Things have been going well this year with our 504 plan, but a couple of major factors have led us to make some changes. As a result, I took the opportunity to meet with our diabetes team at school—principal, nurses, Kaitlyn’s teacher, and the health clerk.
First, we officially added to the plan that Kaitlyn would be using a CGM (continuous glucose monitor) that transmits data to my cell phone. This means that she will have her phone with her at all times as the uploader device, so that I can see her blood sugar numbers from my phone at any time of day. We also set up our school nurse with an app that will follow Kaitlyn’s numbers as well. I think it’s so great that she cares so much about keeping Kaitlyn’s blood sugar in check—she’s actually willing to set up her personal cell phone and smartwatch to follow Kaitlyn’s numbers even when she’s running around to the other schools that she visits throughout the day.
Second, Kaitlyn is growing more mature and capable, and she’s ready to give insulin through her pump on her own. I have written many times about our road to independence, and while we are not anywhere near the end of that road, we are definitely moving in the right direction.
When Kaitlyn was first diagnosed, she did nothing on her own. When she first went to kindergarten, the nurse did everything for her. Every shot given, finger pricked, number read, and button pressed was done by the nurse. Gradually, Kaitlyn began testing her own blood sugar, adding up carb counts, and operating her pump. Since then, everything has still been done under the careful eye of her nurse, who is only there at regular, scheduled times. Even though the health clerk is at school all the time to oversee things and to give juice for an emergency low, our procedure nurse (who is an R.N.) has been the only one legally allowed to give insulin.
This has worked out so far, because Kaitlyn gets regular checks anyway several times a day—right before I drop her off, at snack time, at lunch time, at afternoon recess, and then again right after school. That has been often enough to catch most of the highs and lows, and it has been convenient and predictable for the nurse. As we all know, though, blood sugars are anything but convenient and predictable. I felt that it was time we fine-tuned things a little bit: Kaitlyn should be allowed to give herself her own corrections at any time of day as long as a responsible adult knows about it—not necessarily the procedure nurse. Our endocrinologist agreed, and she wrote up the orders to allow Kaitlyn to give her own corrections.
How have all of these changes made a difference for us? The other day, I dropped Kaitlyn off at school with blood sugar in range. Soon, however, her breakfast of buttery waffles began to catch up with her, and by 9 a.m., the “high” alarms began to go off on my phone. I knew the nurse would not be at school for another hour, but because her CGM indicated that her blood sugar was still on the rise, I thought it would be best to catch it right away. I called the school and texted the nurse. Within two minutes, Kaitlyn was called to the office, where she was able to quickly test her blood sugar, give a correction through her pump, and go back to class. Within about 20 minutes, I saw her numbers dip back down and go right back in range. Under our old system, Kaitlyn would have had to wait for a correction until the nurse was there at snack time. Her blood sugar would probably have continued to rise, possibly even putting her in a position to battle highs for the rest of the day. This new system lets us react more quickly, so we can keep tighter control throughout the day.
It’s great to have a solid school plan in place, but it’s even better to revisit the plan regularly and make those adjustments that lead to independence!
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.