Helping to transition a diabetic to being self directed

[100kids, BSN, RN]

I have a Type I diabetic with huge fluctuations in #s (has been for years since diagnosis). With Dad we are trying to foster more independence in him because the school he will be attending next year works that way. Because of this he is now testing in the classroom and only coming to see me if his # is high enough to test for ketones or low enough where he may be crashing. He also comes to my room to do his insulin shot after we've discussed his reading and his sliding scale.

My question is up until now I have kept records of all of his daily readings, if he had ketones and his insulin at lunch. Do I now only need to keep track if he needs to come see me (ie if ketones are present when tested or when he does his lunchtime insulin?) Or should I get him to report his daily #s to me and keep a record of them?

What would you do?

[Flare, ASN, BSN]

i had a student last year (8th grade) that wanted a bit more freedom. I had her keep her own log book and check in with me for either highs, lows or every friday to get all her numbers. It was crystal clear to her that if she missed logging even one number or failed to come and see me even once that she'd be busted back to daily visits to me in my office. She really rose to the challenge.

[100kids, BSN, RN]

thanks Flare. Did you chart the #s she had put in her log book for your school records or just if she had a high/low or what?

[Flare, ASN, BSN]

i charted everything in a weekly note - except if she came with a # out of bounds - that would be charted at time of visit - charted as a specific office visit. Though the out of bounds number would still be included in the log.

[100kids, BSN, RN]

thanks for the help!

[Spidey's mom, ADN, BSN, RN]

We have 4 diabetic kids in our school district and fortunately 3 are here at one of the elementary schools. Two are Kindergarten students.

Each student has his/her own large binder with pages for charting daily BG/carbs/insulin. We keep the binders in the classroom during the school day and back in the office at the end of school. The older student writes in his own info but is still overseen by the health aide or me. Next year this will all be done in the office at the Jr. High and overseen by one of the office staff.

He's a bit of a challenge - he knows what to do and we make him do all of it but he's not serious about it. It will be interesting to see what happens next year. He refuses to even consider a pump.

[mmc51264, BSN, MSN, RN]

I have a child with T1 and they should not be going to the office if they are extremely low. Someone needs to come to them. My child has a HCP and an IEP that states this. He is in second grade, so obviously needs help. We'll see what's to come.