Diabetes Care in Schools

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States that have passed school diabetes care legislation are marked in red.

Diabetes requires management 24 hours a day, 7 days a week.

For most students with diabetes, this means monitoring blood glucose (sugar) levels throughout the day, multiple daily insulin administration, and responding to diabetes emergencies. It is important to keep blood glucose levels within target range to prevent the dangerous short-term and long-term complications that can result from blood glucose levels that are too high or too low. When students are able to keep their blood glucose levels in check, they are healthier and are more productive at school and at play. 

Accordingly, students with diabetes need a supportive environment to help them take care of their diabetes throughout the school day and at school-sponsored activities. Unfortunately, most schools do not have full-time nurses on campus. In many instances, a single nurse is assigned to cover as many as 10 schools. Even when a school has a full time nurse he or she will not be available at all times, such as during field trips and extracurricular activities. All too often, students with diabetes are left with no assistance in caring for their diabetes and are denied the opportunity to participate in field trips and other extracurricular activities, or even told they can’t attend their neighborhood school.  The safe solution is to train school personnel to perform needed diabetes care tasks when a school nurse is not present.

The American Diabetes Association’s Safe at School Campaign advocates for a team approach to school-based diabetes care.. The campaign is based on protocols established in the National Diabetes Education Program’s  “Helping the Student with Diabetes Succeed: A Guide for School Personnel.” This guide is supported by the Centers for Disease Control, National Institutes of Health, U.S. Department of Education and key organizations in the diabetes and education fields.

The basic principles behind the Safe at School campaign are:

• All school staff members who have responsibility for a student with diabetes should receive training that provides a basic understanding of the disease and the student’s needs, how to identify medical emergencies, and which school staff members to contact with questions or in case of an emergency.
  
  

• The school nurse holds a primary role of coordinating, monitoring, and supervising the care of a student with diabetes. However, in addition to any full- or part-time school nurse, a small group of school staff members should receive training from a qualified health care professional in routine and emergency diabetes care so that a staff member is always available for younger or less-experienced students who require assistance with their diabetes management (e.g., administering insulin, checking their blood glucose, choosing appropriate food) and for all students with diabetes in case of an emergency (including administration of glucagon). These staff members should be school personnel who have volunteered to do these tasks and do not need to be health care professionals.
  
  

• Children possessing the necessary skills and maturity to do so should be permitted to self-manage their disease in the classroom or wherever they are in conjunction with a school-related activity. Such self-management should include monitoring blood glucose and responding to blood glucose levels with needed food and medication while utilizing appropriate safety protocols.

SAS principles are endorsed by the American Academy of Pediatrics, American Association of Clinical Endocrinologists, American Association of Diabetes Educators, American Dietetic Association, Children with Diabetes Disability Rights Education Defense Fund, Juvenile Diabetes Research Foundation, Lawson Wilkins Pediatric Endocrine Society, and Pediatric Endocrine Nursing Society.

ADA has led legislative or regulatory initiatives in 17 states to improve diabetes care in schools.  ADA remains committed to improving the school environment for children with diabetes and to ensuring that all children with diabetes have equal access to educational opportunities.

The American Diabetes Association urges legislators to support the principles of the Safe at School campaign and oppose legislation that would impede the ability of a student with diabetes to safely participate in all school activities. 

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