School Discriminating Type-I Diabetic Student

Hi Everybody
This is Misbah. My son is T1D and was diagnosed when he was three years old. Currently he is fourteen years old and freshman in high school.
I have a very serious concern which I would like to discuss here and would welcome any advise to deal with this situation.
My son is currently studying in a private school (ninth grade). We are from Canada and my son is studying here as an international student and is a boarder (staying at school provided dorms).

The school has currently sent an email which is very absurd and is a reason of creating mental stress for my son just because he has diabetes. See the excerpt below from the email:

“As we face the unknown challenges of our healthcare climate, we will expect the student to take primary responsibility regarding his diabetes care moving forward. We have identified the following four behaviors as challenges for the student and will expect to see him focus on the following in the 2020-2021 school year:

1- Student will be expected to respond to the sensor alarm immediately and within 5 minutes by contacting the Health Center to initiate and discuss an appropriate plan.***
2- Student will be expected to respond to communications (text or phone calls) from the nurses or athletic trainers immediately and within 5 minutes.***
3- Student will be expected to communicate the truth at all times.***
4- Student will be expected to check in with the evening nurse by 10 pm, unless off campus. In those cases, he will need to make an alternate plan prior to leaving.

The student will be given a three strike policy for not fulfilling the expectations outlined above. Upon the third strike, parents will be notified by the Head of Upper School and disciplinary actions, including the possibility of dismissal, will be addressed at that time.”

The last paragraph is really shocking. I received this information form the Head of Upper School in an email. I do not know how to attach the email here. I would appreciate it if you advise me and guide me as to what I should do in this scenario. Do I need to take legal action? Can we take legal action since we are not from US? How are international students with T1D protected in schools? Can someone refer a lawyer we can consult?

I have no one to turn to so would really appreciate any sort of feedback.

Hi @misbah1975. I was diagnosed in 1963, and until I graduated from college I took “a shot” (one) a day, tested my urine for sugar, and had no access to BG meters, much less CGMS and I don’t think I heard the term “insulin pump” until I was in my 30s. There were no 504 plans in place, and I simply let my teacher know if I felt funny and needed something to eat.
Times have certainly changed. There is much more technology - to which your son’s school nurse has access - and while I’m not a parent I imagine with it comes a greater duty on the school’s part to make sure your son, and children with any medical condition under their care - are safe. Whether this is discriminatory or not, I imagine depends on whether or not they are requiring some sort of periodic “check-ins” from students with epilepsy, asthma, and other conditions, which they may or may not be at liberty to reveal. The verbiage may be a bit over the top, but sometimes things are written in a certain manner to convey the seriousness of the matter. “Please have Tony respond to the nurse within 5 minutes…” does not have the same effect; and I imagine if I were a child and did not respond to my alerts quickly, my parents would be concerned.

Let me share a short true story from when I was in my mid 20s: I had graduated from college and was living at home; and I went to spend the night with a friend, thinking I had told my parents I would be gone. When I did get home the following day my father was seething - I hadn’t told them, and he proceeded to ream me up one side and down the other for making him and my mother worry, because they didn’t know if I was at a friend’s house, or was in a hospital or “lying unconscious by the side of a road somewhere” (a direct quote I still recall to this day).
Despite technology, despite how well we care for ourselves and how responsible we are - for someone with a medical condition there is always some degree of concern that something may have happened that would not happen to someone else; and being in charge of the well being of the children under their care, they school wants/needs to ensure your son does his part so they can do theirs.
So I would suggest you step back, take a deep breath, and ask yourself whether this is truly a bad thing, or if they may be trying to keep your son’s best interest in mind. See if you can find out if a similar policy applies to students with other medical conditions. And then consider a lawyer if you feel you should.

Dearest Misbah,
This brief article may be helpful.
I found it searching “type 1 diabetic Canadian private school”

This 1 line needs to be drawn to the attention of the school personnel who emailed you.

“Low blood sugar can affect a student’s ability to think.”

When a T1D has a hypoglycemic episode the 5 (or 10?) minute “rule” may simply NOT work. If one of the knowledgeable people

“At least 2 staff members must be trained to provide support. Even students who are independent need help sometimes. …”

is WITH your son at all times then the time rule MAY be feasible.

It takes years for a diabetic to attune themselves to the symptoms of their hypoglycemia. We need to subconsciously know to take glucose tablet(s), a couple ounces of sweetened beverage or whatever is our preference, to remedy the low glucose alarm or symptom. Often my mind is already floating away into an observation window, or vacation site, by the time my symptoms tell this old T1D that something sweet is needed. Knowing to eat a little bit of something sweet is a key, but it still takes precious time for the digestive process to get that glucose into the cells that require it. 15 minutes is a minimum and for some T1D their recovery time may be closer to an hour. When our brains run out of glucose we are indeed in a sad state of affairs. Making a specific phone call during a hypoglycemic episode sounds like quite a trick to me. If your son’s CGM is set far enough from the blood glucose level that he loses his mind (as I referenced my vacation site above) than such a call to authorities is possible. Thankfully the CGM lets us adjust this low alert number.

It IS up to the diabetic to take care of themselves.

With over a decade of experience he knows more than many health professionals about T1D. Still the school has to watch their own back. If you expect them to tend to all your son’s needs, while he intentionally rebelles as teenagers often do, then the school would not want to be held liable for any major medical incidences involved in his well-being. In my opinion, it seems the phone calls are intended to protect them as much as to protect your son.

I am sorry not to know more useful legal information on our shared health condition.

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Hi @Beulah9. You write that “When a T1D has a hypoglycemic episode the 5 (or 10?) minute “rule” may simply NOT work…” I think this is the reason they put this rule in place, precisely because lack of response could be cause for concern.
Having the CGM gives him the tool to track how he is doing and - theoretically, at least - take action before things reach a crisis level in the first place. As you said, it is up to him as a diabetic to take care of himself. And developing it as a child does make us mature a little faster in some ways.
@misbah1975 have you considered Dexcom’s G6 with Control IQ, or Minimed’s CGM with similar feature? Many people find the system helps them stay in range, which I imagine means a decrease in alerts in the first place. Either way, it is up to your son to do his part in his own care. And since the school is responsible for making sure he is okay - along with all their other students - this doesn’t sound unreasonable.