Diabetes care at school

Position statement

Students living with diabetes have the right to be full and equal participants in school and all school-related activities without the fear of being excluded, stigmatized, or discriminated against.
School boards should develop and communicate a comprehensive diabetes management policy that includes the roles and responsibilities of the student living with diabetes, their parents/guardians and school personnel according to Diabetes Canada’s Guidelines for the Care of Students Living with Diabetes at School.
School principals should work with each student living with diabetes, their parents/guardians and healthcare professionals to develop and communicate to school personnel an Individual Care Plan (ICP) that complies with the student’s prescribed diabetes management regimen.
Each ICP should be comprised of a daily diabetes management plan and a diabetes emergency plan.

Schools should permit students living with diabetes to monitor their blood glucose (sugar), administer insulin and treat low blood glucose (hypoglycemia) and high blood glucose (hyperglycemia) conveniently and safely wherever and whenever required.

Schools should permit a student living with diabetes to carry their cell phone as a tool to help manage their blood glucose levels and prevent emergency events. For many students with type 1 diabetes, a cell phone works with insulin pumps and continuous glucose monitoring systems to provide essential information to inform diabetes treatment decisions.

School personnel should be trained to recognize emergency situations and to respond appropriately according to the student’s Individual Care Plan (ICP). School personnel should be trained to administer glucagon in the event of a severe hypoglycemic reaction.

Background and rationale

To maintain long-term good health, individuals living with diabetes must balance medication, including insulin, food and activity every day. With support from school personnel, most students can manage their diabetes independently while in school. However, some students are unable to perform daily diabetes management tasks and may require someone to assist with or to administer insulin, monitor blood glucose, or supervise food intake and activity.

It is a hardship for many parents/guardians to be present at their child’s school or school-related activities to assist their children with daily diabetes management tasks. Poor management of blood glucose levels may seriously impact academic performance as well as the student’s overall health. Ongoing hyperglycemia that is not recognized and left untreated can eventually lead to serious health problems such as heart disease, blindness, amputation and kidney failure. Each student’s Individual Care Plan (ICP) will inform school personnel about the diabetes care and monitoring required, as well as treatment guidelines for hyperglycemia and hypoglycemia.

Mild to moderate hypoglycemia is common in school and can be treated by consuming fast-acting sugar. Severe hypoglycemia is an emergency situation when a child is unconscious and/or unable to take glucose orally and requires immediate treatment with a glucagon injection by trained school personnel. Glucagon is a hormone secreted by the pancreas to raise blood glucose levels. An injectable form of glucagon is vital first aid in cases of severe hypoglycemia.

Given the seriousness of the condition, parents/guardians, students and school personnel must be clear and confident in their roles and responsibilities in the care of students living with diabetes. Diabetes Canada wishes to work in partnership