Back to School with Type One Diabetes

New Year New Teacher

It’s always a challenge as a parent of a Type One child going into a new year group. If you are anything like us, you just feel like everyone has finally got the hang of the care plan and you can relax and not worry too much when they are at school and then all of a sudden you are transitioning into the next year. Back to square one again with everyone learning the ropes.

It totally depends how old your child is as to the level of care required and how independent your child is at their diabetes care. Our daughter is currently 7 and moving into YR 3 key stage too. She was diagnosed when she was 4, the term before she started school.

Read more about our diagnosis story and Type One journey here!

Our daughter is still 100% reliant on other people taking care of her. The responsibility of Type One is huge and I feel very strongly that it is our responsibility to keep her safe and cared for just as we all do and carry that burden for her and that I’ve no doubt she will become more independent when she is ready. It is our aim that by the time she is in year 6 that she will be a lot more independent and capable of taking care of herself with supervision in preparation for going to secondary school (YIKES!!! secondary school scares me!).

Training up New Staff

We are very lucky where we are that our DSN will come into school in the last few weeks of term to do a training session with everyone involved in my daughters care for the following year. This has been amazing and is a chance for me to meet her new class teacher and answer any questions they have.

Present at this training session was our DSN, me, new teacher, TA for the year group, Wellbeing Officer (does most of care) and one member of the office team (she is extra if the teacher or Wellbeing Officer is off school).

JDRF, the leading charity in TYPE ONE RESEARCH has some amazing resources for schools and raising awareness of Type One. They have a series of online modules designed for people taking care of kids with Type One. Our DSN insists they have completed these modules online before the training session so they have a basic understanding. It’s definitely worth taking a look as it can be useful for grandparents and aunts and uncles too. Check them out below:

JDRF Schools E-Learning Module

We have 3 days transition in July and for these 3 days, the class teacher shadows all the care given by in our case the Wellbeing Officer. This will continue in the new year until she feels totally confident. I make sure I check in regularly with the teacher after school to answer any questions and because I work from home I am always available on the other end of the phone if they have any queries throughout the day. I’ve got high hopes for Year 3 as my daughters feedback after 2 days of transition were mummy my new teacher is awesome she is so good at looking after me and my diabetes already 🙂 BIG SMILEY face as its so important our kids feel safe and secure at school.

Difference in Care Plans

The responsibility of the school and the care plan in place for Type One varies a great deal depending on the kit and technology each particular child has. Whether it be pump or injections, blood glucose testing, CGM, either Libre or Dexcom or others in some cases. It also differs depending on whether the child is aware of hypo’s or not and how old they are.

Our daughter is currently on the Accuchek insight pump and the Dexcom G6 CGM. She has absolutely NO hypo awareness at all, hence the need for a CGM. If you are newly diagnosed and wondering what on earth I am talking about do not worry! These are all words and terminology that were once alien to us too. Let me just say as you get further along into the Type One journey you will be made aware of the amazing technologies for delivering insulin and monitoring blood glucose levels and soon you will understand it all.

If you are fascinated and want to learn more about the things I have mentioned, check out these links:

Dexcom G6 CGM (continuous glucose monitor).

Libre (CGM).

Accuchek Insight Pump (one of many pumps available).

It is really important that you have a care plan in place at school so everyone dealing with their care knows what is expected and that care given is recorded. This is normally drawn up with the school nurse and is regularly updated should the treatment plan change.

Communication with Care Givers

We had a fantastic experience in Reception with the care given as this was in a totally separate part of the school. Her care was given completely by her teacher and TA and they were amazing. In those days my daughters was on injections (MDI), until Easter of reception year when she switched to the pump and she could have anything from 5-15 finger pricks a day. They tested her whenever necessary and injected her 10 minutes before lunch in the class room and they did such an amazing job.

As we have moved through the school the regime has changed slightly. The class teacher and has been fully trained up to give her care but the majority of her care is given by the schools Wellbeing Officer. She is pretty much on call for her most of the time and she gives her insulin in the medical room at lunch time. The class teacher is still very involved too and will respond to dexcom alerts and check before and after play time but there can also be a lot of other teachers taking the class due to training courses orb shares etc.

For me the challenge has been how to best communicate with the staff so that we are not just relying on the Wellbeing Officer but so whoever takes the class is aware of what to do in certain situations to keep my daughter safe.

My Experiences

Let me share with you some of my thoughts and experiences of what has worked well for us so far to help with the dreaded transition into a new year group. I appreciate that what works for one may not work for another but hopefully you might be able to pick up some tips on things you may not have considered.

The Care Plan

The care plan is quite a big document in a folder and not very easy to carry around. Everyone is familiar with the care plan but I have created several things to make following it easy and especially easy for different members of staff to follow too.

  1. Laminated Summary: This has a picture of my daughter, her name and class and condition, obv Type One. It gives a brief summary of what this means and what kit she is wearing and what to do should they hear her dexcom alert or if she shows any symptoms of hypo or hyper. This is pinned next to the teachers computer so can be seen as an awareness for any supply teacher coming in the room.
  2. Flash Cards: I have created a series of A6 laminated flash cards which are in her kit bag so with her all the time. That include what to do before break, before lunch, before PE and afternoon play, as well as hypo and hyper’s and how to treat. One of the cards has carb contents for all the common snacks she may have at school swell as parent phone numbers. It is very step by step such as read dexcom arrow direction, what is the number and this is what you need to do . . . The feedback from the teachers have been that it is so amazing and easy to follow they are in no doubt what she needs at any given time and it really has worked a treat.
  3. Record Log: I print of a little booklet of record sheets for each week. The staff record down times they have checked bg/ checked dexcom, any action given and insulin bolus type and duration for lunch time and initial who administered and checked it. There is also space to record any other events that have happened throughout the day and if I need to notify them of anything I jot it down on here. A bit like a school – parent book but its as a table so easy to use and record info.

The combination of these 3 things have worked so well for us and the staff really do an amazing job. If you haven’t already please sign up to my email list and become a part of my little community because I have a series of Back to School Printables coming your way very soon to all my lovely subscribers so don’t miss out!!

Lunch Time

Carbohydrate counting school lunches is another challenge. Some parents find it easier to send packed lunches. Up until now we have always tried to encourage my daughter to stay for school lunches.

I have written a detailed post on the practicalities of how to best carb count school lunches and ways to make it easier so feel free to check out the post: Carb Counting School Lunches. There is also a link to download my Mini School lunch card printable which I use every day to show the menu choice, carb content of each bit and total carbs to be inputted. My daughter then hands this in to the cook who ensures she is given the correct food.

In Year One my daughter was given her lunch time insulin in the class room by her teacher which was fantastic and not at all disruptive. However, the absence of a TA in year 2 (so the teacher is sorting the rest of the class out) and another child with Type One joining the school has meant that she now has to go to the medical room at 11.50. I felt this was not ideal but I appreciate kids on injection may wish to have some privacy and if there is more than one child with Type One the main care giver can only be in any one place at one time. My daughter has been quite happy with the arrangement as they both have a little chat over whilst bg testing and inputting carbs. She also takes a friend with her for lunch every day too.

For me it is important to reiterate all the minor details to the new teacher early on so things like leaving the class 10 minutes early to go to the medical room, being able to take a lunch buddy plus needing to go straight for lunch are all part of the daily routine and understood by everybody.

Hypo’s and Hyper’s

Its one thing being told what to do in a hypo situation but another to actually remember all the steps to take in the heat of the situation. The first hypo can always be a bit daunting for a new teacher. From experience, once they have successfully dealt with it I always find they being to relax into the role more.

The other thing is we frequently have high alerts on the Dexcom on the days we have cereal. It takes a little while for the teacher to not panic on hearing these high alerts and to realise that after an hour or so bloods normally return into range and this is quite normal at this time of day. On the other hand it takes a while for them to work out when is normal to go high and when to discern something is out of the ordinary. This is where regular communication comes in and being available to answer any questions as the days turn into weeks and months.

Exercise

As we all know, all children respond differently to exercise depending on all sorts of factors. Ensure they have a good selection of snacks available. It may take a while to work out what number your child needs to be prior to exercise to not go low within it. We also found that if she was a little low and needed a snack before PE that a biscuit or cereal bar given just before would not work fast enough so we have taken to given 100ml apple juice as this is quick to drink and works quickly, thus reducing the chance of having to miss out on PE due to low BG’s. We always get them to check bg after PE and after the following play time too as the drop can come up to an hour afterwards.

Educating School Friends

Once they are settled into their new class and year group it is worth looking at the possibility of being part of educating the class. I have found that each year, the kids have been able to take on a little bit more information. I went into reception and talked to each class for 10 minutes about what was different about my daughter and what type one looked like. In year 2 I then went back in and they asked me to do a full afternoon or Type One teaching and activities which was an awesome opportunity to raise awareness. The school might consider doing JDRF fundraisers or assemblies too!

Read more in my post about Teaching Kids about Type One.

What to take in kit bag

Lastly I wanted to tell you about what kit we take into school and how we carry it.

My daughter has her medicine bag as she likes to call it, at the moment we are using a LOVE BUG BAG (check out more pictures and my product review here!). We change bags from time to time but this has been my favourite so far as it is compact yet fits everything in it, she loves it as it is very pretty bonus!

In it she carries her pump meter, test strips and finger pricking device, hypo treatments (dextrose and glucojuice), some snacks (normally 4/5 biscuits or crackers), a small carton of apple juice, school record sheet and flash cards prompts for her treatment. This bag goes all around the school with her, sometimes she carries it and other times the teacher carries it. It is helpful to have all this contained in one bag rather than within her rucksack so it can go with her wherever she is. The only time it gets left in the medical room is when she goes for lunch so she doesn’t forget it when she finishes eating and she is ver unlikely to have a hypo at this time.

In the cupboard in the class room there is also a tupperware box labelled up with her details on. That contains spare lancets, test strips, hypo treatment, cereal bars, apple juice etc and orange box injection. I check it from time to time for expiry dates and if they have used anything the teacher normally tells me so I can replace.

Have a Fantastic Year

I hope this post has given you a few helpful tips to take onboard. I’d love to hear from you about what your experiences of school and type one are and also if there’s anything that I have missed that you would like more info on, so please reply to this email. I’d love to chat with you further.

Finally I hope this new year at school is the best yet for you with supportive staff and teachers and a year for building confidence in our children!

All the best, Rachel

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