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November 25, 2002

School and Daycare

Question from North Attleboro, Massachusetts, USA:

I have an eight year old student who has had type 1 diabetes for two years, and her blood sugars at school fluctuate widely (29-598 mg/dl [1.6-33.2 mmol/L]. She is falling behind in her studies and always appears to be “spacing out” in class. I have been told by her doctor’s office that there is no correlation between the fluctuation in blood sugar and the drop in her grades. Could you please send me information regarding this?


Frequent blood sugar lability can clearly be correlated with impaired school performance. The key is to avoid the lability by adjusting insulin dosing to better meet the child’s needs. It would be an error to simply adjust the school plan to accommodate the blood sugar lability chronically rather than actually treating the problem. Occasional accommodations must be made for those unfortunate days when this may be happening, but on the whole, those days should be infrequent if the diabetes is being appropriately treated.