One in 300 Canadian children are living with type 1 diabetes. This disease occurs when the pancreas does not make enough, or any insulin. Insulin is an important hormone that allows one’s body to convert glucose—or sugar—into energy. Without insulin, glucose levels in the blood become dangerously high and can be life-threatening if left untreated. Children with type 1 diabetes need regular glucose checks and must receive insulin injections or wear an insulin pump every day.

If you are the caregiver of a child with diabetes, especially if they’ve been recently diagnosed, safely managing this condition can be complex and overwhelming. It is important to find the right balance of food, insulin and exercise that will keep blood sugar levels in a healthy range. After figuring out the day-to-day management at home, transferring this to the school day and other social situations like birthday parties can cause a lot of anxiety for families.

However, encouraging your child to manage their diabetes more independently over time will help to normalize their diagnosis, allow them to keep doing the things they enjoy and lead to positive lifelong habits. Read on for some specific tips to help you safely navigate these situations and better prepare educators, peers and other adults in your child’s life.

School

After a diabetes diagnosis, many families worry that their child will be excluded from certain activities and that they won’t have the support they need, not to mention worrying about their safety during the school day. Here are some ways to help your child manage their diabetes at school and have a more positive and healthy school experience:

Make a Management Plan

School staff need to be trained, equipped and available to help your child with daily diabetes management and to provide appropriate support in the event of an emergency. Blood sugar levels can change quickly and the amount of insulin your child needs can be impacted by new schedules, activities, different food options and stress. Even if your child manages most of their care themselves, they may need help if they are unwell. A diabetes management plan must be completed with your child’s school and should include:

• Information on insulin and any other medications
• Directions for the device used to check your child’s glucose levels (blood glucose meter or continuous glucose monitor)
• How (if necessary) to support blood sugar testing
• Target glucose levels
• Signs of low blood sugar (hypoglycemia) that are specific to your child—nervousness, anxiety, hunger, etc.
• How to manage low blood sugar
• When to call emergency services
• Guidance on physical activity

Diabetes at School, created by the Canadian Paediatric Society, Diabetes Canada and the Canadian Paediatric Endocrine Group, provides a customizable Individual Care Plan (ICP) with all of the above information included. After completing, print and review with any school staff who may be with your child during the day. Don’t forget the principal, bus driver and school office team. This resource also provides a quick-reference sheet that briefly outlines all daily diabetes-related tasks for immediate access in the classroom. Update this plan at the start of every school year to reflect any changes. Diabetes at School also has an online course available for educators and school staff to make sure they understand the details of your child’s management plan. It’s a good idea to encourage your child’s immediate teacher to complete this one-hour, self-directed course.

Educate Classmates

Many kids living with diabetes avoid talking about their diagnosis and don’t want to feel ‘different’ or ‘special’. To help your child feel more comfortable, reduce the number of curious questions and empower other children to recognize the symptoms of a diabetic emergency, you should encourage your child to speak openly about their illness.

Particularly for grade-school children, it’s often valuable to teach the whole class or the entire grade about type 1 diabetes. Some caregivers choose to go into the school to talk directly to classmates. Others may find that sending an email and asking families to share this information with their children to be more effective. You will know the best approach for you and your child based on their comfort level with their diagnosis. To prevent some of the common misconceptions that children have around diabetes (e.g., it’s caused by too much candy, others can catch it, or that their friend is going to die) aim to cover:

• What type 1 diabetes is—making it clear that it isn’t caused by diet or lifestyle
• The process of checking blood sugar levels
• How diabetes can be safely managed through insulin or glucose pumps

Create a Packing Checklist

Make a checklist for you and your child to refer to every morning so you know that they have everything they need for their diabetes care at school. While everyone’s treatment plan is different, this checklist may include:

• Insulin dosing schedule and totals
• Alcohol wipes, test strips, lancets
• Blood sugar meter and extra batteries
• Insulin pens or syringes
• Glucose tablets, juice boxes, candy or other fast-acting carbohydrates like raisins
• Glucagon emergency kit
• Medical ID necklace or bracelet

What your child needs at school will depend on their specific symptoms and treatment plan. Always connect with your diabetes health team to create your child’s individual care plan and packing checklist.

Social Events

The excitement, party foods and high energy activities at birthday parties and playdates can make it tricky to manage blood sugar levels. This can be quite stressful for parents, and if your child’s at an age where they don’t want you around for these events, your concern may only increase. With some extra planning, a little practice and open conversations, your child can have the opportunity to strengthen their friendships and work on developing social skills in a variety of situations. Here are some tips to help you:

Plan Ahead

Before the party, playdate or sleepover, contact the host parent or loved one to get an idea of what to expect. Ask questions about the planned activities, food options, timing and other important pieces that may impact your child’s diabetes routine. Once you know the plan, you can pack a separate meal that will meet your child’s requirements. Or, working with your child’s diabetes care team, you may be able to adjust their insulin dose so that your child can eat the same food as the rest of the guests. This conversation is also a good opportunity to go over your contact information, help the host be more aware of the signs of low blood sugar and to know what to do in an emergency.

Go Slowly

Even after all your planning, you may still feel nervous about leaving your child. It’s okay to move slowly—especially if they have been recently diagnosed. If your child uses a continuous glucose monitor that sends their glucose levels to your phone, you can park around the corner so you’re close by if their levels move out of a healthy range. Or you could call or video chat to help during testing and dosing times or pop in mid-party to give insulin and quickly leave again. Remember that there are lots of parents who stay at birthday parties or playdates even if their child does not have a health condition. Your child’s safety is always your top priority.

Don’t Expect Perfection

Although managing these special events may be tricky for parents and caregivers, try to remember that this is one day. Birthday parties and other special events don’t happen all the time, so do your best. If blood sugar levels are just a little higher than usual, you can correct it when the party is over. It can be very beneficial to show your child that type 1 diabetes doesn’t mean that they can’t have any fun or do the things that they love—within a safe range of course. Your health team can help you modify activities, food and medications throughout the process of adjusting to your care plan.

Living with a chronic disease like diabetes is hard. There are a lot of emotional challenges that can come with the physical ones and these are felt by both children and their caregivers. Kids may feel guilty for the complications that come with disease management and that they are missing out on a ‘normal’ childhood. You may all experience sadness, anger, frustration, anxiety and depression and these feelings are both normal and understandable. To help you learn as much as you can, organizations like Diabetes Canada provide a wide range of information and support. Also, talking with other kids and families dealing with type 1 diabetes, either through online or in-person support groups, can help you feel less alone in your struggles.

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If you found this article helpful, you may also want to read:

• Coping With Diabetes Distress
• Dining Out With Diabetes