We have our 34 month old son enrolled in a church mother's morning out program. He attends one day a week from 9am to 1 pm. We have decided we would be responsible for stopping by and doing his standard blood check as we live right up the road AND he is only going one day a week. He has only attended two times and we are having a problem with low blood sugars (70 first week, 50 following week).
Both times when I walked into the room I could tell he was low, but even with giving the staff (it is a 1 - 4 ratio in the class) a handout on signs of lows, talking with them, there is no way they would of caught this until he was falling asleep. Unfortunately our son doesn't display any obvious symptoms until he is falling asleep, or just plain falls over. Both teachers told me they couldn't tell he was low. They are doing their best, and I can't expect them with all that goes on to keep 100% attention on our son. But I also worry about someone getting to him after the fact, when he is sleepy, and he can be hard to get juice down him.
I treated him both times with juice, and checked 1/2 hour later. He did not come up much, so I am glad I did not let him stay. He has the same activity level at home, going outside after bfast, snack and running around like crazy.
We want to treat him like a normal kid, but we worry because he can't yet communicate with us about lows and highs. We have had excellent A1C's and good control as we can keep an eye on him, and do extra checks if needed. Stopping by a lot at pre-school defeats the purpose of sending him. We don't want to get a call after the fact when he is passed out.
Here are our questions:
- Is he too young to be in this pre-school without being able to communicate effectively?
- What else can we change?
We do not want him to be too high as he can be cranky and hard to deal with. We can control the insulin and snacks, but the excitement is totally out of our control and we believe it plays a big factor in this equation. He is also a very, very active little boy, and is always on the go.
All the parents of pre-school diabetic children that I know worry about the same things you do: how can you prevent lows and what if the nursery staff doesn't recognise that your child is low?
In fact you have already provided the answers to your own questions. I agree that excitement is the ingredient that is different on the mornings he goes to nursery. He may also be a bit more animated. It would be a great pity to withdraw your son from pre-school because of diabetes and I would discourage this. Perhaps all you need do is reduce his insulin and give more starchy food on the appropriate mornings. If you just go on providing gentle support for the staff rather than offering to make all the decisions for them, they will be more willing to participate in your son's care. It is particularly important that you support them if they feel he's low and give him some extra sugar without proving it with a blood test. Time and experience are the most important commodities here. Hang in there.
Original posting 29 Sep 96
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