Diabetes management in children, especially in the school setting, requires close collaboration between parents, teachers, and healthcare professionals. The main goal is to maintain blood sugar levels within the appropriate range, prevent hypos or hypers, and provide a safe and supportive environment for the child. Here are some tips for parents and teachers:
Tips for Parents
Fully inform the school:
Be sure to inform the principal, teacher, and school health officer about your child’s diabetes status.
Provide your child with a written diabetes management plan (including medication schedules, ideal blood sugar levels, symptoms of hypos and hypers, how to deal with emergencies, and emergency contact numbers).
Educate your child:
Teach your child to recognize the symptoms of hypos or hypers and to report them to adults.
Your child should learn to always carry the necessary supplies, such as a blood sugar test device, insulin, and a sweet treat (for hypos).
Prepare an emergency kit:
Prepare a kit that includes juice, biscuits or glucose tablets, insulin syringe or pen, blood sugar test strips, and a meter and provide it to the school.
Appropriate meal plan:
Coordinate with the school nutritionist to ensure that your child follows an appropriate meal plan.
Ask the school to allow your child to have snacks if needed.
Tips for teachers and school staff
Knowing diabetes and its symptoms:
Teachers should be familiar with the symptoms of low blood sugar (such as shaking, cold sweat, weakness, drowsiness, confusion) and high blood sugar (such as excessive thirst, frequent urination, fatigue).
Supportive behavior:
Avoid discriminating against or restricting a child with diabetes.
Allow your child to eat their own meals or snacks in class or to test their blood sugar if needed.
Prepare for emergencies:
It is important to learn how to deal with a severe drop in blood sugar (for example, giving a sweet treat if you are conscious or calling 911 if you are unconscious).
Always have your parents’ and emergency contact numbers available.
Regular communication with parents:
Contact parents if you notice any suspicious symptoms, or changes in your child’s behavior or energy level.
Report information about insulin dosing times, physical activity, and meals as needed.
Bottom line:
A child with diabetes can be as active, successful, and happy in school as any other child; provided that the school environment is supportive, knowledgeable, and cooperative. Education and understanding of diabetes are key to successful management.
The role of psychological support in school
Creating a sense of normality in the child:
The child should not feel that he is “different” or “sick”.
Teachers should manage the classroom environment in such a way that the child’s diabetes is not the subject of ridicule or excessive curiosity from other students.
Strengthening the child’s self-esteem:
A child with diabetes may feel weak about his body or his limitations. Encouraging group activities, participation in sports or the arts, and praising successes can boost his morale.
Educating classmates (if the child wants):
In coordination with the parents and the child, simple explanations can be given to classmates so that they can better understand their friend’s condition.
This can reduce fear or misunderstanding and create a more supportive environment.
Exercise and physical activity
Regulating blood sugar levels before and after exercise:
The physical education teacher and parents should be in harmony. It is necessary for the child to measure his blood sugar before physical activity and to eat a snack if necessary.
Excessive activity may cause low blood sugar; therefore, the child should have a fast-absorbing snack with him.
Avoid excluding the child from exercise:
Diabetes is not an obstacle to exercise, but rather a part of the treatment. The child should participate in activities, unless the doctor has special advice.
The role of the school health assistant (if available)
Monitoring blood sugar and medications:
If the school has a health assistant, he can help the child inject insulin or measure sugar.
He should be trained and familiar with the danger signs.
Collaboration with parents and the treatment team:
The health assistant can be a good bridge between home and school.
Some final advice for parents:
Prepare a daily logbook: Recording the time of insulin injection, blood sugar, meals, and the child’s general condition at school can be helpful.
Familiarize the child with your condition, do not scare him. Proper training and emotional support are more important than strict control.
Practice crisis management training at home so that the child is more prepared for school.
Parents’ Role in Preparing for School
Conduct a School Staff Orientation Meeting:
Before the school year begins or even during it, have a meeting with the principal, classroom teacher, health care provider, and school counselor.
Discuss your child’s specific condition, dietary needs, medication schedules, and warning signs.
Develop and present a Diabetes Management Plan:
This plan should include the following:
Dose and timing of medication (such as insulin)
Target blood sugar levels
Symptoms of hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar)
How to respond to emergencies
Instructions in case your child is sick or absent from class
Contact numbers for parents, a doctor, and a substitute in case they are unresponsive
Emergency drills at home:
Practice at home with your child how to tell a teacher or health care provider if they feel weak or have symptoms of hypoglycemia.
Essential tools and equipment for children at school
A child with diabetes should always carry the following equipment:
Blood glucose testing device with test strips and lancets (special needles)
Insulin injection device or insulin pen (if needed)
Fast-acting sugar snacks such as:
Small fruit juice
Simple biscuits
Glucose tablets or gel
Planned snacks
Water bottle
Blood glucose logbook (if used)
How can a child be supported in special situations?
During exams and emotional stress:
Stress can cause blood sugar to increase. Teachers should be sensitive to the child’s condition at such times.
If the child needs to eat a snack or check their blood sugar during the exam, permission should be given.
During school camps or day trips:
Ask parents to prepare the necessary equipment or, if possible, have a trusted person accompany the child.
The camp leader should have basic diabetes education.
On sick or tired days:
On days when the child is sick, the sugar level may fluctuate greatly. Prompt notification to parents is very important.
Final conclusion
Managing diabetes at school may seem complicated at first glance, but with education, coordination and continuous support, the child can grow and succeed peacefully alongside other students. The most important elements of this path are:
Tripartite cooperation between the family, school and treatment team
Continuous education of the child, teachers and classmates
Preparing the school environment to respond appropriately in emergency situations
Maintaining the child’s self-esteem, independence and self-confidence
Self-care training for the child (based on age and ability)
As the child gets older, he or she should be able to gradually take on more of his or her diabetes management. But this training should be gradual, age-appropriate, and supervised.
Preschool and elementary school children (6 to 10 years):
Still need direct adult help.
Can recognize early signs of low blood sugar and report it to the teacher.
Learn when to eat a snack or drink water.
Can observe and practice using a glucose meter.
Older children and adolescents:
Learn to inject insulin with supervision (if ready).
Learn to interpret blood sugar results and take corrective action.
Manage food and exercise according to sugar fluctuations.
Plan for managing diabetes in camps or new environments.
School communication with a doctor or nutritionist
In some specific cases, parents can ask the school to contact their child’s doctor or nutritionist directly, with their formal consent. This can be useful in the following cases:
Changes in the child’s medication schedule
A specific problem occurs at school (for example, frequent low blood sugar)
Planning for the school lunch program
Technologies that help manage diabetes at school
The use of modern technologies can be a great help in easier management of diabetes, especially for children who spend a lot of time at school.
Insulin pump:
Allows the child to receive insulin in adjusted doses.
It becomes easier to control sugar throughout the day.
Continuous glucose monitors (CGM):
Displays sugar levels in real time.
Low or high sugar alerts can be set for parents or teachers.
Mobile apps:
Some devices can send information to parents’ mobile phones.
Food intake, activity, and blood sugar can be recorded.
Important: The use of these tools must be accompanied by training and supervision, and the school must be familiar with how to use them.
Common parental concerns and solutions
| Concern | Suggested solution |
|---|---|
| Will my child be able to manage the illness at school? | With continuous education, support for her self-confidence, and cooperation from teachers, the child gradually becomes independent. |
| What if the teacher doesn’t notice the symptoms of hypoglycemia? | Face-to-face training of teachers and provision of brochures or posters of signs are essential. |
| I am worried about how my classmates will react. | By simply explaining to classmates (with the child’s consent), a sense of empathy and support can be created.✅ Practical suggestion for parents: |
You can prepare a “diabetes alert card” for the child to always carry with him or her. This card can include the following:
The child’s first and last name
A statement such as: “I have type 1 diabetes”
Signs of hypoglycemia and what to do
Parent’s emergency contact number
Permission to test blood sugar or inject insulin at school
The important role of the school counselor
The school counselor can play a key role in providing psychological and social support to a diabetic child, especially if the child:
Has anxiety or fear of the school environment due to the illness.
Has a lack of self-confidence due to being different from others.
Has been ridiculed or judged by classmates.
Suggestion:
Periodic counseling sessions or group discussions with the counselor and other students (with the consent of the child and parents) can help better accept the situation and reduce psychological stress.
Tips about the school meal plan
Cooperation with the school cafeteria or nutritionist:
If the child uses buffet foods, it is better to inform the parents of the list of nutritional ingredients and the sugar value of each meal.
The possibility of choosing healthier snacks for diabetic children should be provided (such as whole grain bread, fruit, low-fat milk).
Teaching your child to choose the right food:
With proper education, your child will learn which foods are best for him and to avoid sugary or processed foods.
Eating snacks at specific times:
Teachers should understand that sometimes a child needs to eat in the middle of class to prevent low blood sugar.
Legal and ethical issues related to children with diabetes at school
In many countries, there are specific laws to protect children with chronic diseases such as diabetes. In Iran, families can also benefit from the following rights:
The right to have a specific treatment plan at school
The right to take medicine or food in class without requiring special permission
Non-discrimination in participating in sports, academic activities or camps
Training and informing teachers and school staff about the child’s illness
Parents can request formal and reasonable support, if necessary, through a conversation with the school administration or the regional education department.
Examples of success of diabetic students
To create motivation and positive spirit in the child, you can give him examples of successful people with diabetes:
Professional athletes who compete at the world level despite diabetes.
Students who were accepted in school or the entrance exam with excellent grades.
People who achieved their career and academic goals despite diabetes.
These examples will help the diabetic child not to see himself as limited and to continue on his path with more motivation.
Final conclusion
Managing a child’s diabetes at school is not limited to measuring blood sugar and injecting insulin. This is a multidimensional process that includes:
Education and awareness of the family, school, and the child
Psychological and social support for the child
Coordination of nutrition, medication, physical activity, and rest
Maintaining the child’s self-esteem and morale during education
The more carefully and compassionately this process is followed, the more calm and confident the child will grow in the educational environment.