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Pediatric Diabetes

Parent letter school forms

Dear Parents,

We want to support your child/teen in the school setting and form a triangle of diabetes support with parents, our medical team, and your child’s school staff. Here are some ways parents can help with diabetes management in the school setting:

  • Please note parents are responsible for communicating changes in the insulin dose directly to the school:
    Parents are responsible for providing our medical orders to the school and for informing the school when insulin doses change. Typically, only one written order per school year is required, as our orders allow for 20% adjustment of insulin dose without new orders. The school must have a specific concern with the new dose to refuse it if it is within the ordered range (+/-20%). They cannot have a blanket policy to refuse updated dosing within the ordered range.
  • If your school uses dosing cheat sheets for dose calculations, please insist on signing it to verify you checked it for accuracy.
  • Minimed 670G users: Please be sure to tell school staff if pump goes in or out of auto mode. If the blue shield is up (auto mode “on”), they may give 10 carbs (instead of 15 carbs) for lows.
  • Tips on Continuous Glucose Monitor (CGM) usage in schools:
    1. Please do not expect school staff to constantly view CGM monitors or to follow your child/teens CGM graph on their own personal phones.
    2. We have ordered that school staff respond to CGM alerts and check the CGM display whenever a fingerstick BG is ordered (such as before lunch).
    3. Please be sure the low & high alerts on CGM receivers/apps are appropriate. If they are alerting more than once weekly in the school setting they could be interfering with a normal school day, and either insulin and/or alert settings may need to be adjusted.
    4. Our orders state that rechecks 15 min after treating a low must be from a fingerstick. This is due to the lag time on CGMs.
  • Please consider asking for a 504 plan.
    1. We provide: written orders that only indicate what is medically necessary in a school setting. If you or the school has issues with the medical orders (insulin dose, frequency of glucose checks, etc.), please talk to your provider.
    2. You and the school work together to: determine where care takes place, who supports the child/teen with care, your parental communication preferences, as well as other similar details which can be worked out in a 504 meeting. If you and the school are having difficulty working out details of how to implement the medical orders, please contact our social worker, Yeymi Jimenez, at 408-851-1163.
    3. If you are requesting we change the school orders, please be sure to ask for all changes at once. We have found it can cause confusion in school settings if the orders are changed too frequently, it’s best for all involved to make all the changes at one time.
  • Consider helping when you can at after-school events and extracurricular events as these can sometimes be difficult times to find diabetes care (though diabetes should not cause your child/teen to be excluded from any school events even if you cannot help).
  • Please provide the school with all the medical supplies/information they need to care for your child/teen:
    1. Plenty of treatment for lows (juice, glucose tabs, etc.)
    2. Meter and test strips
    3. Ketone strips
    4. Glucagon
    5. Humalog insulin (even if you use a pump, in case of emergency)
    6. Syringes and/or pen needles (even if you use a pump)
    7. Multiple emergency contact people and phone numbers (in preferred contact order)
    8. Medical orders from our team
    9. Consider providing training, training material, and/or letters to staff (see JDRF School Advisory Toolkit)

If you would like to discuss changes to the medical orders (insulin doses, independence level, etc.), please discuss with your diabetes provider at your visit. If you are having trouble advocating for care in your school setting or if you need more information on a 504 plan, please call Yeymi Jimenez, MSW at 408-851-1163. Thank you!

Sincerely,

Your Diabetes Team