Helping Your Child With Diabetes Feel More Comfortable at School
By Arvind Sommi
Many parents are wondering how they can best look after the mental wellbeing of their child with type 1 diabetes. We spoke with a licensed mental health counselor to provide you with several easy and actionable tips.
A coalition, including the American Academy of Pediatrics (AAP) and more than 77,000 physicians, declared a national emergency in child and adolescent mental health in October 2021.
“Children's mental health is suffering,” said Dr. Lee Savio Beers, AAP president. “Young people have endured so much throughout this pandemic, and while much of the attention is often placed on its physical health consequences, we cannot overlook the escalating mental health crisis facing our patients.”
In the midst of this crisis, families that have children with type 1 diabetes face unique challenges. We spoke with Dara Melnick, a licensed mental health counselor, to learn how parents can look after the mental wellbeing of their child with type 1 diabetes.
Melnick was diagnosed with type 1 when she was 8 years old and has been living with the condition for 32 years. “I vividly remember the day I was diagnosed with diabetes being one of the scariest moments of my life, knowing then that my whole life was going to change, and I was fearful as to how,” she said.
Now, Melnick works on the emotional management of adults and children who have type 1 and other chronic illnesses. Motivated by her own journey with diabetes, she encourages people to build healthy coping skills to live with the daily stressors of their condition and assist them in managing any fears that come up.
What are some of the mental health challenges that children and teens with type 1 may face as they move from home to school?
“Life is difficult enough for a child or teen,” said Melnick, “[when you] add in diabetes, the ‘mountain’ is even harder to climb.”
At home, parents should try to establish a consistent routine for their child. For example, they might always give their child insulin at a particular time and are there to comfort them during this process.
As more children get vaccinated and schools reopen in person, your child might lose this familiar routine you can provide at home and will need to adapt to a new and dynamic environment. Your child may have to visit the school nurse at different times than they are used to at home, or they may have different nurses on different days.
“The smallest change in routine or feeling/emotion can throw off the whole day for someone with type 1 diabetes,” said Melnick.
Your child may also struggle to “fit in” with their peers as they manage their diabetes. In addition to “peers questioning why they are at the nurse so much,” children with type 1 diabetes might have trouble playing certain sports or having to explain their diabetes devices. For example, when they are “changing in the locker room and their continuous glucose monitor (CGM) or insulin pump may be visible,” she said.
What is your advice to teachers and other school workers who have a child with diabetes in the classroom?
For parents, know that, especially as more kids are getting vaccinated and schools are reopening in person, your child’s teacher may also be anxious if they are not familiar with diabetes. You could help the teachers feel more comfortable by educating them about the condition and simple steps they can take to best care for your child.
“A teacher should know that a low or high blood sugar could alter [a child’s] mood or lead to cognitive difficulties. If [the teacher] notices any changes in behavior, they should check on the student’s blood sugars or ask if they need to go to the nurse as inconspicuous as possible to make sure not to embarrass or single out the student,” said Melnick.
Melnick also pointed out that Section 504 of the Rehabilitation Act 1973 requires schools to offer certain accommodations so that your child is not discriminated against for having diabetes. Talk to your school’s teachers and administration about forming a “504 Plan” for your child – Melnick explained that typical provisions can include:
Permission to leave the classroom as needed (to go to the nurse or have a snack).
Additional time on exams or assignments if the student’s blood sugar is too high or low. Teachers will wait until blood sugars are back within “normal” range to allow the student to continue the exam/assignment.
Some students’ 504 Plan also allows for snacks within the classroom to treat low blood sugars as well.
In addition, parents should consider filling out the Diabetes Medical Management Plan (DMMP) form each year to work with a new teacher or teachers, the school nurse, and other school personnel as needed.
The ADA has helpful templates here, and each DMMP form should be specifically tailored for each child annually (and signed by their healthcare provider). Some healthcare providers or schools may have their own forms they prefer to use – the important part is the information, not the format.
For more information, Dara recommends looking into the Diabetes Research Institute (DRI) or Parents Empowering Parents (PEP Squad) to learn more practical tips about caring for your child with type 1.
You can find more mental health resources here.