From Vallejo, California, USA:
As a school nurse, I am frequently asked to care for a diabetic student. I have an 8 year old Type l student who I can't seem to get into control. Everyday for the past few weeks he has been coming into the office with blood sugar in the low 40's. He gets a snack (a piece of fruit) at 10 A.M. prior to recess. He is supposed to eat all his lunch, but he isn't monitored. At 1 P.M. he comes to the office feeling sweaty. Lunch is from 12:10 P.M. to 12:45 P.M.
We are currently going to keep a log book of what his blood sugar is in the morning before insulin, what he eats all day and what his blood sugar is in the P.M. Hopefully we can get him under control. He receives a school supplied lunch so I don't know if I can get the outside food agency to supply a special diabetic lunch, but I'll try.
The insulin needs to be adjusted around what he wants to eat. It's not a matter of adjusting him, and getting the school to "comply;" rather, he seems to need less insulin in the morning.
You need to talk with the child's parents, and let them know what's been going on. It's their responsibility to talk with the child's doctor, and make the needed adjustments.
Original posting 6 Oct 97
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