To most kids, the end of summer means new school supplies, maybe a new wardrobe and nine months of your mom waking you up saying, “time for school!” For me, the beginning of the school year was all of those things, plus an annual meeting with my parents and teachers.
This was the meeting where my parents and I would talk to my teachers to tell them about my diabetes. My elementary and middle school didn’t have a school nurse to go to, so each year we would have the same conversation with my homeroom teacher that year. I can remember my mom saying, “She’s had type 1 diabetes since she was 20 months old. She’s pretty good at taking care of it, but here’s what you should know…” The conversation that followed was something along the lines of:
- Every morning she wakes up, checks her sugar, gets an insulin shot, eats breakfast and then comes to school.
- She’ll need to check her sugar at snack time, before lunch, and sometime in the afternoon. She will always need to wash her hands before and can do this on her own.
- If she’s running around, she’s more likely to go low. If she’s eating high-carb foods she will most likely need an insulin shot from her sister.
- If she’s giving you a blank stare when you ask her a question, her sugar probably isn’t where it should be.
- If she looks washed out, lethargic and/or is saying she’s dizzy, her sugar is probably low. She will need a snack or two, depending on how low she is. She’ll also need to sit out from physical activity during this time because it will cause her sugar to drop lower.
- If she isn’t processing things quickly, is drinking a lot of water, complaining of a headache and going to the bathroom a lot, her sugar may be too high. She may need an insulin shot depending on how high her blood sugar is, non-caloric fluids like water, and she shouldn’t eat anything during this time.
- If she ever passes out you should check her sugar immediately and if she’s low give her a glucagon injection and call paramedics if she does not come around in a few minutes. (This was followed by a demonstration of how and every possible way to contact my parents as well).
We would go through the contents of my snack box and all the related supplies I needed access to during school. That box went with me on field trips as well. It usually included juice boxes, peanut butter crackers, glucose tablets, granola bars and fruit snacks as well as a glucagon shot. All of the items inside had to have a long shelf-life because we never knew when I would need them.
Of course, that conversation was not all-exhaustive. As time went on and I faced new challenges, there were a few other points that got added.
One morning when I was in fourth grade, my mom gave me insulin for a breakfast that I never ended up eating. I went to school and didn’t think twice about it. In my first hour class that day, we were doing a project in the cafeteria- ironically one of the few rooms in the school that didn’t have a supply of snacks for me. I didn’t feel right, so I raised my hand and asked to go check my sugar. I vividly remember walking down the long hallway, barely able to balance. It seemed like the room was tilting and I was tripping over my feet. I finally made it back to the classroom to check my sugar. It read 22. I panicked for a second and ate everything I could find in my snack box and went back to the cafeteria. It took another half hour before I felt okay again. Had I closed my eyes for a minute and fallen asleep, I may not have woken up.
I remember telling my mom that night, watching the fear in her eyes and then having her walk me into my fourth grade class the next day. From that point on, any time I was checking my sugar, someone had to be with me- a teacher, a parent or a friend.
I was 10 years old when I got the insulin pump. Up until that time, I was too young to give myself shots. We still had the same yearly meetings with my teachers, but everything became much easier because I was in control of everything. I didn’t need to rely on my parents to help me in the morning or my sister to help while at school. The conversation then included what to do in extreme scenarios, why I needed someone with me to check my sugar and a basic understanding of how everything worked, followed by “…but you probably won’t have to do anything, this is just in case.”
As I grew older, I started to understand my body better and started to take greater control of my diabetes. Highs and lows seemed few and far between and most teachers never had to do anything. While I couldn’t change my diagnosis, I could change how I dealt with it, which is something I learned as I advanced through my early years into the college student I am now.
Now in 2019, CGM (continuous glucose monitoring) is the standard of care, and with devices that have alerts and alarms and the ability to share glucose values in real time with others such as parents, having diabetes as a kid in school has really changed. However, something as simple as a yearly meeting and a few snack boxes at my school gave me, my parents and my teachers peace of mind and comfort knowing I was prepared- just in case. In some ways it actually helped me feel like all the other kids. I could focus better in school, wouldn’t have to worry about “making a scene” and I could enjoy my time with my friends. Rather than letting my diabetes control my childhood, I learned how best to prepare for the “what if” scenarios and that gave me the freedom to be a kid.