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November 12, 2004

School and Daycare

Question from Florida, USA:

Today, my son got some of his tests back from school. When I looked at his spelling test, he did not fail the test, but some of the words were spelled funny. In other words, this was not his usual work. I teach were my son goes to school and that week he did have a few lows. I talked to the principal and she stated that he did not tell the teacher he felt low. The problem is that he was low a lot when on shots and is now on the insulin pump. The lows have gotten better, but when he does go low he usually does not realize it until his level is in the 40s mg/dl [2.2 to 2.7 mmol/L]. When he came to me with the lows, I did not think to ask him if he had taken any tests. I am not sure how to handle this with the teacher or the school. It is a Christian school and they are very good about things like this. Should my son be allowed to delay school tests or retake them if he is low at school? The principal does not want my son to use diabetes as an excuse to retake a test. We can't test before every test. I am just not sure what to do. After a low, how long should you wait before testing?

Answer:

I am concerned about your son’s inability to recognize his low blood sugars. Has he had frequent lows which might have created hypoglycemia unawareness? If so, his blood glucose targets should be adjusted to prevent so much hypoglycemia. This allows his body to recognize, once more, what a low blood sugar feels like.

It also sounds like a formal plan needs to be worked out with the school. It may be necessary for a blood glucose check to be done before major tests. If your son treats a low blood glucose, he should be able to complete the test once his blood glucose is back to target.

Your principal�s concern is valid about not using diabetes for secondary gain. It is always a possibility where children are concerned. Watching how frequently your son is requesting a re-test should help to rule out such manipulation.

BS