The hardest part of a new diagnosis of type 1 diabetes is rarely the insulin. It is the first Monday morning afterwards, when your child goes back to a building where you are not.
Most schools want to help and have simply never been told what helping looks like. So tell them, on one page, in writing, and get it signed.
What the school must know
1. The child has type 1 diabetes and needs insulin to live. Not sugar problems. Not something diet will fix. Insulin is not optional and is not a punishment for anything.
2. Low blood sugar is the emergency, not high. A high reading is a phone call to a parent. A low reading is treated immediately, where the child is standing.
3. The child must never be sent anywhere alone when hypoglycaemic. Not to the office, not to the nurse’s room, and not down a staircase.
4. Food and glucose must be within reach at all times, including during exams, assemblies, sports and school trips.
5. The child may need to test or check a sensor in class, and should not have to ask permission or explain themselves each time.
The hypoglycaemia protocol, written out
Put this in the plan word for word.
If the child feels shaky, sweaty, pale, confused, unusually quiet or says they are low, treat first and ask questions afterwards.
- Give 15 g of fast sugar: 3–4 glucose tablets, or half a cup (100 ml) of regular fruit juice or non-diet soft drink, or 1 tablespoon of honey or sugar in water.
- Wait 15 minutes. Recheck if a meter or sensor is available.
- If still low, or still unwell, repeat once.
- Follow with a small snack containing starch, such as a biscuit or a sandwich, if the next meal is more than an hour away.
- Call the parent.
If the child is unconscious, having a seizure, or unable to swallow safely:
- Do not put anything in the mouth.
- Turn on the side, call an ambulance, call the parents.
- Give glucagon if the school has been trained and it has been supplied.
Sport and PE
Exercise usually lowers blood sugar, sometimes for hours afterwards.
- Check before activity. Below roughly 100 mg/dL, eat a snack first.
- Keep glucose at the side of the field, not in a bag in a classroom.
- The child is not excused from sport. Children with type 1 diabetes should play everything. The plan exists so that they can.
Exams
This one gets forgotten and causes real distress.
Schools and boards in India can permit reasonable accommodations. Ask, in writing and well ahead of time, for:
- Permission to carry glucose, a meter or a phone-linked sensor into the hall
- Permission to test and treat in the hall
- Compensatory time for any period spent treating a hypo
- Permission to use the toilet if sugars are high
What to hand over
Print and give the school office:
- The one-page plan. Signs of hypoglycaemia specific to your child, the treatment steps above, insulin timings if any doses fall during school hours.
- Two phone numbers that will always be answered, plus the treating doctor’s clinic number.
- A labelled hypo box kept in a known, unlocked place: glucose tablets, juice, biscuits, spare strips or sensor, and a copy of the plan taped inside the lid.
- A short note for the class teacher, in plain language, on what they may see and what they should do.
Ask for a fifteen-minute meeting with the class teacher, the PE teacher and whoever runs the office. Fifteen minutes at the start of the year prevents most of the phone calls later.
And a note to parents
Your child will, at some point, be treated as fragile by an adult who means well. Push back gently and consistently. Children with type 1 diabetes go on school trips, sit board exams, play cricket, and grow up to do whatever they were always going to do. The plan is not a list of restrictions. It is the paperwork that makes an ordinary childhood possible.
Adapt this to your child with their diabetes team before handing it to a school. Insulin regimens, targets and thresholds are individual.