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April 8, 2007

School and Daycare

Question from Fleetwood, Pennsylvania, USA:

The school nurse was rushing around and entered 186 grams of carbohydrates into my daughter's pump instead of 62 grams of carbohydrates, thus overmedicating her by 6.3 units of insulin. She had no idea how to correct this problem. I instructed her to give her juice and glucose tablets and immediately remove her pump. I had to bring my daughter home from school for monitoring. This was not the first mistake. The nurse is continually arguing with us and not following our instructions. We have a 504 plan, but it was not finalized by her and sent around the school until March (we provided the information in August). We brought up our concerns with the principal, but nothing has happened. What are our options here?


The school nurse needs to follow your child’s Diabetes Medical Management Plan or physician’s orders that should specify a carbohydrate to insulin ratio as well as treatment for hypoglycemia. The DMMP or orders should also authorize you as the parent to make adjustments. I recommend coordinating a meeting or phone call between your child’s CDE and school nurse to clarify. Also, you may also want to arrange for your insulin pump company to do an in-service training (usually for free).