Diabetes Management in Childcare Settings

“Parents want their children to be safe. Problems have occurred when school staff is not trained or available. Some states mandate that only a school nurse provide care for the child with diabetes. The problem is that school nurses are not always available. And unfortunately, even a full-time school nurse cannot be in all places at all times, so there must always be other trained school employees available to assist when the school nurse is not available to do so,” said Siminerio.

“Oftentimes young children cannot articulate how they feel, and childcare providers [may] misinterpret behavior associated with low or high blood glucose as behavior problems, rather than addressing the physical needs of the child,” Chiang added.

Communication Essential for Child’s Well-Being, Safety

Position statements on diabetes management in school and childcare settings from the American Association of Diabetes Educators (AADE) and the American Academy of Pediatrics (AAP) are consistent with the ADA position statement.2,3,4

“All three statements support the provision of care by trained unlicensed personnel when a school nurse is not available to provide care,” said Siminerio.

Each statement targets a similar theme that open communication and collaboration among all parties involved is essential to ensure the well-being and safety of the child within the school and childcare settings, said Siminerio.

“Diabetes management is 24/7, so schools and childcare providers must be prepared to meet the needs of children with diabetes to ensure a safe and smooth transition from home to school. Preparation will reduce the risk of both short- and long-term medical complications and will help ensure that all children with diabetes have access to the same opportunities as their peers,” said Siminerio.

A Team Effort

Siminerio believes it takes a team effort to make sure all children in school and childcare settings receive appropriate diabetes care, and collaboration and communication between school, families and clinicians is essential.

“In order for care to be optimal, the parents or guardians, childcare provider and health care provider need to coordinate and have a well-written care plan for the child,” says Chiang.


  1. American Diabetes Association. Statistics About Diabetes. Data from the National Diabetes Statistics Report, 2014. http://www.diabetes.org/diabetes-basics/statistics. Published June 10, 2014. Updated September 10, 2014. Accessed October 27, 2014.
  2. Siminerio LM et al. Diabetes Care. 2014;37:2834-2842.
  3. American Association of Diabetes Educators. Management of Children with Diabetes in the School Setting. AADE Position Statement. http://main.diabetes.org/dorg/PDFs/Advocacy/Discrimination/aade-ps-diabetes-school-care.pdf. Published August 2012. Accessed October 27, 2014.
  4. Council on School Health. Pediatrics. 2009;124(4):1244-1251.