since elementary school. So their 504 plan should, too.
Update the 504 plan to reflect new needs, such as extended testing time and access to food during exams.
Ensure all teachers and staff are aware of the student's diabetes management plan and know how to respond in an emergency. Unfortunately, insulin pumps can sometimes be mistaken for cell phones and get confiscated. Be sure to explain pumps and CGMs to staff and show them what these devices look like, so that doesn’t happen.
At this point in the game, your child is more independent and is learning how to navigate not only the physical management of diabetes, but also the practical and emotional challenges that can sometimes come with it. This is where your role is to teach and empower. After all, if you’re always making arrangements for them, they’ll never learn to do it themselves. But remind them you’re always available if they need support.
By middle school, your child should know how to read their CGM and administer their own insulin. Encouraging more self-management skills like these will help them feel confident managing their diabetes on their own.
Remember how embarrassing almost everything was in middle school? Students at this age are preoccupied with what others think of them and may be worried that a CGM will make them stand out — and not in a good way.
So empower them to educate their classmates about the disease. Prepare them to answer questions other students might have (like “Does wearing a CGM hurt?”), and let them know diabetes is nothing to feel embarrassed about. When their questions are answered, the novelty of the disease will wear off, and before long, their classmates will accept it as part of the package.
Note: It's also important for your child to teach their friends what to do in case of a hypoglycemic event. They should know what a beeping CGM means, how to react, what to give your child, and who to contact.
As they grow older, your child’s calendar will probably start to fill up. Between sports and other after-school activities, they’ll be spending less time at home … and less time with you.
Make sure they’re prepared to advocate for their needs to coaches, teammates, and activity leaders. They might need to get permission to have a snack after track practice or duck out of choir rehearsals to take insulin.
By the time your teen or young adult enrolls in college, they should be responsible and in control of their diabetes management. Let them know you’ll support them any way you can, but that you’re no longer in the driver’s seat.
While you might not be managing your child’s diabetes hands-on, you still have an important role to play in helping them make the final leap to a healthy adulthood.
When considering a college, look for ones with strong support for students with diabetes. Some schools will have a diabetes resources program and will help students apply for diabetes-related accommodations. Look on the college’s website to see what they offer, and ask as many questions as you need to during tours and before enrollment.
Support groups like the College Diabetes Network and The Diabetes Link also have chapters at universities across the country where your student can meet and bond with others who share their challenges.
Your child might need support or advice as they work with the college's disability services department to set up special accommodations. These might include:
Don’t forget to encourage your student to connect with campus health services to discuss their needs and inform roommates or friends about their condition so they can be on the lookout for signs of danger and react accordingly.
Before your student leaves for college, do a gut check with them to make sure they can handle their own glucose readings, insulin, and supply management.
College can be a culture shock for some students. And adapting to living situations, schedules, a new environment, and lots of homework might be stressful. And as you probably know, stress can affect blood sugar. Teach your teen or young adult to manage their stress through breathing exercises, meditation, walking, or other methods.
Managing diabetes at school can be challenging, but with the right strategies, it’s possible for children of all ages to thrive. From creating a strong foundation in elementary school, fostering independence in middle and high school, and ensuring self-management in college, each stage requires different approaches and a slow exchange of control from you to your child. The key? Effective communication and a solid support system.
If you or your child needs more tips on managing diabetes, check out our guide on customizing CGM app alerts and settings.