For Professors and Teachers

This page is intended to serve as a simple starting point for professors, teachers, mentors, and other educational staff (for middle/secondary school and older) who have a student with type 1 diabetes. For more information and specifics details regarding your institution, please consult your school nurse, accessibility office, administration, or other trained professional. 

Before you begin...

This page includes an abundance of information in order to provide the most accurate and useful guide to having a student with type 1; however, you will most likely not need to intervene or treat your student's diabetes during their time in your class. 

Most people with type 1 are entirely self sufficient and will not need assistance. 

What is type 1 diabetes?

Type 1 diabetes (often abbreviated as T1D) is an autoimmune disorder where a person's body attacks and destroys the insulin-producing cells in the pancreas. Insulin is a hormone that travels through the bloodstream and helps glucose (a type of sugar that is the body's main form of energy) pass from the bloodstream into the cells and tissues that need it. 

Without insulin, a person's body can't process glucose, meaning that it has lost its main source of energy. This causes glucose to build up in the bloodstream and the body to start rapidly burning fat as an alternative fuel, both of which are harmful if left untreated.


How is type 1 diabetes treated?

Unfortunately, there currently isn't a cure for type 1, but it can be treated and managed with careful monitoring of a person's blood sugar and injections of insulin. Since someone with type 1 diabetes can't produce insulin themselves, they must give injections of insulin, either through a syringe and needle, through a pen, or with an insulin pump (see below). This is used to help their body absorb the glucose from the food that they eat and to ensure that their blood sugar stays within an acceptable range. 

However, giving manual injections of insulin isn't as finely tuned and accurate as the pancreas doing the job itself, so people with diabetes must carefully monitor their blood sugar at all times. A person with diabetes can check their blood sugar using either a handheld meter that uses a small finger prick of blood or using a continuous glucose monitor (CGM), which is a device that sits on a persons stomach, leg, or arm with a small wire just below the skin that measures their blood sugar and relays it to a special receiver or sometimes to a smartphone (see below).

A insulin injection can be given using a syringe, needle, and vial of insulin, but this is most common only in hospitals. 

A glucose meter uses a small finger prick of blood to check blood glucose levels. 

An insulin pen can be dialed to a certain amount and then injected through a needle screwed on the end.

A CGM automatically checks blood glucose and sends that infomation to a connected device or smartphone.  

An insulin pump automatically delivers insulin at set intervals and upon request before eating food.

People with diabetes will also use a variety of other medical supplies to help manage their condition. 


What should I know as a teacher?

There are times when a person's blood sugar may go too low and they need to eat some fast acting sugar (ie. candy, frosting, juice box) to help raise it again. There will also be times when a person's blood sugar goes too high, and they will need to give themselves more insulin to bring it back down. A student with diabetes will likely be actively managing their blood sugar during class, particularly around meal times. 

However, most people with type 1 diabetes, especially those who are in middle school or older, are completely self sufficient in their care and will rarely need assistance. There are two main occasions when you may need to intervene, cases of severe hypoglycemia (low blood sugar) or cases of severe hyperglycemia (high blood sugar). Read below about how to notice and treat such cases. 

Severe Hypoglycemia (Low Blood Sugar) Symptoms

Symptoms may include:

**These symptoms only occur in the most severe and rare cases. 

Severe Hyperglycemia (High Blood Sugar) Symptoms

Symptoms may include:

**These symptoms only occur in the most severe and rare cases. 

When to Intervene

If a person is conscious, coherent, and able to take care of their diabetes independently, then there is usually no reason to get involved. However, if the person is unable to treat themselves, is unconscious, or is not responding, then you should follow the steps below. 

Severe Hypoglycemia (Low Blood Sugar) Treatment

Steps to take:

Severe Hyperglycemia (High Blood Sugar) Treatment

Steps to take:

How to Administer Glucagon/Baqsimi

In the event that a person is unconscious with suspected hypoglycemia (low blood sugar), then you may need to administer Glucagon (an emergency injection) or Baqsimi (an emergency nose spray). Both serve the exact same purpose of quickly raising blood sugar and are fairly simple to use. 

A student with type 1 diabetes should be carrying one or both of these medications either on their person or in their backpack or other belongings. In some cases, a school's nurse office or main office may have the student's medication or have a supply of their own. It is a good idea to check with your student about where they keep their Glucagon and/or Baqsimi beforehand. 

The video on the right demonstrates how to administer glucagon. Click on the link to view how to administer Baqsimi. 

If either Glucagon or Baqsimi need to be used, call 911 (or your local emergency number). They are not "magical" medicines that will cure hypoglycemia, and the individual will still need professional medical attention. After administering one of these medications, turn the student on their side and place them in the recovery position (see image at right). 

They should regain consciousness after about 15 minutes, but if they do not, a second dose of Glucagon or Baqsimi should be administered if available. Both of these medications may cause vomiting, so ensure that the person will have a clear airway by having them in the recovery position. If you have further questions in the moment, ask the emergency dispatcher about what steps to take. 

Accommodations and Accessibility

All U.S. public schools and colleges, most private schools, and any institutions that receive federal funding are required by law to provide reasonable accommodations to students with type 1 diabetes (or any disability). 

The Americans with Disabilities Act and Section 504 of the Rehabilitation Act state that, “No otherwise qualified individual with a disability in the United States, as defined in section 7(20), shall, solely by reason of his or her disability, be excluded from the participating in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance…” These laws also specifically state that this provision applies to any "college, university, or other postsecondary institution, or a public system of higher education.” 

Schools and/or individuals who fail to meet reasonable expectations regarding accommodations or are negligent in their implementation may face civil lawsuits and/or criminal charges. Schools and/or individuals who fail to meet reasonable expectations regarding accommodations or are negligent in their implementation for third party testing (ie. College Board, ACT), may lose their right to administer such tests on a school district or county-wide basis.

Certain testing companies, such as College Board and Princeton Review (the companies that administer the SAT, AP tests, and the ACT), require that accommodations be provided for their test to students who need them as a part of the contract that allows schools to offer these tests. 

While accommodations vary based on the individual's needs and the resources available to the school, here are some commonly accepted reasonable accommodations to students with type 1 diabetes:

Usually, school or district administration and/or the schools accessibility/student services office are responsible for developing 504 plans and ensuring that students receive the proper accommodations that they need. As a teacher, it is your responsibility to ensure that you always follow such guidelines.

Legal Privacy

The Family Educational Rights and Privacy Act (FERPA) dictates how personal educational information (including information about accommodations and medical conditions) can be shared and accessed. While the legal implications are long and complex, there are two simple concepts that cover most situations. 

These laws are strictly enforced and come with heavy civil and criminal penalties for negligent or willful violations, including a loss of all federal funding for the most serious cases. It is in the best interest of the institution, the teachers, and any other individuals who have access to private student information to ensure that it is secured privately. 

While the legal provisions of FERPA and similar laws extend far beyond what's discussed here, recall the two simple principals above that can be used to determine whether you have the legal right to share a student's personal information. 

Ethical Privacy

There is almost universal agreement that ones personal health information should be kept private and only disclosed with their permission. While the laws mentioned above provide robust legal protection, perhaps an ethical approach may resonate more effectively with some individuals. 

You can hopefully understand that if you went to a doctor and received a life-changing diagnosis, you would require time to process the sudden news and you may be reluctant to share that information with everybody you know. Not only does such news take time to cope with and understand, but when it is compounded by the fact that one must learn how to treat a complicated condition, the onset of a new disease is a stressful and emotionally traumatic period of someone's life. 

Unfortunately, there is also a lot of stigma around diabetes as being a disease associated with obesity, poor eating habits, or laziness, none of which is true for type 1 diabetes. 

While some choose to wear their diagnosis of type 1 as a badge of pride and resilience for all to see, others choose to share it only with their closest friends, or even just their family. Neither option is right, wrong, good, or bad, they are all different and reflect how people process their life's difficulties in their own unique way.

As teachers and professors, your job is chiefly to teach students and ensure an appropriate and encouraging environment for learning. Sharing private information without permission can cause significant emotional trauma for some. If you are ever in doubt about what information you can share, always ask the student privately first, or simply do that share information. 

Sources and Further Reading

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