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June 29, 2001

School and Daycare

Question from New York, USA:

I'm in the process of setting up a 504 Plan for my son who is entering kindergarten. The school nurse is the only person on hand to administer glucagon. The nurse takes a lunch hour away from the school or could be involved with another medical emergency. If the nurse is unavailable, the school's next plan of action is 911. I feel another person should be trained in administering glucagon. What are my rights?


Go to the American Diabetes Association website and go to the advocacy section. There is a large amount of material available that summarizes your legal rights under federal statutes. The key is not to antagonize the school officials, but merely to state the facts that they are responsible for a safe medical plan for your child. Exactly how they respond is up to them. There are also several states such as Washington State that have statewide tackled this problem quite successfully. You can use the Washington State material as a model.


[Editor’s comment: You want to be very careful what you ask for. I agree with Dr Brink that you don’t want to antagonize school personnel while, at the same time, you need to be certain that your son is safe while in the school environment, and he is allowed to participate in all school activities. A 504 plan should be designed to meet all of these criteria and constructed in such a way as to assure the cooperation and comfort of those implementing it.

The chances of needing glucagon are very slim, it is expensive, some insurance plans don’t cover it, and it can be very intimidating for a lay person. Glucose gel, rubbed into the gums with a soft baby toothbrush or placed between the cheeks and gums, works nearly as quickly as glucagon. The only situation where this would be difficult or dangerous would be if the child was having a seizure. So, it might be better to have lay school personnel trained in this simpler approach to treatment of hypoglycemia.

Also, see The Law, Schools, and Your Child with Diabetes and Diabetes at School.