About Diabetes
Diabetes is a condition where the body cannot regulate blood glucose (sugar) levels properly. Type 1 diabetes is the most common form in children and young people.
In Type 1 diabetes, the immune system destroys the insulin-producing cells in the pancreas. This means the body can no longer produce insulin, the hormone needed to move glucose from the blood into cells for energy. Type 1 diabetes is not caused by diet or lifestyle and cannot be prevented. It requires lifelong insulin treatment.
Modern management increasingly involves technology. Many children now use continuous glucose monitors (CGMs), which automatically track blood glucose levels and send readings to a receiver, phone or smartwatch. Some pupils use insulin pumps, which deliver insulin continuously through a small device worn on the body. Schools should develop an Individual Healthcare Plan with the family and the child's diabetes team.
Understanding Blood Glucose Levels
| State | Blood Glucose | Signs | Action |
|---|---|---|---|
| Hypoglycaemia (hypo) Too low | Below 4 mmol/L | Shaking, sweating, pallor, confusion, irritability, hunger, dizziness, difficulty concentrating, slurred speech, drowsiness | Give fast-acting sugar immediately (e.g. glucose tablets, sugary drink, fruit juice). Follow with a slower-acting carbohydrate (e.g. biscuit, sandwich). Do not leave the child alone. If unconscious, call 999. |
| Hyperglycaemia (hyper) Too high | Above target range (usually above 10-14 mmol/L) | Increased thirst, frequent urination, tiredness, headache, blurred vision, nausea | Allow access to water and the toilet. Follow the IHP. Contact parents if levels remain high or the child feels unwell. |
Classroom and School Strategies
Daily Management
- Allow the pupil to test blood glucose levels or check their CGM at any time
- Allow the pupil to eat or drink in class when needed, including during tests and exams
- Provide access to a private, clean space for insulin injections or pump management
- Allow unrestricted access to the toilet
- Never prevent a pupil with diabetes from eating, drinking or accessing the toilet
- Ensure all staff (including supply teachers, lunchtime supervisors and trip leaders) are aware of the pupil's needs
- Allow the pupil to carry their diabetes kit, glucose and snacks at all times
In the Classroom
- Be aware that both high and low blood glucose can affect concentration, mood and behaviour
- Allow extra time or a break if the pupil has recently had a hypo, as recovery takes time
- Do not penalise poor concentration or behaviour that may be related to blood glucose levels
- If a pupil's CGM alarm sounds, allow them to check it immediately
- Be discrete and avoid drawing unnecessary attention to the pupil's condition
Physical Education and Exercise
- Encourage full participation; exercise is beneficial for diabetes management
- Ensure the pupil has their glucose meter, fast-acting sugar and water available during PE
- The pupil may need to test blood glucose before, during and after exercise
- The pupil may need a snack before or after exercise to prevent a hypo
- Be aware that hypos can occur during exercise or several hours afterwards
- Follow advice in the IHP regarding insulin adjustments for PE
School Meals and Snacks
- The pupil should eat regular meals and may need additional snacks
- Carbohydrate information should be available from the school kitchen for carb-counting pupils
- Ensure the pupil has enough time to eat, including time for blood glucose checks and insulin
- Do not restrict food or use food-based rewards or punishments
Trips and Residential Visits
- Plan carefully with parents and the diabetes team well in advance
- Ensure a trained member of staff accompanies the pupil
- Take all diabetes supplies, including spare equipment and hypo treatments
- Adjust plans for activity levels and mealtimes
- No child should be excluded from a trip because of diabetes
Further Information and Resources
Diabetes UK provides dedicated schools guidance and training resources.
NHS information on Type 1 diabetes offers accessible medical information.