Supporting Students with Type 1 Diabetes: A School Nurse’s Role

Managing Type 1 Diabetes at School

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Diabetes at School: What Every School Nurse Should Know About Type 1

Type 1 Diabetes (T1D) is one of the most medically complex chronic conditions managed in the school setting—and as the school nurse, you're at the heart of it all. In 2021, it was reported that approximately 1.2 million children and adolescents are estimated to have T1D globally. source

From blood sugar checks to carb counts to emergency responses, students with T1D need daily support to stay safe, healthy, and ready to learn. Whether you’re brand-new to school nursing or just need a refresher, this guide will walk you through what you need to know to feel confident managing diabetes at school.

Type 1 Diabetes: The Basics

Type 1 Diabetes is an autoimmune condition. The pancreas stops producing insulin, the hormone needed to let glucose into the body’s cells for energy. People with T1D must balance insulin, food, and activity levels 24/7 x 365- no days off!

At school, that means:

• Frequent blood sugar monitoring (fingersticks or CGM)

• Scheduled or flexible insulin doses

• Carb counting for meals/snacks

• Emergency plans for highs (hyperglycemia) or lows (hypoglycemia)

Know the Signs of Highs and Lows

Low Blood Sugar (Hypoglycemia):
Can come on fast and be dangerous. Look for:

• Shakiness or dizziness

• Sweating

• Confusion or irritability

• Headache

• Slurred speech

• Seizure or loss of consciousness (in severe cases)

What to do: Follow the student’s Diabetes Medical Management Plan (DMMP). Most students will need 15 grams of fast-acting carbs, rechecked in 15 minutes. Always keep emergency glucose and glucagon nearby.

High Blood Sugar (Hyperglycemia):
Usually develops more slowly. Watch for:

• Increased thirst

• Frequent urination

• Fatigue

• Blurry vision

• Nausea or vomiting (possible DKA warning sign)

What to do: Follow the DMMP, notify parent/guardian, and monitor for ketones if indicated.

What’s in a DMMP—and Why It Matters

The Diabetes Medical Management Plan (DMMP) is your go-to guide for managing each individual student’s care. It’s typically written by the student’s diabetes care provider and signed by the parent/guardian.

It covers:

• Blood glucose monitoring schedule

• Insulin dosing and delivery method (injections or insulin pump)

• Meal and snack plans

• Exercise considerations

• Emergency actions for hypoglycemia and hyperglycemia

• When to call home—or 911

Keep it updated and easy to access.

Know the Law: Diabetes Care in Schools

In Illinois, the Care of Students with Diabetes Act (105 ILCS 145/) outlines specific responsibilities for schools and staff supporting students with diabetes. It requires schools to:

• Follow the student’s DMMP as written by their healthcare provider

• Allow capable students to self-manage their care (including testing and insulin) in the classroom or elsewhere

• Ensure trained school staff are available to recognize and respond to diabetes-related emergencies

Not in Illinois? Be sure to check your own state’s laws. Many states have similar protections to ensure students with diabetes can safely participate in all school activities.

Snacks, Supplies, and School Staff

Make sure students:

• Have access to snacks and water at all times

• Can carry glucose tabs or juice

• Know where to go when they feel “off”

And don’t forget your team. Educating teachers, coaches, lunch staff, and even bus drivers on basic signs of high/low blood sugar can make all the difference.

Communication Is Key

A solid communication plan with families helps keep everyone on the same page. Use daily logs, messaging apps, or email—whatever works best. Ask questions. Clarify unclear orders. Keep the DMMP updated.

And most importantly: listen to the student. They live with this every day. Even young students often know their bodies better than anyone.

Pro Tips from The School Nurse

• Have a quick-grab “diabetes emergency kit” in the health office

• Laminate a hypoglycemia cheat sheet to post in your office

• Schedule a staff in-service at the beginning of the school year

• Advocate for 504 Plans when needed

• Don’t forget to check expiration dates on glucagon and supplies

Final Thoughts

Managing Type 1 Diabetes at school can feel like a lot, especially in the beginning. But you don’t have to figure it out alone. Lean on your school nurse community, ask for support when you need it, and create systems that make daily care smoother for both you and your students. Want to make things easier? Grab my ready-to-go T1D Printable Resources HERE!

 

 

Top 10 Type 1 Diabetes Resources for School Nurses & Families

1. American Diabetes Association – Safe at School

https://diabetes.org/safeatschool Includes training resources, sample care plans, and guidance on students’ legal rights related to diabetes care at school.

2. National Association of School Nurses (NASN) – Diabetes Resources

https://www.nasn.org/nasn-resources/resources-by-topic/diabetes Offers evidence-based practice tools, care coordination tips, and policy updates for managing diabetes in the school setting.

3. Centers for Disease Control and Prevention (CDC) – Managing Diabetes

https://www.cdc.gov/diabetes/managing/children.html Provides guidance for supporting children with diabetes, including school accommodations and safety measures.

4. JDRF (now Breakthrough T1D) – T1D School Resources

https://www.breakthrought1d.org/t1d-resources/school/ Features school readiness tips, 504 Plan tools, classroom management strategies, and parent resources.

5. Joslin Diabetes Center – School Nurse Information

https://joslin.org/services/pediatric-diabetes/educational-programs/resources-school-nurses Educational tools for school staff, including diabetes care plans and communication checklists.

6. Beyond Type 1 – Educator Resources

https://beyondtype1.org/t1d-and-school/ Practical tips for school staff and families, covering everything from school supplies to emergency protocols.

7. Oregon School Nurses Association – T1D Toolkit

https://www.oregonschoolnurses.org/oregonschoolnurses/resources/toolkits/t1d-toolkit-for-school-nurses Toolkit with editable care plans, delegation guidance, and best practices for diabetes management in schools.

8. Children With Diabetes – School and Legal Support

https://www.childrenwithdiabetes.com/for-parents/diabetes-at-school/ Guidance on students’ rights, 504 Plan tips, and advice for ensuring safe diabetes care in school.

9. Association of Diabetes Care & Education Specialists – T1D School Strategies

https://www.adces.org/store/online-education/detail/going-to-school-with-t1d-essential-insights-strategies-v2 Online course designed for educators and parents to improve diabetes care understanding in school settings.

10. KidsHealth – Diabetes in Children

https://kidshealth.org/en/parents/diabetes.html Family-friendly diabetes education, including school-specific tips, sick day management, and glucose monitoring basics.

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How School Nurses Build Trust, Connection, and Community

From Trust to Teamwork:

How School Nurses Build Stronger Communities

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Welcome! As a school nurse, you're so much more than the person who hands out Band-Aids and checks temperatures. You're a trusted adult, a calm presence in the storm, and often the bridge between a child’s medical needs and their ability to learn and thrive at school. 

One of the most powerful tools you have? Relationships.

The stronger your relationships—with students, families, staff, and your wider community—the more impactful your role becomes. Let’s talk about how to grow those connections and why they’re so essential to your work as a school nurse.

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1. Students First: Creating a Safe Space

You might be the only healthcare professional a student sees regularly. When you learn their names, ask about their weekend, or listen without judgment, you’re doing more than taking a temperature—you’re building trust.

When students feel seen and safe with you:

• They’re more likely to share how they’re really feeling.

• You’re more likely to catch things early—whether it’s a hidden health concern or emotional distress.

• They start to see the health office as a supportive space, not just a place to go when they’re sick.

Tip: Even small things like remembering a student’s favorite sport or complimenting their new glasses go a long way in building rapport.

2. Partnering with Families

Families want to know their child is in good hands. A quick phone call, a note home, or a positive email to share something kind their child did can help you build those bridges before there’s a problem.

When families trust you:

• They’re more open to sharing important health information.

• You can work together to support chronic conditions, medication needs, or mental health concerns.

• You become a vital partner in their child’s success.

Tip: Start the year with an introduction letter or email letting families know who you are, how to reach you, and that you’re here to help.

3. Supporting and Collaborating with Staff

Teachers and staff are your teammates. When you work together—especially when navigating tricky student situations—everyone benefits.

When you build strong relationships with staff:

• They’ll come to you sooner with concerns.

• You can help support classroom needs, whether it’s managing a student’s asthma, understanding a 504 plan, or promoting hygiene practices.

• You’ll feel more like part of the school’s leadership team.

Tip: Invite staff to visit your office for more information on certain situations, share health updates or helpful info, and remind them you’re here as a resource, not just in emergencies.

4. Reaching Beyond the School Walls

Some of your strongest supports might be outside your school building. Community partners can help you provide services, education, and supplies that you couldn’t access otherwise.

Tip: Keep a simple spreadsheet or list of your go-to community contacts so you’re ready when needs arise—or when someone offers to help!

5. You Deserve Connection, Too

Remember: you need support as well. Whether it’s a Facebook group for school nurses, a fellow school nurse in your district, or even an online friend who “gets it”—you’re better when you’re not doing this alone.

Final Thoughts

Strong relationships aren’t just a “nice to have” for school nurses—they’re essential. When people trust you, they listen. When you trust others, you collaborate better. And when students know you care, they feel safer, healthier, and more ready to learn.

So take a moment today to reach out, check in, or simply smile at someone you pass in the hallway. Every little interaction builds something bigger.

Because in school nursing, relationships really do make all the difference.

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The Power of Communication For School Nurses

Why Strong Verbal and Written Skills Matter for School Nurses

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Good communication is one of the most important tools in a school nurse’s toolkit. Whether it’s a quick hallway conversation with a teacher or a formal email to a parent, strong verbal and written communication skills are essential in the school setting.

As a school nurse, you're often the bridge between health care and education. Clear verbal communication helps you explain health information, build trust, and work effectively with students, staff, and families. It also helps during crisis situations, where calm and clear directions are key.

Equally important is your written communication. From documenting student visits to writing health plans or 504 accommodations, your words matter. Well-written records support student care, demonstrate your professionalism, and can protect you legally if questions arise later.

Improving your communication skills not only makes your daily interactions smoother—it also strengthens your reputation as a knowledgeable, approachable, and reliable health professional in the school community.

Communication Tips for School Nurses

1. Use plain language.
Avoid medical jargon when speaking with students, parents, or school staff. Keep your explanations clear, simple, and age-appropriate.

2. Practice active listening.
Give people your full attention, nod to show understanding, and repeat back key points to confirm clarity—especially when discussing health concerns.

3. Document objectively.
Stick to the facts in written notes. Avoid opinions or emotional language. Example: “Student reports headache and nausea” instead of “Student looked miserable.”

4. Double-check your emails.
Read your messages aloud before sending to catch errors or unclear language. Keep emails short, friendly, and professional.

5. Set communication boundaries.
You don't have to be available 24/7. Use auto-replies or voicemail messages to clearly communicate when you'll return messages and what to do in emergencies.

6. Tailor your tone.
Match your tone to your audience—use a warm and supportive tone with students and families, and a more formal tone in documentation or official reports.

7. Keep confidential info secure.
Use secure systems for emailing or sharing student health details. Never discuss private info in hallways or over unsecured platforms.

8. Build relationships.
Consistent, positive communication builds trust. Take time to connect with your team—it makes collaboration easier when challenges arise.

Click the pic below to get some specifics on school nurse related conversation starters!

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