Q: My son has a really long bus ride to and from school. How can I make sure he’s safe during the trip? I also worry about the added time this creates between breakfast and his class’ designated snack time, as well as between lunch and the time he gets home.
A: As you sit down with your child’s teachers and the school nurse to plan for how his diabetes health needs will be met at school (preferably before the beginning of the year), it’s absolutely appropriate to discuss how to keep your son safe during the bus ride to and from school.
Part of this planning should, at minimum, entail making all bus personnel aware of your son’s type 1 diabetes, how to recognize a low, and an outline of procedures to follow if your son requires assistance. In many school districts, bus drivers and bus monitors are assigned to bus routes for the entire year. If this is the case at your son’s school, it may just be a matter of requesting that the bus driver and monitor receive diabetes training right alongside other school personnel. In school districts that rotate drivers or don’t provide monitors, you may need to work out a separate plan to make sure all drivers get this basic awareness training.
Next, to minimize the chances that emergency plans will ever be needed -- and to get your son’s day started off right -- think about moving the time he eats breakfast to shortly before the bus arrives. Just give him enough time so that he doesn’t rush and skip some of his food. To help with any issues that might crop up on the way to school (or on the return trip), have him carry snacks, juice, other rapidly absorbed carbohydrates, water, and his meter in his backpack. As part of their training, school bus personnel should know that your child is allowed to have a snack on the bus as needed.
Once he gets to school, he should check his blood sugar (or have his teacher or the school nurse check) to see if he could benefit from a snack. At the end of the school day, an extra blood sugar check and a quick 15-gram carb snack, as needed, can help to keep blood sugar stable on the ride home. If your son’s numbers are low or high at the end of the day, you can also request that the school nurse call you to arrange for you or another family member trained in diabetes care to pick your son up from school. Once he’s home, test again, and respond as needed.
--Alex Ginos, R.D., L.D., is a pediatric clinical dietitian at St. Louis Children's Hospital in Missouri.
How Other Parents Deal
“The school bus monitor assigned to our son’s bus attended training sessions with the school nurse on how to recognize and treat lows. She keeps a tote bag on the bus with some juice and snacks in it, but our son also carries a meter and some snacks in his backpack, just in case. If his numbers have been off that day, we also have him check his blood sugar at the end of the day. If he’s running low or high, he can call me, and I pick him up instead.”
-- Tamara W., mom of 6-year-old Andrew
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