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The first day of school: Inhale, exhale, it’s going to be okay

school lunch

When kids with type 1 diabetes start school, it can be scary for parents, too. Having some plans in place can help.

Sending your young child off to daycare or school for the first time can be stressful.

It’s an emotional experience—for both of you! And when your child has type 1 diabetes, there are many other concerns.

The good news is that most daycare groups and schools are already familiar with diabetes care. And, if they are not, they will need to get up to speed very quickly. That's because, by law, they are required to meet your child's diabetes care needs.

We can help you take an active role to ensure that this happens as smoothly as possible.

Start with:

  1. Putting your child’s care plan in writing
  2. Reaching out to your child’s diabetes care teamDiabetes care teamYour diabetes care team may include a primary care doctor, a diabetes and hormone doctor (endocrinologist), a registered nurse, a diabetes educator, a dietitian, a heart doctor (cardiologist), a foot doctor (podiatrist), an eye doctor (ophthalmologist/optometrist), a kidney doctor (nephrologist), a dentist, a pharmacist, and a mental health professional. and school or daycare staff to create a plan that everyone can understand. This way, everyone will know what to expect and how to help.

Here are some of the plans that are available.

Diabetes Medical Management Plan (DMMP)

The DMMP is a plan to help everyone involved in your child’s care understand his or her diabetes care needs. It goes into a lot of detail, including what your child can do on their own and what he or she may need help doing.

You and your child’s diabetes care team can work together on creating one and then discuss it with your child’s school or daycare facility before finalizing it.

Your DMMP will contain important information such as:

  • When your child was diagnosed with type 1 diabetes
  • Emergency contacts
  • Specific instructions for:
    • Blood glucoseBlood glucoseThe main sugar found in the blood, and the body’s main source of energy. monitoring (testing)
    • Taking insulinInsulinA hormone made by the beta cells in the pancreas that helps glucose move from the blood into the cells. Insulin is also an injectable medicine that is used to treat diabetes by controlling the level of glucose in the blood. and other medicines
    • Meals and snacks
    • Physical activity
    • Dealing with low blood glucose (hypoglycemia) and high blood glucose (hyperglycemia)
    • Checking for ketonesKetonesOrganic compounds produced when the body breaks down fats and fatty acids to use as fuel. This is most likely to occur when the body does not have enough glucose or carbohydrates or the body cannot use glucose effectively. Because high levels of ketones are dangerous, a urine test is one way to check the level of ketones in your body.
    • Emergency evacuations

DMMPs should be updated at least once every year to keep up with:

  • Changes in your child’s care plan
  • Diabetes self-management ability
  • Daily school

For information on creating a DMMP and to download a sample form, visit the American Diabetes Association website at www.diabetes.org.

woman taking selfie with daughter diabetes medical management plan
Section 504 Plan

The Section 504 Plan is the next step to take after creating a DMMP. It helps make sure students with diabetes have access to the same education as children without diabetes.

Based on the DMMP, the Section 504 Plan clearly outlines the responsibilities of everyone involved:

  • The student
  • Parents/guardians
  • People who work at the school

The 504 is a game plan for working through challenges and avoiding problems. It is similar to a DMMP, but is more focused on making sure your child’s educational needs do not suffer because of their physical needs.

For more information on 504 Plans and to download a sample form, visit the American Diabetes Association website at www.diabetes.org.

Individualized Education Program (IEP)

An Individualized Education Program (IEP) is used for children with disabilities. It is a plan to make sure they get the special education services they may need.

In many cases, children with type 1 diabetes do not need an IEP because everything they need is already covered in the Section 504 Plan. Other children may have a harder time learning because of their type 1 diabetes. That’s when it may make sense to work with your child’s school to create an IEP.

Special needs that you may want to consider including in your child’s IEP could be:

  • Make-up tests as needed. If your child has a blood glucose high or a low during an exam, it should not be held against him or her. They should be allowed to retake it
  • Flexibility in attendance requirements. Especially in the case of health-related absences, including doctor visits
  • Bathroom breaks. Permission to leave class to use the restroom as needed
  • Diabetes management time. Allowing your child enough time to adjust or inject insulin, check blood glucose, and complete meals and snacks
  • Something to drink. Access to increased fluid intake as needed

For more detailed information on your child’s rights in school or daycare, visit the following websites:

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