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From Nashville, Tennessee, USA:

I am a kindergarten teacher who had a child with diabetes in my classroom last year. This child was insulin dependent with widely fluctuating blood sugar readings. Her mother told me to give diet Coke when her blood was above 200 as that would bring it down as good as insulin. Is that correct? She also gave me instructions to let her eat what she wanted so that she would not be "different" from the other children. Could you comment? Should I have notified the child's doctor? What is my responsibility in a case like this?


If you have questions regarding the parent's recommendations regarding management of the child's diabetes in the classroom, I suggest you ask the parents to either have the child's physician send in written instructions for the child and/or ask the parents for written permission to speak to a member of the child's diabetes team.

Diet Coke may be appropriate to give the child when her blood sugar is high, but does not technically lower the blood sugar like insulin.

It is important to try and have the child eat as many of the snacks that the other children eat in the class so she doesn't feel different. Most snacks can be fit into the meal plan of a child with diabetes. Although some professionals may feel that it is best to let the child eat whatever the other children eat, this can lead to unpredictable swings in blood sugar if there is wide variation from day to day in carbohydrate (sugar) intake. You may want to give the parents a list of the most common snacks served in school and ask them to give you information regarding how much the child can have of each snack, and whether or not there are some snacks that are difficult to fit into the child's meal plan. You might be able to provide a choice of 2 snacks so the child can always have an acceptable choice and not feel left out. Again you might ask the parents to provide written guidelines from the child's physician, nurse educator, or dietitian.


Original posting 22 Jul 97


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