Scared by complaints

FelicityG said:

Thank you!!! Every time she has high or low they make her contact us. Also for lunch adjustments. And every time she suggests to do what I would suggest. She knows what to do (apart from times she tries to nibble on something sweet and thinks I cants see ). But they take her from lessons till sugars stabilise - can you imagine high sugar stabilise in like 10 minutes? Yes, I see how afraid they are even though she never had ketones, for example.

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They expect a correction dose to kick in in 10 minutes? Oh hell no. it certainly don't need to take you out of the game.. (A member of staff must have been watching Con air?)
What they don't know is that their idea of "back covering" is actually undermining this kid's confidence.
Or it could trigger resentment.

There don't seem to be any "support" at her school if they are not listening to the kid. when you corroborate too.

FelicityG said:

thank you! Yes, sometimes Dexcom is a real curse. They make her wait till sugars go back to normal so she misses lessons, and their faces if I have to collect her... it’s like if they say last goodbyes! Just... unbelievable!

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Oh, hello? i don't use a Dexcom. i use a Libre. same principle. what i do know is they work my testing Interstitial fluid.
coming back up off a low, my sensor can lag by up to half an hour before my blood meter says I'm OK & the meter can lag a bit after i feel fine? Pending on the type of hypo. i can just treat & go. (Others can struggle.)

FelicityG said:

Thats what I want - I want them to let her manage it herself. And she can. But they hear her CGM beeping and send her to manager straight away. She can’t even go to toilet to do her finger prick or injection - always under supervision. It’s like taking care to such a level you want to run. Maybe they do it on purpose?

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No need to hide it out in the "Bog."
Now this is "Political correctness" gone wrong at this school.. (But i can apreciate the whole C19 thing happening right now, However.) She should just be accepted to do her "thing" in the company of her school chums..? It should be that thing her mates think she has to do to eat? (They don't need to get their heads round anything else.)

The staff should engage & support. But this don't sound ideal all round.

Maco said:

@FelicityG Sounds like they’ve got major issues & if I was you I’d be taking it further, maybe governing bodies? Making her miss lessons because her bloods aren’t in range is absolutely ridiculous, I thought school set you up for work life? So they are basically saying when you eventually get a job if your bloods aren’t in range you can go and sit in the lunch room for an hour. Their thinking is absolutely shocking, I’m actually annoyed for you!

I’m not being funny here, but if when I was at school they said if your bloods aren’t in range you can’t attend classes I would of been sticking 10 donuts down my neck every morning. Without a doubt take it further, go beyond the school because it’s shocking

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It's ignorance. But then again, they are non-medical professionals. So how could one expect them to know what we have been educated to know through managing our own condition and completing courses and being overseen by a diabetes consultant and DN? Just having a meeting with the teachers would be enough and be reasonable.

Does this situation all spring from some sort of risk assessment / statement of special needs ? Perhaps it is based on whatever the school's experience was with some other pupil. Is there a school nurse who has laid down these rules about sending her home ? This sort of panic reaction isn't helping anyone. I would suggest you write down clearly what you expect the school staff to do and in what circumstances and also find out who told the school to keep sending her home. Explain to them that insulin doesn't bring down blood test levels instantly too.
Perhaps you can get a DSN to offer them some more sensible written advice to refer to. I think they are just worried about covering themselves legally speaking.

FelicityG said:

she is the only diabetic there. CGM beeps when it’s 8 and when it’s 3.4.

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I'm fairly new to this but an upper limit of 8 seems very low, especially as libre I'm on considers up to 10 'in range'. I only manage to stay under 10 after food if I nail the pre-bolus timing, so no wonder they are getting a lot of beeps!

FelicityG said:

the point is they had a meeting with nurses. They have a whole plan printed out what to do. But it was when she had a “honeymoon” and sugars were mild. Now with puberty and after lockdown basal rate rose, sugars (as nurses warned us several times!) are not that predictable and school panics and make our kid panic too. Every time she goes to school now I wait for the call, I can’t relax at all.

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As someone who has found it a difficult journey as a fairly recent type 1 and as you must know as a parent, a single meeting with a nurse won't be sufficient for anyone to understand the complexities of managing this condition.
As sugars spike after eating carbohydrates, 8 is not going to be a useful high alarm to set. It will take 5 hours after eating to know if the fast-acting dose was correct for the meal. Corrections, if needed, should be done with the next meal. This is something you should ask your diabetes team about.

So from what you've said, the nurses need to issue a new set of guidance points / adjust the point at which the CGM beeps. You said earlier that the school always reports that your daughter is pale and shaky when they ask you to collect her. That sounds a lot like a description of typical hypo symptoms to me. Perhaps they are confused. Make sure you are copied in /attend the meeting so you know whatever advice the nurses are providing. when they issue their new version.

ert said:

As someone who has found it a difficult journey as a fairly recent type 1 and as you must know as a parent, a single meeting with a nurse won't be sufficient for anyone to understand the complexities of managing this condition.
As sugars spike after eating carbohydrates, 8 is not going to be a useful high alarm to set. It will take 5 hours after eating to know if the fast-acting dose was correct for the meal. Corrections, if needed, should be done with the next meal. This is something you should ask your diabetes team about.

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The point is she should be allowed to monitor & control her own condition without being jumped on by staff because of any sort of high or low. Even a couple of meetings with a DSN or getting a member of staff to do a course wouldn’t help because let’s be honest they aren’t going to be that interested to take it all in. She’s a young adult, treat her like that. Isn’t school about prepping you for adult life? As someone who has gone through what she’s going through i can understand her frustrations.

Hi, a few thoughts...
Sounds like they've had some sort of bad experience in the past with another diabetic pupil which has probably influenced their policies now? Sounds like they are scared of allegations of poor treatment and have outdated protocol (possibly based on primary school aged pupils given the lack of ownership it allows your daughter?). I wonder if in the past they have had complaints about lack of support for a diabetic who has refused to inject for meals and had to implement a policy for them which is now their 'go to'? Ignorance seems to be the problem here, but it is understandable given many schools don't even have nurses, just first aiders.

Completely agree that your diabetes centre needs to get in contact with the school and share info and suggested protocols. This is what happened when I was diagnosed at secondary school, and it is the practice with diabetic pupils at the school I work in now. I wouldn't wait until a clinic to sort this, if you can email her DSN that would be the easiest. Especially if she is hypo, a policy whereby she moves to another room to test in front of staff could delay much needed treatment.

While dangerous to not aim for bloods under 8, given the potential lack of learning when she is waiting for it to drop again for a high, I wonder if the threshold could be changed to 10? Perhaps just during term time?

Is it a private school? If not I don't see any reason they could reasonably use this to suggest your daughter can't continue attending lessons. I regularly have pupils complaining of headaches/stomach ache etc but their parents can't collect them and they prefer to stay in lesson rather than waiting in the first aider's room and missing out. I don't know if things are different on this front in private school... but I believe you could eg ask the DSN to clarify with school that unless ketones are at higher levels, and bloods remain above (insert reasonable but high value here-15mmol?) for more than 1 hr after correction that you have no reason to collect her?

Your diabetes team contacting the school to provide them updated education/training/guidance is the key to improving this situation I think. Sounds to me like the school are scared and trying to cover their backs with an outdated policy.

Hope this helps a little!

Maco said:

The point is she should be allowed to monitor & control her own condition without being jumped on by staff because of any sort of high or low. Even a couple of meetings with a DSN or getting a member of staff to do a course wouldn’t help because let’s be honest they aren’t going to be that interested to take it all in. She’s a young adult, treat her like that. Isn’t school about prepping you for adult life? As someone who has gone through what she’s going through i can understand her frustrations.

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This needs to be outlined by the parents. They have asked for support, so that's what they're getting from the school. The next step, which is what you are suggesting, is for the student to manage their own blood sugars.

ert said:

This needs to be outlined by the parents. They have asked for support, so that's what they're getting from the school. The next step, which is what you are suggesting, is for the student to manage their own blood sugars.

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You would honestly say that what the school is doing is supporting the parents, are you serious? If the school was supporting them, we wouldn’t be sat having this conversation.