In Episode 3 of Dia-Logue: The Diapoint Podcast, the discussion about managing diabetes at school continues between Pam Durant and Sarah Adhami, Certified Diabetes Educator & Accredited Practicing Dietician. They’ll talk about special situations like parties, after school activities, exams and more. In addition to sharing some tips on these topics, they also highlight the importance of advocating for your child with diabetes.

Part 1 of this discussion is here.

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Sara Adhami - managing diabetes at school

Sara Adhami is an Australian Accredited Practising Dietitian (APD) and Credentialled Diabetes Educator (CDE) currently working at Mediclinic City Hospital – DUBAI.

In 2005, she began her career as an APD and advanced over 12 years working in both clinical and private practice settings during which she also studied further and became a CDE. Her experience included adult type 1 and type 2 diabetes care and gestational diabetes whereby she covered out-patient clinics and ran diabetes group education sessions to help reduce waiting times for those newly diagnosed with type 2 and gestational diabetes. Her research interests have been in the area of first trimester weight gain in women who developed gestational diabetes. After moving to Dubai in 2016, her experience furthered to include diabetes care in the pediatric population. This coincided with the increase in use of the Continuous and Flash glucose monitoring which has been an opportunity for research that she participated in to compare the 90 day CGM hba1c prediction to the laboratory Hba1c. In 2019, the abstract submission for the study got her selected as part of the ISPAD 2019 Science School which has been a motivator for further research to explore the impact that structured education can have on metabolic outcomes and Time in Range (TIR) for youth living with type 1 diabetes. She is passionate about diabetes education that is patient centered and the use of diabetes technologies to help guide education and diabetes care.

Follow Sara on Instagram @diabetes.simplified_bysaraa

Episode 03: Managing Diabetes At School, with Sara Adhami (Part 2)


Part 1 of this discussion is here.

Pam  0:02 

I’m Pam Durant, the Founder and Managing Director of Diapoint, you’re listening to the Dia-Logue podcast. Let’s get to the conversation. Welcome back to the second part of my discussion with Sara Adhami certified diabetes educator and accredited practising dietitian about managing Type 1 Diabetes at school. In the second half of this discussion, we will be talking about special situations like school parties, trips, sports and after school activities. If your child rides the bus what to do, also how diabetes can affect exams and testing and the importance of advocating for your child because sometimes we do have to do that we are our child’s strongest advocate, especially when they’re small, and they can’t advocate for themselves. super important. So lots of juicy discussions today on the podcast. And I hope that you’ll find this second half of the discussion helpful. Now, when it comes to, you know, to the trickier part is the special situations. And you know, when it doesn’t go as planned, so I think it’d be good to get into some of the special situations that we have to deal with. At school, it might be a class party, it might be sports, or PE, it might be a field trip, it might be riding the bus, which is an everyday thing. But again, outside of the school, it might be actually a fire drill. That’s usually at your time of checking blood sugar or a snack. It might be I know some schools started last year doing emergency lockdown training. And what do you do then? So there’s all these a host of different things that that happen week to week, birthday parties. Some months, I feel like every kid in the class has a birthday, like every other day. And don’t.


Sarah  2:02 

I mean, are they haven’t they? I mean, even before COVID when they’re becoming a lot stricter about food coming into the classroom, I know my candles became a negative, like you don’t want to blow candles. And so I know I’m pretty short. Maybe it’s a school by school thing, but I think there was a policy in our school no food allowed them birthdays. I went potty bag, but you are not allowed to bring in food.


Pam  2:25 

I wish and it is a school by school thing. And I would send you know, something fun. But when my son reached kind of later primary years, it was always doughnuts. Yeah, I kid I kid you not like doughnuts. And we’re not a house that really eats donuts, but doughnuts are apparently Well, I they taste great. But for my physical being they’re not really great. So doughnuts were coming in a lot. And I was really blown away by this. So but some schools don’t allow it Some do. And we’ll we’ll start with that topic right now for parties. What do you do? As long as my son’s blood sugar is in range for me personally, I allow him to eat what his peers are eating. He eats very healthy the other 90% of the time. And while I’m not a fan of you know, a lot of sugar and junk food, he’s not eating like that every day. Exactly. And the the doctor that I had in the US when my son was diagnosed here, but at that time, I could not find any paediatric endocrinologist. I didn’t know what to do. I went back home to the US and I was assigned to I don’t know if you’ve heard of his name, sir. Dr. Morey Heyman. He


Sarah  3:50 

ate in which diabetes centre was


Pam  3:52 

Oh, in Texas Children’s Hospital. Okay, a paediatric endocrinologist. One of the he’s done a lot of early research in glucagon mini and mini dose injection and also insulin pump in small children. Like when they first came out. I think he’s kind of retired from seeing patients now. Okay. And I cried the day I learned he retired, like life changing. But the first thing he said to me was child first diabetes. Second. I think that was the second thing he said to me after he said diabetes is going to really be a nagging thing and get on your nerves. And I thought what a weird thing to say. But it was true. And I always carry that with me and I remember child first diabetes second, as long as you know, his blood sugar is not through the roof. It’s in range. We know how many carbs are in this thing. And I let him eat it. Was it perfect every time. Of course it was not. But we survived and we got through it. And now he knows how to handle those situations on his own. There is nothing I think more heartbreaking. For a child it’s I mean, it’s really difficult if you have celiac or some other things that you have to consider. Then, you know, parents have been very, you know, I know parents are very accommodating, they send in something that’s gluten free and other things like that. But if you don’t have that challenge, it is it is very challenging. And it happens sometimes because people don’t understand diabetes, that even the teacher even though you’ve met with her talk to her educated her, and you said they can eat everything, but poison, they still leave your child out, because they’re so used to thinking about Oh, type two, and really strict diets and things like this.


Sarah  5:30 

And that’s, again, why it’s so important, I think, for the parents to have that communication with teachers in the beginning. So you are, you are the driving force of advocacy of raising awareness about type one diabetes, that, you know, it’s not because of their food or their diet that they got diabetes to begin with, it’s not because of a lifestyle issue. This is because, you know, it was it’s an autoimmune area. And it may be difficult to explain it to them exactly how they develop type one diabetes, but, you know, basically, they can eat, what any sort of healthy nutrition plan should be for any child. And a healthy way of eating, I mean, we’re going to get into that in a little bit, includes all food groups, and includes treat foods occasionally as well. And so there is not just like any other child can have treat foods your child can have treat foods. One tip I would give for school parties is think about I mean, you mentioned doughnuts. And that was the first thing I thought of as well when you think about what gets brought into classrooms on birthdays, but think about the frequently bought in foods, at birthdays, it’s donuts, and donuts vary in size. So you’ve got me donuts, you’ve got a sheet of glazed plain doughnuts, and you’ve got iced doughnuts. Now I’ve got my carbs and cows over here. And I’m sure many of you, many of you have the carbs and cows, these kinds of resources, whether it’s this or whether it’s My Fitness Pal, they you can get information about you can even find out what how much carbohydrate is in a Dunkin donut or a Krispy Kreme or any of those Tim Hortons or whatever it is. And the sizes, you just need the general average of a mini plain and a sugar glazed sprinkled donut. And you do the same with the with the cupcakes, you’ve got mini cupcakes, you’ve got medium cupcakes, you’ve got large, large cupcakes. And you do the same as a standard Piece of cake, a standard Piece of cake, triangular piece sponge cake, iced or not iced to the maximum, you’re going to have about eight to 10 items on a list, keep it in the teacher’s classroom, put some glue tack on the wall and say whenever a child comes in, just in case you can’t call me, we can’t WhatsApp me, you know, if you’re allowing your child to have the snack and you want insulin to be given, that’s a reference point at least so that they know how much carbohydrate is in the in the food. Yeah, that’s


Pam  7:54 

a great suggestion. I have never done that. And I had, like, they would call me and they’re like, Oh, it’s Dunkin Donuts, and he wants to eat this one. And then I would look it up immediately and say this is it, go for it. And initially, I was still afraid even though I looked it up. And sometimes what we would do is I would say, you know, if the blood sugar was writing kind of the lower side of the range, we might not give the entire bolus we might not get the entire dose. And we might say, Okay, try this because he’s going to recess or PE, and maybe that’ll drive it down. And let’s check in again after PE or recess and see what it is, you know, or give the whole dose but most of the time, they needed that entire dose for the doughnut. Another thing they would do for class parties, if it’s like, you know, end of year parties, I’m sure with COVID that won’t be happening this year. So you know, it’s kind of a good year in that respect, there’s less things to worry about there, there probably won’t be kind of buffet parties where the kids go and pick up their stuff. But when that would happen, my son would pick his food and a teacher or somebody would send a picture of what he selected. And I would say okay, this looks like this plate probably has about this many carbs. But in the case of kids parties, they don’t always usually eat everything that’s on their plate if they picked it up in buffet style, if it’s more than one thing, so you just want to be cautious to if your child might be one of those it’s like suddenly you know going to his friends after the picking up the plate and not eating all of it, maybe not dose for all of it. And also I would always ask you know, in the case of a party, they would always ask for one or two chaperones and I was able to take off work and I would go help out with the food and chop around the party.


Sarah  9:34 

That’s a really important step as well whether it be for class field trips, or whether it be for volunteers on sports days or anything like that. You know if you have the ability to take time off work or you know you’re a stay at home mom, hat’s off to you honestly but I think you know, try and be as involved as possible. Because again, not only are you keeping a closer eye in the special situations. But again, it’s an opportunity to raise awareness and advocate.


Pam  10:04 

Yes. And I was lucky that I was working in the corporate world at that time. And they were understanding, I was constantly kind of following up with the school to be proactive to know what the schedules were for sports days and things like that they don’t always know right away, and then kind of the notice comes. So you might want to ask them early about that. And I’ve been on field trips where they say they wouldn’t want chaperones, they were always kind of relieved that I went, because then the nurse didn’t have to go, the teacher didn’t know. Yeah, there are, exactly there is no harm in asking, and they will probably appreciate it, and you just, you know, I would go and I would be as invisible as I possibly could in the background. I would just sneak in and, you know, do my thing, do the dose. I mean, once I got to lead a group of first graders on a scavenger hunt, and that was more difficult than managing diabetes, I hats off to teachers that deal with, you know, large groups of small children. But it was it was super fun. So yeah, you can you can do that too. If your job allows you and hopefully they do, because that is so super, super important. Sports, I think and activities like after school, we have a lot from the other day the questions about, you know, exercise and sports with diabetes, we had a lot of questions. So we have a lot of young athletes and very active children. What is your take on how we manage diabetes with exercise, the sports and all of those things?


Sarah  11:33 

Yeah. It depends on what you agree on with me, you need to know your child, you need to know how intensive This is, what they’re doing, how long they’re doing it for? Is it a set routine that they do sports on? Like it’s set sort of number of days of the week where they go? what time of the day? How long before they played sport, had they taken a bolus for a meal? So are they playing while the insulin is during the active phase, which is not usually advisable, because you just don’t know how rapidly the glucose is going to change in that environment? So if it’s we’re talking about school situation, I always ask what time is the P is it first thing in the morning? By the time they do it, it’s probably at around nine. If they’ve had their breakfast at 630, then I’m not too concerned, I think Well, okay, the active insulin from breakfast is gone. And, and there’ll be okay to play sports. And I always discuss with the parents what the guidelines recommend in terms of what the pre glucose level should be before sport starts. Now, I understand the fear of hypo’s. And I really do listen to the parents. So it can range not It can be as low as 90 milligrams, before a meal, sorry, before participating in sports. But for some, it needs to be 100 or 120, because it just rapidly comes down. And so it can vary anywhere from about 90 to about 120 or 140, just depending on the child. And that’s something you need to discuss with your diabetes team. So that you know it can be in the plan so that that way the teachers know exactly what to do, they will remind the child to check the glucose level and if it is under that, then you always have a supply of snacks labelled for labelled with the sticker saying PE your child knows that this box that’s in my bag doesn’t get touched unless my glucose level is below a certain threshold before I play PE. So you do have lots of boxes. You have the hypo box, you have the P e box, and you have the normal snack and lunch box that comes to school as well. Is there any other boxes I’m not thinking of? No, that’s it.


Pam  13:45 

That’s most of the boxes. And that’s, that’s a good segue into a picture that I will share.


Sarah  13:52 

It has all the food that is potentially in Erin’s bag?


Pam  13:56 

not in Erin’s bag, but this is a picture from a few years ago of 1234 that’s only five boxes that was going into five classrooms that did not include the box. Now in the health office. There’s medical supplies, there’s pump supplies, there’s insulin, there’s glucogenic You name it, it’s all there and finger checking things all of it. And then you need to be


Sarah  14:21 

you need to be inspected that goes around to check the shortages and how much you need. Yeah, yeah,


Pam  14:27 

yeah, yeah. And some of the you know, some of the teachers are good about telling the nurse like Oh hey, we need more especially PE the PE box goes fast because that’s where you might see the most hypos but and you know I’m a I was never a Girl Scout but I’m always over prepared. So the you know, four juices per box but we had a set number for juices, X number of date bars X number of raisins. What up back then he was younger, and you know those little purees that are in the bags. Those were amazing. I was really kind of, you know, my heart sank a little bit when he’s like, Mom, I don’t want to take those first, because they were so healthy and easy. But that’s okay. But so that’s an example of the boxes that I put in the classrooms to help with hypoglycemia. And I suggest having one in every classroom where your child is because it keeps them from not having to go somewhere far like the health office or to another classroom to get it. And it just is less disruptive of their day,


Sarah  15:30 

and safety and for the safety. So remember, we don’t want a child who is potentially having a lower glucose level could be a mild could be a moderate hypoglycemic event, and they’re having to go down a flight of stairs, for example, they might be unattended. So it’s always better to discuss this, again with the school to say that I need to keep a container in case my child is having a hypo, I don’t want them going to the nurse’s office, I want them treated in the classroom. And you remember, you need two things for hire, I always need to remind you what you need to take if it’s a true hybrid. So a true hypo, under 70 milligrams, or under formula moles, you need a rapid acting carbohydrate to bring it back up again, followed by a sustaining carbohydrate if the next meal is more than 30 to 30 to 60 minutes away, like roughly. So you potentially have to take both. So you always need to keep in your kids, I would suggest something like as Pam has shown he’s got juice, that’s fine, I would, I probably would want to go for the smallest I find available. Only because I get scared that overtreatment of hyper cluster. So if you can find something that’s more like 120 to 150 ML, is it possible to find I haven’t actually looked but there are someone bringing that in


Pam  16:45 

the challenge with those I find there, the less healthier ones. But


Sarah  16:49 

again, you don’t necessarily want them to have the added sugar as well as the natural sugar from the fridge. No, what if it’s a hypo, you need rapper? Do you just take it right? So yeah,


Pam  16:59 

the way I did it, actually, I would have two types of juices. And one is kind of this organic brand, I forget the name and I’m not really affiliated or plugging anybody, I forget the name, but that one has a lower carb count than the other juice. And I would teach everyone and Aaron knows this lower one is for like a mild hypo. And the bigger carb juice boxes for a severe one. We also have in there some chocolate milk, because that’s always not for treating hypose. But when you’re getting for him, like a number I’d like 90 when he was active, you know, in preschool, especially he would have a very small chocolate milk. And that would kind of sustain his blood sugar and not positive.


Sarah  17:43

Well, it can be doesn’t have to be chocolate milk. Yeah, actually, it could be a cookie or a weak cookie, it could be a few pieces of dried fruit, something that’s going to have a longer shelf life, obviously have a you know, expiry that’s true, too. So


Pam  17:59 

yeah, not everything that we put in there was long lasting because some in some classrooms, he would never touch these boxes. One other thing I saw when I was pulling this picture that I wanted to share that I think is important to put on top of each of your boxes, especially if it’s a big school. There’s cleaners that come and go and they might think, you know, depending on where the box is stored, they may not realise that it’s important. So I put this on the top of each box. It’s just a simple piece of paper, I put a picture of my child, his name, the grade, his teacher, the teacher, not each teacher that He has for each subject, it was who his primary teacher was. And it’s just kind of what you know, his symptoms are his range for his blood sugar of what you know, or what his doctors defined medically as a low or moderate low. And the emergency telephone number on here was actually the mobile phone for the health office that I actually don’t have and I never use it. But within the school system sometimes all teachers might have the nurse on speed dial in case you know, there’s like a nut allergy or severe hypo. So ask your school if you choose to do this. You don’t have to. But you can ask your school what is the emergency contact that the teacher needs to know in order to reach someone in the health office if it’s a severe hypo and the nurse or someone needs to come to your child. So that’s just a little puts a little and makes it you know, how can I say it helps them to understand also the seriousness of a low blood sugar. When someone sees that medical sign they then it registers quite differently than just like, oh, here’s a snack box. It’s you know, for all of us, this isn’t a snack box. This is like life saving stuff right here. So that’s just a little something else. You can do. And I would say if anyone has children that ride the bus. Mine, mine never did, I always took them. And again, that was, you know, largely out of my fear of how am I going to manage diabetes on the bus. But some people do it. And buses typically have rules about children not being allowed to eat on the bus. And you have to meet, I suggest maybe someone within the school maybe it’s the nurse or whoever in the school oversees the bus service in a bus communication, and whoever the bus driver is going to be and the helper on the bus so that everyone is aware that this child needs to have maybe from time to time something to treat a low blood sugar, and it cannot wait until they get home. It needs to be treated then and there on the spot. Now here with the heat, you may not want to keep you know snack boxes inside a bus. But you want to make sure whatever bag your child has, that it’s got some snacks or low blood sugar, something to treat low blood sugar, in addition to what you’re putting in the classroom. And one, okay, so then going to special situations. And if you have any other special class party situations, you know, for field trips, again, it’s sending a small bag with low blood sugar, you know, supplies, juices, etc. The schools that my child has been in for every child that has a special medical need, whether it’s a nut allergy or something else, they would always give the nurse that was in charge of the particular bus or group that the kids were in, they would always give them the bag with


Sarah  21:37 

every child that might have a need all the supplies together. And just to make this really important, they offer a nurse to go on the field trip,


Pam  21:46 

oh, well, they don’t always offer a nurse to go there’s just kind of a charge nurse,


Sarah  21:51 

I think the parents need to ask if they can attend at least you know, if they’re worried that the child is not independent enough to give insulin and the teacher. I mean, the teacher might say, Look, I’ve known your child for a while now I’m happy to supervise, if you just told me over the phone, what they need to take in your child’s able to take insulin, maybe that can also work. So it just depends on the stage of the diabetes, how confident your child is, and what the school is willing to do in terms of either allowing you to attend or the teacher can supervise or a nurse can come along.


Pam  22:21 

Yes. And actually, I know it happens for actually, as the child gets older, around, usually age 11 or so days. Now again, with COVID, this is probably not going to happen. But there would be an overnight trip somewhere. And this is a big deal for school because sometimes they go in different groups. Some parents have been told that they’re not sending a nurse in the group that their child’s in for whatever reason. And that is heartbreaking. Or they asked they said well, maybe you know, maybe your child shouldn’t go because there’s no one to oversee it. And we’re not allowing parents to go or whatever. My answer to that is you need to advocate an advocate again, and again, for your child to go, wherever you’re living, there should be documented regulations that allow your child to go and to participate, just like everybody else there is, you know, for your child there. Yeah, there is no reason for your child to not go. I think most people on this call are in the EU in the UAE and Abu Dhabi or in Dubai. And there is very clear outline protocols. And like Sarah mentioned earlier in the call, often under the legal guidance, there’s the word disability, and diabetes is covered as a disability within the eyes of the law. Diabetes is not a disability, we all know this. It’s a superpower, our kids have been given a superpower. However, should your child be denied certain rights, you need to go find those disability laws because that is what is protecting them. And it is okay in that instance, to surrender to that word. Let’s say I hate that word disability because our children are super able, very able, and it will help you advocate for your child to make sure that they are treated just like every other child that does not have diabetes. So that’s super important. And kind of leads into you know, there there’s been times where things have not gone as planned, you can’t mitigate every single risk. Not everything is going to be perfect. Not everyone is going to understand diabetes. And people you know administrators, sometimes health office, sometimes teachers, they have a lot of fear around the unknown because then when as soon as they hear oh my gosh, this child to go unconscious. This is really serious. What do I do? And what do you do in those instances where you know, someone says no, I’m sorry, your child can’t go on this field trip or your child cannot purchase dissipate in sports day or, or something, it’s not a matter of if but when it will happen. And I always try to take a deep breath. And I know that those things are said or those decisions are kind of made out of a place of fear because they don’t understand diabetes. So my advice is communication and follow up are absolutely key. I try not to be reactive, I do write a lot of emails I write, and I’ll write something. And I’ll even let it sit. And I’ll go back and I’ll read it to make sure that I don’t sound really outraged, and I might change my language in different things. Because I really want to be heard. I don’t want it to come off, as you know, outraged mom, even though inside I might be really outraged at something that happens. Don’t be afraid ever to ask questions about the treatment that’s given to your child. Even though there are medical professionals, but at the end of the day, it’s your child, you have a paediatric endocrinologist and a diabetes care team that have instructed you to do certain things. Sometimes someone may disagree with that, because they read something or they’ve heard something, or they’re not really sure, I had one, you know, well intentioned nurse, once that she gave my son came home with a blood sugar like 300 something. And I was like, What is going on? This is really strange. And then I followed up and I didn’t see you know, quite the documentation, I looked back. And then I said, You know, I talked to the nurse maybe the next day, and I just kind of said, what happened. And she said, Well, he looked tired. So I gave him a juice box, no checking of the blood sugar, there was no CGM back then and those things can happen. So try to remain calm. Go ask learn why. Because it may just be that they didn’t really understand what needed to happen and what should have been done. And it might require, you know, meeting again, talking about it again, even if you feel like you may have shared how to check how to manage when if they look a little tired, but just to make sure, you know, double check the blood sugar first, before treating those kind of things that seems so basic to us that we do every day. Again, they, you know, the schools have hundreds of children to look after, and not just our children. So they can forget, I try to always unless it’s something really, really severe. And I’ve never had to go immediately to, you know, a top administrator, but I always tried to meet with the nurse or whoever administered the care first understand their side of the story. And what happened. If then after that point, you can decide if it’s necessary to escalate to their boss, if there’s a doctor that oversees the health office, then go there it or if administration, like a principal or Superintendent or somebody needs to be informed, then you can do that and request a meeting and take that school diabetes medical management plan. This is why it’s so important to me, before school starts get all of that documented, get them to sign it, because that is the document that you will speak to about your child’s care and what was agreed upon at the beginning of the year. And again, that’s this also relates back to why you want them to write everything down. Because if it did, if it wasn’t written down that it didn’t happen.


Sarah  28:13 

Yeah, we have the roles and responsibilities of the school. And part of the roles and response of the school is to provide those equal opportunities and to cater for all children. And again, I don’t see your children as having disabilities, you know, they need extra points of care. They need somebody to monitor to supervise and oversee. But you are responsible parents who have been following up with your healthcare team, you are well educated, do you have it under control, like you’ve actually got it well under control, and you’re basically trying to tell the school that we know what we’re doing our toll is fine, but we just want to make sure that you guys can also do the same and give our child that same opportunity. I mean, yes, there are there when they talk about and Pam sent me the document, I had a quick look at it today. And again, these disabilities they’re referring to children who have cognitive disabilities, their children who have whose academics is going to be affected. And you know, the law wants to protect these children so that they can still have extra time and exams and etc. Your children Yes, they may be affected by their sugar levels. And we spoke about the effect. Pam and I about how you know, a low or a high can affect their concentration. Again, that’s something we might need to review if you feel they need extra time in exams. So that’s something you’re going to need to discuss with your healthcare team which can help support you in getting extra time for example, if your child is having to require a glucose device to check their glucose levels during the exam time or if they have a hypo during the exam and that makes them have to stop and take treatment and therefore they’ve lost time in the exam to they should be allowed that extra time. So that being under that scheme allows you to utilise it to your advantage. But certainly, you know, they don’t have the they don’t have a disability. I mean, it’s Yeah,


Pam  30:04 

no, not at all. So yeah, it is it really the more people I meet with Type One Diabetes, the more you know, the first question you ask when your child is diagnosed, will they be okay? Will they be able to do everything, that we’ll be able to do everything and so much more. It’s just really, really amazing. But these laws that exist and they use that word disability, don’t be afraid of that word. And you know, very rarely, and hopefully, you’ll never be in a situation where you need to escalate it to a regulatory agency or anything like that. But if you if you do, do not be afraid, because they are there to help, and we’re lucky, where, you know, if you’re if you’re here, and you’re in the UAE, and you know, we had the Europe tolerance and all these other things, and there’s so many different cultures here. And people are so open minded. And, you know, most schools are really helpful and supportive. So, so that’s, you know, really great. And oh one just one thing I do want to say that you mentioned, before we go there about testing, I had read about people, you know, children in high school and things with blood sugars and testing. And it wasn’t until my son had one test, and he felt he didn’t do so great because of his blood sugar. So last year or the year before, was the first time that I put in his plan was could you know, he please check his blood sugar 15 minutes before any testing. So that way, if it was borderline, that it might go low, he could eat something before the test. And then he wouldn’t have a hypo during the test because nobody can concentrate when they’re having a hypo. Or that he can check in if his blood sugar’s high, then he can he can give a bolus. So as your children get older, that is an important one, because it won’t, you know, it’s not they have a cognitive challenge. But to concentrate with a low blood sugar is really, really difficult, especially low blood sugars. I cannot believe how quickly this call has gone. Again, I think Sara and I can sit here and speak another two hours, easily. But I’m going to wrap it up. And I just want to leave you with, you know, the thought during these times of COVID. And everything is uncertain for everyone. And if you cannot meet face to face with your child’s teachers, or nurses or whoever that you need to meet with, do it virtually asteroid, zoom, Google what whatever, you can still it will be just as effective. If they say no, we’re not letting people parents in and say okay, when can we schedule that zoom call, don’t give up just because we’re not able to meet face to face. And I am, you know, giving a lot of grace this year, like usually by now I’d be more prepared, I have the boxes ready. And all these different things by now. But with COVID I know that it’s a completely different situation and environment for the teachers and the health office. So initially, they’ve got a lot more on their plates this year. And you know, just give them some grace in the beginning as they get used to their new situations, and we get used to ours. Thank you all for joining there. If I’m forgetting anything, please let me know. And thank you very much. It


Sarah  33:13 

was a great space. And it’s always a pleasure.


Pam  33:16 

Thank you so much for joining me.


Sarah  33:18 

Good luck everyone, good luck.


Pam  33:20 

Thank you so much for joining us today. I know that’s a lot of information. And it’s a lot to think about. And you don’t always have to have it all figured out by the first day of school, you can take it one day at a time. Take the special situations as they come. And if you have any tips and tricks about how to manage certain situations at school or things that you found that have worked for you, I’d love to hear from you. drop us an email or feel free to make a comment in our social media about the episode as well. And I wish all the kids going back to school this month and next month, a wonderful year ahead and much success. Thanks for joining See you soon.

Show Notes and Links

Pam’s son’s diabetes school emergency supplies box:

diabetes school emergency supplies

Emergency supplies box cover page:

Diabetes school supplies cover page

Disclaimer: It should go without saying that the Diapoint podcast is not intended as or should not be used as personal medical advice. You will hear us interview medical experts and others, but please always always ask your qualified doctor, diabetes team or other expert about your health. What works for one person does not always work for another person. What you should always do when you discover any new health information is ask YOUR doctor about it. This information should empower you to have a discussion with your healthcare providers about it. Diapoint, our guests, sponsors and business partners are not here to replace that advice. Living a full, healthy life means taking the proper medical advice from your qualified physicians, diabetes team or other healthcare providers.

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My Diabetes School Journal
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Today’s episode has been brought to you by My Diabetes School Journal. My Diabetes School Journal is formatted to take the guesswork out of documenting carbohydrates, insulin doses and other things while your child is at school, you will speak with your school nurse and teacher daily about your child’s diabetes. In addition to your verbal communication, documentation of daily discussions and treatment are so important. Each page has a dedicated space for parents and school caretakers to document the day, including a space for snacks, lunch school activities, as well as an area for additional notes of things that happen throughout the day. It also includes pages for weekly reflection and review. This nine-month, five-day week journal is not dated so you can start using it any time of the year in any school system in the world. It’s recommended for the management of Type 1 Diabetes in nursery elementary and primary school aged children. The interior pages are designed to match the colourful motivating exterior and it was also selected by a child with Type 1 Diabetes himself.

This episode is also brought to you by The Ultimate T1D School Game Plan, the online course for parents of school children with Type 1 Diabetes. We have it on sale now for just $17 in our back to school special offer. The Ultimate T1D School Game Plan is a video-based, self-paced online course for parents and caretakers of school children with Type 1 Diabetes. It was created by the Founder and Managing Director of DiapointME with her extensive knowledge gained from her professional background in international Healthcare Management, as well as the firsthand experiences she had in caring for her own son, who has had Type 1 Diabetes for more than 11 years now. In this online modular program, you will learn about planning the day to day management, special situations and get special links and tips for resources that will also help you along the way. You can enrol now at or at

About Dia-Logue: The Diapoint Podcast and Pamela Durant

Here at Dia-logue: The Diapoint Podcast, we talk to experts and people living with diabetes about social situations, nutrition, mental health, travel, and many other topics related to health and wellness.

The Founder & Managing Director of Diapoint, Pam Durant, shares her experience as the mother a teenage son who was diagnosed with Type 1 Diabetes at 20 months old.

Pam was also a healthcare manager for 25+ years, and is a certified Wellness and Lifestyle Medicine coach. She is passionate about showing people how to not just survive, but thrive.

If you are interested in appearing as a guest, please email us at We would love to hear your story and your connection to diabetes.

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