How Educators and Support Staff Can Help Students Manage Diabetes at School

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How Educators and Support Staff Can Help Students Manage Diabetes at School

Managing diabetes at school can be a major challenge for kids and their families. Students spend over 30 hours each week in school, where they need to take care of their own diabetes management without direct help from their parents or guardians, on top of their schoolwork, extracurricular activities, and social life. Educators and support staff can play an important role in ensuring that school is a safe and caring environment where students living with diabetes feel free to be themselves and learn to manage the condition with confidence as they grow up.

Understanding How Diabetes Affects Students at School

Diabetes is a complex condition that impacts everyone differently. It has unique effects on children as they grow, especially during their teen years. Many people are diagnosed with type 1 diabetes (T1D) for the first time as school-aged children, with the rate of diagnosis peaking between the ages of 4 and 7 and again between 10 and 14.¹ Though fewer children are diagnosed with type 2 diabetes (T2D) than T1D, the number of young people living with T2D is increasing.2

What is diabetes?

Diabetes happens because of issues with the hormone insulin, which is responsible for helping the body absorb sugar in the blood, also known as glucose, for energy³. In T1D, an autoimmune event destroys the cells in the pancreas that make insulin. This means individuals living with T1D must use insulin injections or an insulin pump to make sure they can use the glucose in their body effectively.¹ In T2D, the body doesn’t make enough insulin or has a hard time using the insulin it does make, known as insulin resistance. T2D is generally treated with lifestyle changes like diet, exercise, and stress management. However, some people do need medications or insulin injections to help them manage their glucose.⁴

How does diabetes impact kids’ everyday lives?

For individuals who don’t live with diabetes, the process of turning food into fuel so that the body can function properly is automatic—they don’t have to consciously think about making sure they have the right amount of glucose in their bodies. People living with diabetes must constantly monitor their glucose levels and carefully plan out what they will eat, when and how long they will engage in physical activity, and how much insulin or medication they need to take, among many, many other considerations. The diaTribe Foundation has identified at least 42 factors that can affect the amount of glucose in the blood and how the body uses it.⁵Those living with diabetes are constantly juggling these factors in addition to managing the demands of everyday life.

It’s important for educators and school support staff to recognize that managing diabetes is like having a 24/7 job on top of academic work. In addition to learning math, literature, science, and history, kids living with diabetes are tasked with their personal medical education as they figure out how to monitor and manage their glucose and take care of themselves.

Kids may have to check their glucose regularly with painful fingerpricks if they are using a blood glucose meter (BGM). Those using insulin therapy also need to either inject insulin themselves or pay attention to the doses administered by their insulin pump, especially around mealtimes. Constantly thinking about and dealing with these self-care tasks throughout the day, while managing their glucose, can be frustrating and distracting for kids. Changing glucose levels, such as experiencing high and low glucose, can affect a student’s mood and their ability to focus.⁶ The stress that comes with managing diabetes can also have an impact on their participation and performance at school.

Despite the obstacles on their path, students living with diabetes are more than capable of fully engaging in and excelling at school and their extracurricular activities. With the right support in place, kids living with diabetes can enjoy their learning experience and get the most out of their time in class.

How Educators and Staff Members Can Support Students Living with Diabetes

Helping kids manage diabetes during their school years sets them up for a healthy future. Here are just a few actions educators and support staff can prioritize to ensure that students living with diabetes thrive at school.

1. Know the Official Policies for Diabetes Management at School in Canada

Each province and territory has specific guidelines that outline the mandatory standards of care for students living with diabetes. Many school boards have established their own standards in addition to the regional guidelines. Diabetes Canada and leading national health authorities also have standards of care for children living with diabetes at school. It’s a good idea to familiarize yourself with these policies, in addition to your regional and school board guidance, to ensure you can provide an excellent experience for students:

Diabetes Canada Guidelines for the Care of Students Living with Diabetes at School
The Diabetes at School website from Diabetes Canada, the Canadian Paediatric Society, and the Canadian Paediatric Endocrine Group

The Canadian Paediatric Society recommends that at least two staff members at the school receive annual training around diabetes care for students.⁷Diabetes at School offers an online course for educators and support staff that outlines the basics of caring for kids managing type 1 diabetes (T1D). You can also learn more about diabetes and glucose management from a Certified Diabetes Educator (CDE). Staff need specific training if they will be required to administer insulin or help the student test their glucose levels as a part of their regular diabetes management routine.⁶

2. Maintain Clear Lines of Communication with the Student’s Guardians

Guardians may not always know what’s happening with their child throughout the school day. Young children are likely still learning how to communicate about their diabetes management, while tweens and teens might not always feel like being open about their lives at school. Having a direct line of communication between your team and the student’s guardian is essential for ensuring that the student gets the care they need.

It’s a good idea to appoint a primary point of contact for the guardian, which could be the student’s homeroom teacher. This person is the one who can communicate with the guardian on a regular basis about the student’s glucose management and overall well-being. Creating a structured communication process gives everyone the opportunity to discuss challenges as they come up, make suggestions about improving the student’s care plan, and talk about any changes in the student’s schedule, such as field trips and special events like sports or pizza days.

3. Learn How to Address Blood Sugar Emergencies

A student’s diabetes management plan is designed to help ensure that they avoid glucose emergencies like hypoglycemia, or low blood sugar, and hyperglycemia, or high blood sugar. However, glucose management can be very challenging, and there is always a risk that individuals living with diabetes will experience low or high glucose while at school. With the right training, educators and support staff can help spot and prevent glucose emergencies and act quickly to address them when they happen.

Managing Hypoglycemia

It’s a good idea for all educators and support staff to learn how to recognize the signs of low glucose.⁸ Not every child experiences lows the same way, and it can be especially hard for kids to notice that they are experiencing hypoglycemia. Just a few of the visible symptoms of hypoglycemia include:⁹

Looking pale
Shaking
Sweating
Having difficulty concentrating
Being irritable or anxious
Losing coordination
Acting confused
Slurring speech

You and your student may be able to treat mild hypoglycemia (generally defined by Diabetes Canada as 3.0 to 4.0 mmol/L^10,11) with fast-acting carbs like a juice box, Life Savers candy, or glucose tablets.¹¹

Serious lows under 3.0 mmol/L may require glucagon, a hormone that quickly raises blood glucose levels.^10,11 Glucagon can be given as a nasal spray or an injection and should be included in the student’s emergency kit.⁶ If a student is experiencing a low that requires glucagon, you must call 911 and ensure that the individual receives emergency medical care.⁶

Managing Hyperglycemia and Diabetic Ketoacidosis (DKA)

Unlike hypoglycemia, there is no quick medication that you can give to a student to treat hyperglycemia. Serious hyperglycemia can lead to diabetic ketoacidosis (DKA), which is a medical emergency.¹² If you notice a child is showing signs of serious hyperglycemia, call their guardians to pick them up. Just a handful of common symptoms of serious hyperglycemia to look out for include:¹²

Frequent urination
Rapid, shallow breathing
Vomiting
Fruity-smelling breath

Chart showing signs of Blood Sugar Emergencies

4. Foster an Inclusive, Compassionate Learning Environment

Every child has the right to feel safe, supported, and included at school. Students living with diabetes can face stigma from their peers who may not understand why diabetes happens. They may also feel embarrassed about taking time out of class or social situations to prick their finger and test their glucose, give themselves insulin injections, or take medications. If the supports aren’t in place to ensure that they can participate in gym, sports, and school outings and events, students living with diabetes will feel left out.

Educators and staff can create a positive, caring environment by acknowledging the student’s unique needs. Diabetes Canada recommends that students always have access to a private space to perform glucose readings or injections and that they should be allowed to check their glucose at any time, anywhere in the school.⁶They should also be allowed to eat according to their diabetes management plan, including regular snacks that they may need to consume during class or while taking tests.⁶

Kids may not always be compassionate or understanding about each other's differences. It’s a good idea to talk to the student’s classmates about diabetes to dispel any negative assumptions they might have. For example, Dexcom Warrior Chloe and her dad Conrad make a yearly presentation to her class to raise awareness about type 1 diabetes.

Educators should also consider how glucose fluctuations affect learning. Changes in glucose can affect a student’s cognitive ability, making it more difficult to learn and demonstrate their knowledge. Diabetes Canada recommends that educators provide an alternative time to complete a test or offer a redo if necessary.⁶

Learn More About Diabetes and the Ways it Can Affect Those Living with the Condition

While guardians are typically responsible for keeping educators and staff informed about the nuances of diabetes and how it affects their child, it’s a great idea for your team to learn about the condition for themselves.⁶ Diabetes education equips you with a deeper understanding of what students are going through so that you can provide informed support when needed. It can also help reduce bias around chronic conditions like diabetes so that you can foster an inclusive, accepting environment where students living with diabetes feel understood.

If you’re looking for somewhere to get started on your learning journey, just a few trusted sources for diabetes education available online include:

You can also find articles about living with diabetes on the Dexcom CGM Blog and hear from people who bravely manage diabetes every day in our Dexcom Warrior stories. You can get started on your learning journey with these articles:

Explore more diabetes education resources on the Dexcom CGM Blog

* Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
† For a list of compatible devices, please visit dexcom.com/compatibility.
‡ Followers must have compatible smart devices to use the Dexcom Follow app. To view a list of compatible devices, visit dexcom.com/compatibility.
§ Separate Dexcom Follow app and internet connection required. Internet connectivity required for data sharing.

1 Type 1 diabetes. Mayo Clinic. March 27, 204. Accessed September 23, 2024. https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/symptoms-causes/syc-20353011
2 Panagiotopoulos C, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 2 Diabetes in Children and Adolescents. Can J Diabetes. 2018;42 Suppl 1:S247-S254. doi:10.1016/j.jcjd.2017.10.037
3 Thota S, et al. Insulin. StatPearls Publishing. Updated July 10, 2023. Accessed September 23, 2024. https://www.ncbi.nlm.nih.gov/books/NBK560688/
4 Type 2 diabetes. Mayo Clinic. MArch 14, 2023. Accessed September 23, 2024. https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
5 42 Factors That Affect Blood Glucose?! A Surprising Update. The diaTribe Foundation. Updated September 29, 2022. Accessed September 23, 2024. https://diatribe.org/diabetes-management/42-factors-affect-blood-glucose-surprising-update
6 Diabetes Canada Guidelines for the Care of Students Living with Diabetes at School. Diabetes Canada. Accessed September 23, 2024. https://www.diabetes.ca/DiabetesCanadaWebsite/media/Managing-My-Diabetes/Tools%20and%20Resources/Diabetes_Canada_KWDIS_Guidelines.pdf?ext=.pdf
7 Lawrence SE, et al. Managing type 1 diabetes in school: Recommendations for policy and practice. Canadian Pediatric Society. February 6, 2015. https://cps.ca/documents/position/type-1-diabetes-in-school
8 How teachers can support students with type 1 diabetes. Diabetes at School. Updated September 2024. Accessed September 23, 2024. https://diabetesatschool.ca/supporting/how-teachers-can-support-students-with-type-1-diabetes
9 Diabetic hypoglycemia. Mayo Clinic. May 26, 2022. Accessed September 23, 2024. https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525
10 Wherrett DK, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 1 Diabetes in Children and Adolescents. Can J Diabetes. 2018;42 Suppl 1:S234-S246. doi:10.1016/j.jcjd.2017.10.036
11 Lega IC, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Hypoglycemia in Adults. Can J Diabetes. 2023;47(7):548-559. doi:10.1016/j.jcjd.2023.08.003
12 Hyperglycemia in diabetes. Mayo Clinic. August 20, 2022. Accessed September 23, 2024. https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631

Understanding How Diabetes Affects Students at School

How Educators and Staff Members Can Support Students Living with Diabetes

Learn More About Diabetes and the Ways it Can Affect Those Living with the Condition

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