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The Child Advocate is devoted to children and the parents and professionals that work with them and advocate for them.  Diabetes has long been a problem for countless children.  Insulin pumps and classroom testing have improved treatment, yet schools often are hesitant or have concerns regarding their use.  Here are example documents originally developed by Dr. Mary Simon and shared through Bear Skin Meadow Camp.  These documents go a long way toward addressing school issues.  The information presented at this site is for general use only and is not intended to provide personal advice or substitute for the advice of a qualified professional.  If you have questions about the information presented here, please consult a physician skilled in diabetes management, the resources listed or other professional in your area.

Insulin Infusion Pump Therapy (Sample agreement for school below)

Suggested Protocol for Blood Sugar Testing in the Classroom

Diabetes in Children (return to main diabetes page)


Insulin Infusion Pump Therapy (Sample agreement for school)


My patient, _______________________________, is using an insulin pump to control their diabetes. The following instructions apply to their care while in school.

_____I. Independent Management

This student has been trained to independently evaluate pump function and change the infusion sets. This student can interpret blood glucose levels and take appropriate action. Including, but not limited to:

  1. Changing of insulin infusion sets using universal precautions.
  2. Give boluses of insulin for both correction of blood glucose above target range and for food consumption.
  3. Switch to injections, should there be a malfunction with the pump.

_____II. Non-Independent Management

Because of young age or other factors, this student can not independently evaluate pump function nor independently change infusion sets.

  1. Parent and the school nurse will provide training in the supervision of the operation/guidelines for the designated school personnel.
  2. Parent must be called with pre-lunch blood glucose so parent can give dose.
  3. School personnel will need to verify the dose in pump before child pushes the activate button.




  1. Parent must be called at anytime the child has a blood glucose of 170 mg/dl or above. Parent must be called and a glucose tablet given immediately at anytime the child has a blood glucose of 70 mg/dl or below.
  2. The student will report pump alarms/malfunctions to school personnel who will call the parent for problem solving.
  3. The student will report site tenderness to school personnel who will call the parent for problem solving.


In case of pump malfunction

7a If parent decides there is a pump problem, the parent will come to the school within 30 minutes to remedy the situation.


7b If parent decides there is a pump problem, this child has been trained to take an injection with an insulin pen. School personnel will verify the dose as instructed by the parent and ensure that the correct amount of insulin has been “dialed” into the insulin pen. School personnel will also observe the injection of insulin by the student.


III. For all students utilizing insulin pumps

1 . Parents will provide complete supplies for set changes, insulin & syringes or insulin pen and cartridges, and batteries to be maintained in the health office.

  1. The school will provide a secure place to store the pump during intense activities such as Physical Education or Sports Activities.
  2. Parent agrees school is not responsible to replace pumps that are lost, damaged, or stolen at school.


In the situation where the school is unable to reach the parent, call ______________Clinic or Hospital at phone number___________ and  speak with the physician or nurse for assistance.

These orders are effective from ________ to ________, unless amended by both the parent and the physician’s office.


____________________________________              ______________________________________

Parent                                                                                      Physician

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