Imagine the most difficult type 1 diabetes management task you can think of. For me, I’m thinking a birthday party with a swimming pool and a bounce house, with donuts and a Chinese food buffet, during a growth spurt. Those kinds of factors — foods not usually consumed and unusual amounts of physical activity, coupled with excitement and other variables influencing blood sugar — can be challenging for even those of us parents that have been at this for a long time.
Fortunately, most days are much more ordinary, and it is this ordinariness, this regularity, that helps make it possible for us to outsource the care of our kids to the school nurse. The school schedule itself helps make the nurse’s job a little easier. At both elementary schools that James has attended, the regular snack and lunch breaks are perfectly scheduled during the day so that the nurse can make good assessments of where James’ blood sugar is and provide insulin to cover the foods he eats.
Our school nurses have loved the way that we send in his food. We send him with a lunch from home most days, mostly because that is what he wants to eat. We have an insulated lunch box, a water bottle and a lunch “tray” with a lid in which we put the few items that he says he’ll eat. On the outside of each tray section, I use masking tape and a marker to indicate the carb count. This enables the nurse to communicate with James and ask him what he wants to eat. She can give the proper amount of insulin based on what he’s in the mood for that day.
Every day, I try to put in options that have varying carb counts. Sometimes the nurse will test him and his blood sugar will be high. So I usually include some string cheese that won’t cause his blood sugar to go even higher. I also include a little snack pack of almonds that is fairly low in carbs. Of course, there are days when we really need carbs to keep James stable. He likes to eat crackers or breads, and often he’ll find a homemade cookie!
At the end of last year, James really wanted to try the hot lunch provided by the school. We decided that we would go over the menu when we receive it each month. James can select a few days that he wants to try the hot lunch. The carb count information is provided on the menu so it’s just a matter of communicating with the school nurse, and then he can eat just like all of his friends. On a day-to-day basis, school is actually pretty easy…at least until the day of the school carnival. Bring on the bounce house!
Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring. Jen and Kim are real moms of kids with type 1 diabetes and have been compensated for their contributions to this site.