Common Issues Involving Diabetes Care Tasks at School/Child Care/Camp

Special Considerations

Common Issues Involving Diabetes Care Tasks at School, Childcare, or Camp

Below is a list of diabetes care tasks which are frequently reported by parents/caregivers as barriers to the provision of care to children with diabetes in the school, child care, and camp settings. A description of the Association’s recommendations for the performance of each diabetes care task and sources of authority are provided below to help schools, child care programs, and camps establish a set of best practices consistent with guidance from key diabetes stakeholders.

Insulin administration by school, childcare, or camp staff

Insulin may be administered by trained non-medical staff using the child’s prescribed insulin delivery method of a syringe, pen, or insulin pump.

Insulin adjustments by school or camp staff

Adjustments to insulin dosage should be based upon the child’s Diabetes Medical Management Plan or physician’s orders which should include authorization for adjustment of the dosage by the parent/caregiver. 

Insulin pump and CGM site changes at school or camp

A back-up plan for insulin pump, CGM malfunctions and site changes sound be included with the child's Diabetes Medical Management Plan or physicals orders.

Blood glucose monitoring by school, childcare, or camp staff

Access to blood glucose monitoring by trained staff should be available at all times.  It is recommended to monitor and quickly respond to blood glucose levels in accordance with each child’s individualized plan. 

Glucagon administration by school, childcare. or camp staff

School, childcare, and camp health care professionals and non-medical staff should be trained to treat and respond to hypoglycemia including the administration of glucagon.

Remote monitoring by parents or guardians

Children using certain devices have the capability to share data with parents and caregivers remotely.  This enables children to receive real-time guidance from parents on diabetes management.  A parent’s access to this data does not absolve the school/child care program/camp of its responsibility to provide diabetes care.  Data sharing with school/childcare/camp staff should be discussed and agreed upon by parents and the school/child care program/camp.

Training non-medical school, childcare, or camp staff

Non-medical staff should be trained to provide routine and emergency care in the event a licensed health care professional is not available to provide this care.  Non-medical staff should be trained on blood glucose monitoring, insulin administration by syringe, pen or pump, glucagon administration, ketone checks, and carbohydrate counting.

Appropriate level of self-management and support

The ability to self-manage diabetes is different for every child.  Many children can perform all of their care. Others will need help and/or supervision by a trained adult.  Each child needs to be supported and supervised as the readiness to take ownership of their diabetes management transitions throughout their childhood. All children, even those who can independently manage their diabetes, will need assistance in the event of a diabetes emergency such as hypoglycemia.

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