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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Asthma At School

Understanding Asthma in Schools:

What Every School Nurse Needs to Know

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Asthma is one of the most common chronic conditions in children, making it a significant health concern in the school setting. As school nurses, it’s essential to understand the basics of asthma, how it affects students, and how to manage it in the school environment to ensure students are safe and supported throughout their school day.

What is Asthma?

Asthma is a chronic disease that affects the airways in the lungs, making them inflamed and narrow, which can make breathing difficult. Asthma symptoms can vary from person to person but typically include:

• Wheezing (a whistling sound when breathing)

• Shortness of breath

• Coughing, especially at night or early in the morning

• Chest tightness

Asthma attacks occur when the airways become even more inflamed and narrow, making it harder to breathe. Triggers can include allergens (like pollen or pet dander), irritants (such as smoke or strong odors), physical activity, and even cold air or stress.

Prevalence of Asthma in Schools

Asthma is one of the most common chronic conditions among children in the United States. According to the Centers for Disease Control and Prevention (CDC), about 1 in 12 children has asthma. This means that in many schools, it’s likely that several students will be managing asthma on a daily basis.

Children with asthma may have different levels of severity. Some may only experience occasional symptoms, while others may face frequent asthma attacks that require medication or even emergency medical care. As school nurses, we need to be prepared to manage asthma in both mild and severe cases.

Critical School Tools

When managing asthma in schools, it’s important to understand the distinct roles and differences for the following types of forms / documents!

Asthma Action Plan, Individualized Healthcare Plans (IHPs), and State Policies & School Procedures

1. Asthma Action Plan (AAP) – An Asthma Action Plan (AAP) is a written, personalized guide created by the student’s healthcare provider, usually their doctor, to manage their asthma. This plan provides clear instructions for both the student and school staff on how to handle asthma symptoms and prevent attacks. It’s designed to help everyone involved know what steps to take during a specific student's asthma episode. There are many free examples available online to help create or update an AAP. A comprehensive Asthma Action Plan typically includes:
• Personalized triggers – What sets off the student's asthma, such as dust, pet dander, or cold air.
• Symptoms to watch for – How to recognize the early signs of an asthma attack, such as coughing, wheezing, or chest tightness.
• Medications – Detailed instructions about daily medications (like inhalers) and emergency medications (such as rescue inhalers).
• Emergency actions – Steps to take if the student’s asthma symptoms get worse, including when to call for help or seek medical attention.
• Contact information – Emergency contact numbers, including the student’s doctor and parents.
2. Individualized Healthcare Plan (IHP) – Written by the school nurse, the IHP is a comprehensive plan that outlines the student’s health needs and how nursing staff will meet those needs during the school day. For students with asthma, and IHP would most likely include the nursing assessment, nursing diagnoses, goals, interventions, expected outcomes, and an evaluation area. IHPs should be reevaluated and updates as needed, but at least each school year.  
3. State Policies and School Procedures – When it comes to managing asthma in schools, it’s important to understand the difference between state policies and school procedures—both are essential, but they serve different purposes.

State Policies- State policies are laws or mandates passed by the state legislature. In Illinois, for example, the law 105 ILCS 5/22-30 allows students to carry and self-administer their asthma medication (like an inhaler) at school, as long as the proper documentation is provided by the parent/guardian and the student’s healthcare provider.

These laws are designed to protect students' rights and ensure schools follow standardized safety guidelines across the state. In Illinois, 105 ILCS 5/22-30 requires schools to:

• Permit self-carry/self-administration of asthma medication with appropriate written authorization

• Ensure staff are informed and trained on the school’s asthma policies

• Maintain an asthma emergency response protocol

• Request an Asthma Action Plan for each student diagnosed with asthma

School Procedures- School procedures are the step-by-step processes each school or district puts in place to carry out the state policy. They are the way each school or district follows the law, based on their own staff, setup, and available resources. Examples of school-level procedures include:

• How inhalers are stored in the nurse’s office (if not self-carried)
• When and how staff are trained to recognize and respond to asthma symptoms
• Which forms need to be submitted and how often
• Protocols for field trips, gym class, or after-school activities

Role of the School Nurse in Managing Asthma

As the primary healthcare provider in the school setting, the school nurse plays a key role in managing asthma. Here’s what school nurses should know and do to ensure that students with asthma receive the best care:

• Engage with families and healthcare providers for consistent asthma care

• Ensure Asthma Action Plans are up-to-date 

• Educate school staff 

• Encourage the proper use of inhalers 

• Eliminate and monitor environmental triggers 

• Emergency response preparedness 

On the surface (no pun intended) this video is funny, but it's also scary because it perfectly highlights how crucial it is to educate our students on everything from their diagnoses to recognizing symptoms and using medications properly!

Final Thoughts

As a school nurse, you’re on the frontlines of asthma management. By staying proactive, informed about asthma care, and building strong partnerships with families and staff, you can help students with asthma thrive at school.

The key to success is an individualized approach. When you follow a student’s Asthma Action Plan, recognize early warning signs, and respond quickly, you’re not just managing asthma — you’re helping students stay healthy, confident, and ready to learn.

Together, we can make sure that students with asthma are safe, supported, and fully included in every part of school life — from classroom learning to sports and field trips.

Top 10 Asthma Resources for School Nurses & Families

1. Centers for Disease Control and Prevention (CDC) – Asthma
   https://www.cdc.gov/asthma Offers data, management tips, educational materials, and CDC’s National Asthma Control Program resources.

2. American Lung Association – Asthma
   https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma
   Provides asthma basics, treatment info, downloadable Asthma Action Plans, and school-focused resources.

3. National Heart, Lung, and Blood Institute (NHLBI)
   https://www.nhlbi.nih.gov/health-topics/asthma Offers in-depth clinical guidelines and educational resources for professionals and families.

4. Asthma and Allergy Foundation of America (AAFA)
   https://www.aafa.org A comprehensive resource for asthma facts, webinars, support groups, and multilingual asthma action plans.

5. Allergy & Asthma Network
   https://www.allergyasthmanetwork.org Focuses on patient education and advocacy; includes school resources, handouts, and inhaler technique videos.

6. Healthy Schools Campaign – Managing Asthma in Schools
   https://healthyschoolscampaign.org Offers school-specific asthma policies, training modules, and action plan development guides.

7. National Association of School Nurses (NASN)
   https://www.nasn.org/nasn-resources/practice-topics/asthma Curated asthma resources for school nurses, including toolkits, webinars, and evidence-based practices.

8. KidsHealth – Asthma Center
   https://kidshealth.org/en/parents/asthma.html Parent-friendly and kid-friendly information, plus printable guides and student asthma support tips.

9. Global Initiative for Asthma (GINA)
   https://ginasthma.org International guidelines for asthma management and prevention; excellent for updated care standards.

10. Environmental Protection Agency (EPA) – Asthma and Indoor Air Quality
    https://www.epa.gov/asthma Offers resources about managing asthma triggers in the school environment and improving air quality.

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