For some families, getting ready for a new school year requires them to buy clothes, backpacks and notebooks. But for families of children with diabetes, back to school also necessitates meeting with school staff to review the child’s diabetes management plan.

Diabetes is one of the most common chronic diseases in school-aged children. Most kids with it have type 1 diabetes, a condition in which the immune system destroys the body’s insulin-producing cells.

Insulin does not cure diabetes, but allows the person with type 1 diabetes to get energy from the foods they eat. Children with diabetes or their caregivers must be very knowledgeable about how various foods and the timing of meals and snacks affect blood sugar. Often, the child’s insulin will need to be adjusted accordingly.

The nutritional needs of children with diabetes are the same as those for kids without diabetes. The only real difference is that children with diabetes need to take insulin before they eat. Typically, insulin is dosed based on the amount of carbohydrates they consume. Some children will have a meal plan that requires a consistent amount of carbohydrates from day to day. Other kids may have a more flexible meal plan that allows for the adjustment of insulin based on the number of carbohydrates they choose to eat. Occasional treats are allowed, but must be worked into the plan. It is important for the school to follow the meal plan that is prescribed by the child’s doctor.

The time of day that a child with diabetes eats lunch can also affect blood sugar levels. With school schedules the way they are, some kids eat lunch at 10:30 a.m. and others at 1 p.m.. The child’s lunch time must be written in the school plan. Variations in the lunch schedule due to testing or other school activities need to be communicated to the child’s family. Parties and field trips also require prior communication with the family.

A child’s blood sugar is also affected by physical activity. If recess or PE is scheduled after lunch, some children may be able to change the amount of insulin they take at lunch. Others kids will need an additional snack before physical activity.

Fortunately, children and their families have help when it comes to managing diabetes during the school day. According to the American Diabetes Association, schools should provide information on the serving size, calorie, carbohydrate and fat content of foods served. This information will help the child get the right amount of insulin for school lunch or breakfast meals. The school should ensure that the? child is getting the correct serving size and have a back-up plan if the child does not eat all of the meal.

The American Diabetes Association has a lot of very helpful back-to-school information for families and school personnel. The ADA can be reached at 1-800-DIABETES (1-800-342-2383) or online at www.diabetes.org.

Another great resource is “Helping the Student with Diabetes Succeed – A Guide for School Personnel” from the National Diabetes Education Program. A single printed copy is free, or it can be downloaded at http://ndep.nih.gov. To order NDEP publications by phone, call 1-888-693-NDEP (6337).

The Juvenile Diabetes Research Foundation has a School Advisory Toolkit available. Call 1-800-533-CURE (2873) to request a copy.