September 23, 2002
School and Daycare
Question from Pepperell, Massachusetts, USA:
My son, diagnosed at age two, has started Kindergarten. We have always tested his blood sugar before each meal and snack, and at 3:00 am. His school is looking for documentation for testing at snack time, but everywhere I look, the guidelines seem to be for before meals only. Am I alone in my schedule with my son? If there is a low, I often catch it at snack time which lets me know to adjust insulin at meal times.
I cannot supercede the advice that you have been given by your son’s pediatric diabetes specialist., and I would not want you to do things that you are very uncomfortable with. So if you want to or need to check his glucose that often, then you should do so and your son’s team should support you.
However, you do not indicate which insulin regimen your son is on, so I should also add that, in general, it usually is not necessary to check glucose levels as often as you routinely do (again depending on the specific, individualized diabetes plan). There is some growing evidence that checking glucose levels after meals may be more important than classic teaching, but it probably depends on the insulin plan. Checking before meals and bedtime, and as needed for illness or hypoglycemic symptoms, is usually adequate.
[Editor’s comment: If your son’s physician strongly feels that your son needs to have blood sugar testing that often, he should write a letter of medical necessity.