Back to School with Type 1 Diabetes

It’s a time of year parents usually look forward to—the beginning of the school year. But this year, many parents and students are facing anxiety and uncertainty during the unprecedented circumstances of the continuing global pandemic and what it will mean for the school system. For our Medtronic Diabetes Ambassador, Amy, who is a teacher, as well as her son, Alan, who both are living with type 1 diabetes, going back to school this fall is particularly challenging. Below she shares her family’s story and the steps they are taking to return to school safely in light of COVID-19 and managing their diabetes.

Back to school time is usually a very exciting time for me to get back into a routine after a summer of relaxing. The kids get to go back and reunite with their friends, and I get to see how much the students in my building have grown over the summer break. This year with COVID-19 happening, it’s been a time of anxiety. Even more so since my son, Alan, and I both have type 1 diabetes, which puts us in a high-risk category. We will be adding spare masks and extra hand sanitizer to our supply list. And although lots of things are up in the air, I’m sure we will be very attentive to suggestions on how to keep ourselves safe, such as social distancing from people whenever possible, wearing a mask, washing our hands more frequently, and being mindful to not touch our faces.

Typically, before school starts, we review Alan’s 504 plan and make sure we don’t need to make any changes. A 504 plan is a blueprint for how a school will support a student if they have unique needs, such as a medical condition or disability. If your child doesn’t have a 504 plan, I highly recommend finding out how to get the paperwork started with their school. When Alan was first diagnosed with type 1 diabetes, we started with the school nurse, who helped us begin the process. I also recommend checking with the Special Education department. Even though type 1 diabetes isn’t a learning disability, this department is familiar with the law and paperwork to meet special needs of any type.

The accommodations you ask for in your 504 will be unique to your child’s needs to care for their diabetes. We specifically spell out the use of cell phones in Alan’s plan because schools are cracking down on their cell phone policies, especially in middle and high schools. He is sixteen years old and has had teachers tell him to put his phone away when he is actually using his insulin pump! There are also times when a cell phone is a useful tool to use in figuring out carb counts. When he was first diagnosed, he was allowed to text or call a parent to confirm insulin and other diabetes decisions.

I was also very adamant that Alan be allowed to carry and use any and all of his supplies at school at all times. He is completely independent in his diabetes management. Having the supplies in the nurse’s office or front office are not practical and could in fact be dangerous if he was on the other side of the building and needed to treat a low blood glucose quickly. Our 504 plan also gives Alan the ability to eat in classrooms or at any time he has a low blood glucose, as well as access to water and restrooms if his blood glucose is running high. This is important to avoid problems he may encounter with typical classroom policy regarding food, drink, and restroom use.

On the first day or two of class, Alan usually introduces himself to his teachers and makes sure they have a copy of his 504 plan. He lets them know they can ask him or his parents any time they have a question. He also shows them his diabetes bag and specifically points out where the glucagon is kept. He briefly shows them how to use it and reinforces that they should call the nurse and get it out of his pack for the nurse to administer if the teacher is unable to.

His friends are also aware of his diabetes bag, its contents, and what to do in an emergency. I also write a short letter to teachers explaining what to do in an emergency. I include a photo of Alan and request the teacher include this in their substitute teacher folder/binder so anyone in charge is informed. I have been both a full-time teacher in elementary and high schools, as well as a substitute teacher, and am often flabbergasted at the lack of information in substitute teacher folders for students with severe health circumstances. It is important to us as a family that we don’t keep diabetes a secret. We choose to talk about it freely with people. Our mentality is that the more people who know about diabetes and what to do if we find ourselves in a situation where we can’t communicate, the safer we all are. I remember when I made the cheer squad in high school and had my friends actually give me some of my injections (I was on multiple injections at the time) so they wouldn’t be afraid to help if the need for glucagon ever presented itself. 

You might be asking, what does Alan keep in his diabetes bag? We use a small pack that can be inserted into a shoulder bag that he carries when going out to places other than school. It can also be attached to the outside of his backpack at school for easy access in an emergency. We don’t want anyone to spend precious time digging through all the things in his book bag! The small pack has two sides closed by mesh. In one side he keeps glucose gel and plenty of fruit snacks (they work best for him in treating lows).

The other side of the bag has his blood testing kit, a back-up infusion set and inserting device for his MiniMed 670G system, spare batteries for his pump, change for the vending machine, extra Tegaderm tape and Simpatch tape, a small foldable scissor for his sensor, alcohol swabs/IV prep wipes, and most importantly, his glucagon. (Check with your school nurse for the proper procedure for having glucagon. Some states require the prescription sticker to specifically say, “for use in an emergency at school.”) In addition to his diabetes bag, we keep glucagon, extra blood testing strips, and glucose tabs in the nurse’s office.

I make sure to take care of myself as well. As a teacher, I always inform my co-workers at our first staff meeting of the school year that I have type 1 diabetes, and that if I’m not acting like myself, to get me any kind of sugar as fast as possible. I keep my glucagon in the classroom emergency kit, and I keep a specific drawer in my desk stocked with fast-acting sugar and other snacks. When teaching high school, I also inform each class and show them where supplies are kept in the classroom. I give less detail to the elementary-level students, but I specifically talk about the snacks and explain they are for emergencies only, so the students won’t take anything from that drawer without my permission leaving me an empty drawer when an emergency happens.

We are a Boy-Souting family, and we apply the Boy Scout motto to our daily lives, especially in dealing with diabetes: Be Prepared!

The testimonial above relates an account of an individual’s experience with a Medtronic device. The account is genuine, typical and documented. However, this individual’s experience does not provide any indication, guide, warranty or guarantee as to the response or experience other people may have using the device. The experience other individuals have with the device could be different. Experiences can and do vary. Please talk to your doctor about your condition and the risks and benefits of Medtronic devices.

Important Safety Information

MINIMED™ 670G SYSTEM

The Medtronic MiniMed™ 670G system is intended for continuous delivery of basal insulin (at user selectable rates) and administration of insulin boluses (in user selectable amounts) for the management of type 1 diabetes mellitus in persons, seven years of age and older, requiring insulin as well as for the continuous monitoring and trending of glucose levels in the fluid under the skin. The MiniMed™ 670G system includes SmartGuard™ technology, which can be programmed to automatically adjust delivery of basal insulin based on Continuous Glucose Monitor sensor glucose values and can suspend delivery of insulin when the sensor glucose value falls below or is predicted to fall below predefined threshold values. The system requires a prescription. The Guardian™ Sensor (3) glucose values are not intended to be used directly for making therapy adjustments, but rather to provide an indication of when a fingerstick may be required. A confirmatory finger stick test via the CONTOUR®NEXT LINK 2.4 blood glucose meter is required prior to making adjustments to diabetes therapy. All therapy adjustments should be based on measurements obtained using the CONTOUR®NEXT LINK 2.4 blood glucose meter and not on values provided by the Guardian™ Sensor (3). Always check the pump display to ensure the glucose result shown agrees with the glucose results shown on the CONTOUR®NEXT LINK 2.4 blood glucose meter. Do not calibrate your CGM device or calculate a bolus using a blood glucose meter result taken from an Alternative Site (palm) or from a control solution test. It is not recommended to calibrate your CGM device when sensor or blood glucose values are changing rapidly, e.g., following a meal or physical exercise. If a control solution test is out of range, please note that the result may be transmitted to your pump when in the “Always” send mode.

Pump therapy is not recommended for people whose vision or hearing does not allow recognition of pump signals and alarms. Pump therapy is not recommended for people who are unwilling or unable to maintain contact with their healthcare professional. The safety of the MiniMed™ 670G system has not been studied in pregnant women. For complete details of the system, including product and important safety information such as indications, contraindications, warnings and precautions associated with system and its components, please consult http://www.medtronicdiabetes.com/important-safety-information#minimed-670g and the appropriate user guide at http://www.medtronicdiabetes.com/download-library

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