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June 3, 2001

Hypoglycemia, School and Daycare

Question from a nurse in Amherst, Massachusetts, USA:

I'd like to know what your thoughts are about the efficacy of glucose gel versus glucagon in case of emergency in a child with diabetes on a school field trip. Since only a licensed person can administer glucagon, we are trying to figure out if we have any safe and realistic alternatives to having either the nurse or parent along for every field trip this 10 year old goes on.


Federal law and state law in Massachusetts mandates that schools have appropriate, reasonable and mandatory education plans — including medical coverage — for kid with diabetes. So, first of all, it is the school’s responsibility to ensure that a trained adult (nurse or teacher or administrator is up to the school) knows how to recognize and treat hypoglycemic emergencies including the use of glucagon injections.

Glucose gel or any other oral glucose product would work fine for mild or moderate hypoglycemia where swallowing is not impaired. If a child is severely unconscious and in danger of choking or aspiration, it is incorrect to use oral glucose gel since it would place that child at risk — and would also take too long — 5-15 minutes — to raise the glucose levels under such an emergency situation.

I would suggest that you go back to the school and remind the school personnel of the Federal and state laws since they must adhere to such laws.