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March 29, 2002

School and Daycare

Question from Clifton, Virginia, USA:

My 11 year old daughter was diagnosed with type�1 diabetes four weeks ago after going into DKA [diabetic ketoacidosis]. This was extremely traumatic for her as well as the entire family. She has returned to her small parochial school where she is a sixth grader. The actual facility is lacking an adequate clinic, cafeteria, classroom space, etc., and privacy has been a concern for my daughter. The entire school knew of her hospitalization and diagnosis before she returned to school. How can she maintain privacy for glucose monitoring when the clinic measures approximately five by six feet and is always filled with other students? She must leave her classroom before lunch and during hypoglycemic reactions to travel one floor down to the clinic for glucose monitoring. She does not want to go to the nurse's clinic for glucose monitoring, but would like to utilize a room on the second floor. Space is limited, but I think we could find a room or space for such a purpose. Does she have the right to request such? I understand some schools do not allow monitoring at all. The staff is so anxious regarding my daughter's hypoglycemic reaction, is there something more I should be doing to alleviate their anxiety? My husband and I provided an in-service to the entire school staff, and we personalized it so they would know exactly what my daughter's hypoglycemic reactions would entail. The endocrinologist says my daughter is not special nor is she different, but that is not how the school treats her. She is "honeymooning" right now, and, almost every day she has a hypoglycemic reaction which disrupts the class and makes her different. Don't misinterpret, I am pleased that she is in a loving school environment, but my life is now consumed by this disease, and the school staff's anxiety. I have not been able to go anywhere unless my daughter is with me. I must stay by the phone all day long awaiting the call I know will come regarding an insulin reaction. I could move in to the school; although, her doctor is opposed. I could home school, but that would isolate my daughter even more. Would public school be more equipped to deal with this disease? Any suggestions as to how to make school a normal every day activity as before her diagnosis?


I am not a lawyer, but as I understand it regarding her “rights” to request special space, I do not believe a private school is required, unless they receive some Federal monies, and then you could request a 504 Plan and IEP under the American with Disabilities Act. [ED: See The Law, Schools, and Your Child with Diabetes.] However, I think the issues are really broader.

It sounds as if your daughter is “trying to hide” her diabetes, and that is understandable, but perhaps not too realistic. Teachers know. Students know. Her friends know. Would counseling help her to embrace the support and help that these people can give? This may be especially true as she honeymoons and is experiencing the hypoglycemia that you describe. While you and she may not believe me, her friends really don’t care that she has diabetes. One need not dramatically flaunt diabetes — management can be subtle and unobtrusive with deskside glucose monitoring (with a proper place to put needles out of harm’s way) and easy access to a snack. I’d still gently work with the school folks and ease them into being your advocate and ally, rather than being adversarial. Find initial compromises and go from there.

Additional comments from David S. Holtzman, Esq.:

Virginia law requires that each school have personnel who are trained to administer insulin and glucagon. There is no provisions covering the issue that you raise. As for the issue of privacy, in my opinion, the school has a reasonable basis to expect that a minor child should be in the presence of an adequately trained staff person while testing their blood glucose levels. If there is only one or two people in the school trained to administer insulin and glucagon then it follows that the child be directed to perform such procedures in the school clinic. Further, I am not certain if the law requiring trained personnel applies to a parochial school. For further assistance you might want to contact the American Diabetes Association National Office. They have staff with extensive knowledge in this area.