Chapter 15: School :: Nationwide Children's Hospital


Children need adult help to manage their diabetes during the school day. Children with chronic medical conditions, like diabetes, have a legal right to go to school and do school-related activities. The school, parent, child, and healthcare provider all help make a school health plan for diabetes so children can go to school and do school activities. At home or at school, the treatment goals for children with diabetes include:
  • Good blood glucose control
  • Normal growth and development
  • Good emotional health
  • Learning to the best of their ability
Diabetes management during the school day should support these goals.

How to Work With School Staff

School staff will need information about diabetes and about the special needs of each child with
diabetes. The role of the school nurse and teacher will be different at different ages. The school nurse should be the first contact to help prepare a diabetes management plan for your child.
It can be stressful for parent and child to return to school. We suggest the following to prepare for the return to school:
1. Meet with the school nurse or the person who will help with diabetes care at school. Do this before starting the school year to talk about your child’s needs. You may want to include any or all of the following school staff:
  • Nurse’s aide/medicine monitor
  • Teacher(s)
  • Principal
  • Food service manager
  • Bus driver
  • Guidance counselor
  • Gym teacher/coach
2. During your meeting, you may want to talk about the following topics:
  • Who will help my child test blood glucose?
  • Who will help give my child insulin, if it is needed?
  • Where will the diabetes supplies be kept?
  • How will I know when more diabetes supplies are needed?
  • What is the best way to reach the school nurse or staff member in charge of diabetes management?
  • Who is able to give glucagon in case of an emergency?
  • What time is gym or recess?
  • What is the process to keep my child safe when there is a low blood glucose? Who can walk with my child if he or she need to leave class because of low blood glucose?
  • How and when are blood glucoses communicated to the parent?
  • Who tells the parent and makes special arrangements when there are parties or field trips?
3. Give the school a school healthcare plan for your child. We will give you a school health care plan packet during your first hospital stay and at your spring or summer clinic visit. This packet has general instructions for diabetes management.
4. Bring the packet with you to your meeting. We ask that you tell the school staff your child’s current insulin dose. Fill out the “MUST BE COMPLETED BY PARENT” section on the last page of the school packet. The last page of your packet is an insulin dose order form. You can also find this on the Diabetes Center website, A parent or guardian needs to fill out the form. If the school needs a signed order, then fax (or have the school fax) the form to the Diabetes Center. We will sign and return the form to the school or parent.
5. Bring the diabetes supplies your child will need at school. Use the checklist below:
  • Blood Glucose Meter
  • Blood Glucose Test Strips
  • Lancet Device
  • Lancets
  • Ketone Test Strips
  • Glucagon Emergency Kit
  • Insulin
  • Syringes or Insulin Pen Needles
  • Food or Drink to treat or prevent low blood sugar
For many children, the school healthcare plan and open communication with the school nurse are all that is needed. Some parents like more detailed, written instructions. It is your right to make a 504 plan or an Individualized Education Plan (IEP) for your child. There is a sample 504 plan on the American Diabetes Association website here.
504 Plan: Outlines a specific plan to make sure that chronic illness is managed safely during the school day.
IEP (individualized education plan): Outlines a specific plan for a child who has problems that affect ability to learn.


There may be times that you need to give school staff education about diabetes care or the rights of children with diabetes. Your school nurse is often a good resource to help educate other staff members.
You may also find the following resources helpful:

American Diabetes Association

Information about rights and responsibilities at school; sample 504 B Plan

Juvenile Diabetes Research Foundation (JDRF)

School Advisory Toolkit for Families; free resource

National Diabetes Education Program

Guide called Helping the Student with Diabetes Succeed: A Guide for School Personnel; free resource

Legal Rights

There are many federal laws that protect the rights of children with chronic illness, including diabetes. Public schools must make accommodations to make sure these children get a fair and equal education. Private schools and charter schools that do not get federal funding are not held to the same legal standards.

Individuals with Disabilities Education Act (IDEA)

Protects children who may have learning problems due to a disability. This is the law that supports the making of an IEP.

Section 504

Section 504 of the Rehabilitation Act of 1973 is a civil rights law that protects children with physical or mental disability and prohibits discrimination because of the disability. A Section 504 Plan may need to be made between the parents and the school so the child’s special needs related to their diabetes care in school are met.

Americans with Disabilities Act

This is a civil rights law. Like Section 504, it protects students with disabilities. This law applies to all students in public or private schools, except those run by religious organizations.

Ohio House Bill 264

State law which protects students with diabetes and the school employees who help those students. The law supports the following:
  • Allows school staff without formal medical training to get education so they can care for children with diabetes. If staff volunteer, the school must let them be trained. No staff will be forced to give diabetes care if they are not comfortable doing so.
  • Allows students who are able to manage their diabetes by themselves to carry diabetes supplies with them. The student’s parent or guardian must make this request. There must be a written doctor’s note for this request. The right may be taken away by the school if the student misuses the diabetes supplies.
  • Students with diabetes must be allowed to go to the school they went to before diagnosis.

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