March 8, 2003
Hyperglycemia and DKA, School and Daycare
Question from Lebanon, New Hampshire, USA:
My 14 year old son was diagnosed with type 1 diabetes on his 12th birthday, and because of my husband’s work, we have made out of state moves twice in the past two years so we are on our third pediatric endocrinologist.The first two physicians told me to keep my son home if his sugar is over 350 mg/dl [19.4 mmol/L], but the third says send him to school no matter how high it is or to bring him in. I cannot bring him in every time his sugar is that high, and when it is, he feels terrible. He is very lethargic, has headaches, is weak, and does not do well in school. I have to drive him to school because he is too tired to stand at the bus stop, and he barely makes it through the day. Are the first two doctors right or is this one? At what glucose level should I not send my son to school? Should I send him no matter what?
I would suggest evaluating the cause of the high blood sugars and work to avoid them as you likely are already doing. Your physician has likely had a bad experience with patients that manipulate their blood sugars to avoid school. Although, I certainly see a need to hold a child at home for occasional illness, I would hesitate to set a limit to blood sugars for school attendance. I would recommend working diligently to fix the high blood sugar and proceeding with school. Working hard to keep a child from using diabetes as an excuse to avoid schoolwork is very important.