American Diabetes Association Releases Position Statement on Diabetes Management in the Childcare Setting

Alexandria, Virginia
September 23, 2014

Offers Resources for Childcare Providers Who Care for Young Children

Very young children with diabetes have legal protections and can be safely cared for by childcare providers with appropriate training, access to resources and a system of communication with parents and the child’s diabetes provider, according to a position statement being published in the October issue of Diabetes Care.

“People are sometimes afraid that putting a child with diabetes in childcare can’t work, but it certainly can and does,” said Larry C. Deeb, MD, clinical professor of pediatrics, Florida State University College of Medicine, past president of the American Diabetes Association and co-chair of the Association’s Safe at School Working Group. However, he added, it’s also important to recognize that very young children are totally dependent upon adults, and therefore the adults in charge of their care must receive the appropriate training and education to be able to monitor blood glucose levels, administer insulin and recognize symptoms indicating that glucose levels may be too high or too low.

The provider should also collaborate and communicate with parents/guardians and the child’s health care provider, the position paper asserts, while recognizing some of the challenges that may occur, such as staff turnover, language barriers, ethnic and cultural practices, health literacy and limited resources and support.

Diabetes among children has been increasing over the past decade. This increase in prevalence, along with the lack of guidelines for daycare providers, prompted the Association to develop this position statement to aide childcare providers and families of very young children with type 1 who wish to place their children in a childcare setting.

As part of its newly developed position statement, the Association has developed a sample diabetes management plan for children in the childcare setting, along with resources and tools, such as a tip sheet for parents that can be found online at “You can’t just drop these kids off,” Deeb said. “But at the same time, we have put together tools that people can use to successfully and safely take care of children with type 1 diabetes during their time in childcare.”

“This can save the life of a young child,” said Jane L. Chiang, the Association’s Senior Vice President for Medical and Community Affairs. “Children at this age have very limited communications skills. They may not be able to articulate what’s wrong. They may be hyperglycemic, or high blood glucose levels, which can lead to excessive urination and be mistaken for just having a heavy diaper. Or they may be hypoglycemic, experiencing low blood glucose, and acting out. A childcare provider who is unaware that diabetes may be triggering this may not realize they should be checking that child’s blood glucose levels.”

In addition to better diabetes care, the guidelines were designed to help children so that they can live normal lives, Dr. Chiang said. “For example, if there’s a birthday party, the child with diabetes shouldn’t be left out of the celebration.  We just want the childcare provider to be able to check the blood glucose and give insulin for the piece of birthday cake if that is the management plan. We want to adapt diabetes to the child’s life, not the other way around.”

For more information on the Association’s position statement, or to obtain a copy, please visit

About the American Diabetes Association

Nearly half of American adults have diabetes or prediabetes; more than 30 million adults and children have diabetes; and every 21 seconds, another individual is diagnosed with diabetes in the U.S. Founded in 1940, the American Diabetes Association (ADA) is the nation’s leading voluntary health organization whose mission is to prevent and cure diabetes, and to improve the lives of all people affected by diabetes. The ADA drives discovery by funding research to treat, manage and prevent all types of diabetes, as well as to search for cures; raises voice to the urgency of the diabetes epidemic; and works to safeguard policies and programs that protect people with diabetes. In addition, the ADA supports people living with diabetes, those at risk of developing diabetes, and the health care professionals who serve them through information and programs that can improve health outcomes and quality of life. For more information, please call the ADA at 1-800-DIABETES (1-800-342-2383) or visit Information from both of these sources is available in English and Spanish. Find us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn)