Q: How do we handle Sunday school at church, ballet lessons, swim class and all those other drop-off programs for children that last only a short period of time? Do we still need to go through the type 1 diabetes teaching process or is it simply overload?
A: Whenever you leave your child in someone else's care, even if it's for less than an hour, it's important for the adult in charge to know about your child's type 1 diabetes. However, when compared to other situations, like school or leaving your child with a sitter for an entire evening, the amount of information you share may be different for these shorter activities -- and have a slightly different focus.
As a good rule of thumb, make sure the person or organization running the activity knows upfront about your child's diabetes. Typically, sign-up forms have a box or line to list special medical needs. If not, write it in yourself at the bottom of the form, along with a short note that you will be in touch. Try to make an appointment to talk at least a few days before the activity is scheduled to start.
What does the coach or teacher need to know? First of all, make sure they understand exactly what type 1 is (and isn't) and the basics of your child's daily care routine. And then zero in on what will likely be this person's biggest role in caring for your child: monitoring for signs of low or high blood sugar. Your diabetes educator should be able to provide you with an illustrated poster that shows common symptoms. Use it as a visual aid to help you describe symptoms of low blood sugar, which can include nervousness or restlessness, dizziness and confusion, shakiness, irritability, sweating, pale skin, blurred vision, nausea, hunger, and headaches. With high blood sugar, a child may need to urinate frequently, complain of overall malaise, lose energy, be excessively thirsty, and/or appear pale. Encourage the teacher to keep the poster visible in the activity room as an easy reference.
The teacher or coach not only needs to know how to recognize these symptoms, but also how to respond. This means that the next step is coming up with a plan. Give the teacher some juice and crackers to keep on hand in case of a low blood sugar episode, a blanket or towel to serve as a resting spot, and a list of your up-to-date contact information so you can be notified in case of emergency. Include your cell number and the name and number of another trained caregiver for your child should you be unable to be reached.
For children, lessons and sports practices are often the highlights of their week, but it can feel much less familiar or even intimidating working with adults they may not know as well as their regular teachers at school. If possible, have your child meet their coach or teacher beforehand and make it clear that this person will know what to do if your child isn't feeling well -- your child's job is to communicate this information to the adults in charge.
--Theresa Garnero, APRN, BC-ADM, MSN, CDE, is a clinical nurse manager for the Center for Diabetes
Services at California Pacific Medical Center in San Francisco, California.
Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.
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