Managing Diabetes: Guidelines for School Your child spends a major portion of each day in school, so making sure that school personnel understands diabetes and its management is extremely important. These guidelines will help you to reach that goal. Set up a conference with the school nurse and your child's teacher(s). The school nurse will be your primary contact person in the school. Be sure to discuss with him/her the plan for informing all other school personnel (gym teacher, cafeteria monitors, bus driver) about diabetes and symptoms/treatment of low blood sugars. At the conference you will want to review the following information: Blood Glucose Testing Demonstrate the procedure for doing a blood test on the meter your child will have at school. Be sure the nurse can correctly operate and clean the meter, and is aware of the "fine points" of obtaining an accurate reading that you have been taught (i.e., proper strip coverage; avoiding the addition of extra blood; and proper timing). Decide how blood sugar results will be communicated on a regular basis. You may want the nurse to call you for any blood sugars <80 and >300 and send all readings home on a weekly basis. Be sure you get regular, written records of blood sugars done. Low Blood Sugar Review symptoms of low blood sugars, emphasizing the need for the teacher to be aware of behavior changes, loss of concentration or sleepiness. Review "prime times" for lows to occur (i.e., mid-morning, just before lunch, after exercise, and mid-afternoon). Review appropriate treatment, as outlined in the school letter. Ask for your child to be sent with someone to the nurse to test if low blood sugar is suspected. Older students may prefer to treat symptoms with glucose tablets without leaving class. Lunch/Snacks Discuss how your child will handle snacks in school (i.e., whether the child will be reminded, at what time they will be needed, etc.). If at all possible, snacks should be eaten in the classroom without singling the child out. For younger children it is very helpful when everyone in the classroom has a snack at the same time. Emphasize that snacks should never be skipped or delayed for any length of time. Ask to be notified ahead of time of parties or special occasions which will include food, so you can plan ahead with your child so he or she can participate. For the future, you may want to plan with the nurse/principal for the best placement for lunch and gym periods.