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One-page Instruction Sheet for Teachers

When you send your child to school, you should include some kind of instructions for the teacher that describe what you expect of the teacher. The instructions should include a list of symptoms that your child exhibits when he or she is hypoglycemic, when you expect the child to perform blood glucose tests, and how to respond to episodes of hypoglycemia.

Written instructions are particularly important when your child has a substitute teacher. Make sure that your instructions are prominently posted in the classroom, preferably close to the teacher's desk. You might even want to print it on bright yellow or pink paper so that it stands out.

The following example must be adapted to the needs of your child with the help of your diabetes team. 

Remember, this is only an example.

Guidelines for Caring for [child's name]

  1. When to do a blood sugar check
    1. She says "I'm low," especially if during or after exercise.
    2. If she has symptoms of low blood sugar, including:
      • Irritability
      • Erratic responses to questions
      • Sleepiness

  2. What to do based on her blood sugar reading
    (Remember, this is only an example and must be adapted to your child's specific needs.)

    Under 60 Give two Glucose Tablets, followed immediately by food containing 30 grams of carbohydrates. If she doesn't respond within 10 minutes, telephone her mother/father, [name/name], at [phone number] for further instructions.
    61 to 100 Give one Glucose Tablets. If a meal or snack is within 30 minutes, she can wait, otherwise give her a snack including carbohydrates and protein, such as cheese crackers with peanut butter or cookies and milk.
    101 to 125
    She is fine. If exercise is planned before a meal or snack, she must have a snack before participating. This includes recess.
    126 to 200 She's fine. She could feel low if she was previously high and is dropping.
    201 to 240 She's a bit high, but this is not uncommon for her, especially in the early morning.
    Over 240 Her blood sugar is too high. She must be given access to water or other non-caloric fluids. Use of the bathroom must be allowed as needed.

    She needs to check her urine for ketones. If ketones are present, the parents or the diabetes team should be called for advice.

    Note: She may confuse being this high with being low, since many of the symptoms are similar.

  3. When giving sugar, the following are roughly equivalent:
    • Four ounces of fruit juice
    • 1/2 to 1 cup of milk
    • Two glucose tablets (some are different: 10-15 grams of sugar are recommended)
    • One-half tube of Cake Mate (should be placed between the cheek and the gums if unable to swallow)
    • One-half of a can of soda (regular, NOT diet!)

    Chocolate candy is not to be used unless there is no other source of sugar available. It is often not absorbed quickly enough, due to fats in the candy.

If the blood sugar remains low despite treatment and the student is not thinking clearly, the parents or the diabetes team should be called for advice.

Following an episode of low sugar, it can take several hours to fully recover. Hence, the student should not be expected to perform at optimal levels. However, diabetes should never be allowed to become an excuse for school performance.