Teachers questioning 504 plan

So the 504 plan is in place, i held a meeting with all of the teachers to discuss type 1 and symptoms, everyone seemed supportive and understanding....Drew has been having some lows this week (at home and in school), I am sure it is honeymoon period, stress, etc.  Here is a letter from one of the teachers.  Any suggestions on how to answer it????

Mrs. Bowen,


1)      How do I explain to the class that it is “ok” for him to snack in class, but not the rest of the class, without letting them know there is a non-specific  reason. I do not understand why everything has to be so secretive.  

2)      He gave some of his snack to another student, so I had to tell that student he could not eat.

3)      Should he have snacks with him in his back-pack? He came to class, left and was “tardy” because he was getting a snack. I did not send him for a pass, but this could get to be a distraction.

4)      I am having to “push” him to start his work. He does not have paper, pen or pencil – had to borrow from another student several minutes after we had started assignment.

Thanks for any help with this situation,  B. Knox / 5th period – Law Studies


Hi jeniffer, i dont know how old your son is but i have a 6 year old in first grade with t1 he as well has snack time but the rest of his classmates do not ,for this reason we decided that it was best for the nurse to come to his class have him excused bring him the hall where theirs a desk and chair where he gets his sugar checked and has his snack.It takes no more than 5 or 6 minutes because i only pack him a quick snack,then he goes back in to the class and it seems as if none of the students even notice.I hope this will help you good luck.      

Hi Liza, 

My son is in 10th grade this year, he was just diagnosed in July 09.  I can't imagine what it would be like to have such a young one diagnosed!  I have just re-read the email...and it is not as bad as i first thought.  The "mama bear" in me went into protect mode at first and i think i was blinded by the red sparks of anger shooting from my eyes!  Now that i have calmed down and re-read it, the only thing that irks me is number 1 on his list.  I wonder if the teacher and my son switched places would he feel the same about being "secretive".  These kids want to fit in, not stand out.  Although i tease my son all the time by telling him "You're different...just like everybody else."  On a serious note, i know that you guys have to be as exhausted as i am.  I just don't have the energy to fight with these teachers right now, and hopefully i won't have to!

My 10 year old daughter was diagnosed at 15 months old.  She has been on a pump since she was 4.  We have always told the class about her diabetes, I have spent a lot of time teaching her that it is nothing to be ashamed of and she has never gotten teased.  On the pump she doesn’t need snacks but she does go low at times and have to have glucose tabs in class.  She now has a glucose sensor that goes off some times during class but the teacher likes it because of it is warning them of the impending high or low.  My personal feeling is it is better for people to know about the diabetes in case something happens so they can get help.  Our teacher last year had the class help us raise money for our JDRF walk.  They even did a fundraiser at school and my daughter talked to the school.

I talked to my son again this morning about telling the class...and he says he gets picked on enough, that would just give the kids one more thing to pick on him about.  I know eventually everyone will know, but he wants to keep it to himself now.  Drew has been feeling low and tired a lot lately, several teachers have emailed me that he is not paying attention and sleeping in class.  He says he has just been trying to snack all day to keep it up.  He has only been testing it during lunch and only once has it been below 50.  So i told him to test more often during the day, that way we have the glucose results to back up his story and the teachers know it isn't just an excuse.  He is terrified of the lows because they make him feel so bad.  I think he has been skipping his breakfast shot because he has doesn't want to go low.  I wonder if he feels low because his sugar is spiking after he eats and then is dropping to a normal range.  He sometimes feels low when he is at 100 and 90.  I asked the endo about this and she said he might be coming off of a high because it doesn't make since to feel low with those numbers.  So much to learn and so overwhelming!  I guess i will call the endo and see what she says to do.  He has been ranging between 60-140 for the past few weeks with very little insulin.  maybe we should adjust his dose.


Absolutely call the Endo. Maybe the Diabetes Educator could talk to your son. I have a son who is 20 (non- diabetic) and my daughter is 6 dx T1 @ 3 yrs old. As bad as it may seem to have a three year old diabetic, I wouldn't rather have had her be diagnosed as a teen for anything. Little kids will not know any other way of life. A teen is another story. It was difficult enought at times raising a non-diabetic teen! I can't imagine what he must be going through right now! Try to get him to talk with the diabetes educator at your endo's office. I know at ours they are fairly young women and one is a diabetic herself. Ask if there are any other teen diabetics that would be willing to talk to your son. Or maybe an adult who had it as a teen. His health is at risk if he doesn't keep tight control by testing 6-8 times per day. He easily could end up in DKA or worse. Maybe you could schedule an appt for counseling with the endo's office but maybe don't tell him that's why you are going.  Maybe act like it's a regular appt. Actually, not long after dx we had to see the counselor at our office. God bless you... I hope things get better for you and your family. Reach out to other diabetic families if you can, I have never met a family that wasn't willing to help another.... we are all in the same boat, just trying to stay afloat!


I agree with Susan - my daugter is 10 and was DX in June09 - she is fine with sharing, but I have been thankful this didn't happen a few years from now.  He does not need to share it with the class, that teacher should be more understanding.  It would be better though if he got a good handle on his BG levels (easier said than done, I know) - he may need to reduce his doses or something, I agree call the endo. 

Perhaps you could "thank the teacher for being concerned" and ask for a meeting.  I get better co-operation after a meeting than through letters/notes - it is harder for people to be dismissive face to face.  Letting the teacher know that you understand he is in a difficult spot - but so is your son, might help.  Also explain that some of the other issues are likely due to BG as well.  People should be more understanding when this is all new to your son.

Also, for the first month or so my daugter felt low at 100 as well.  The CDE told us it was common and likely due to being high for so long and getting used to higher BG prior to diagnosis.  She indicated that she could eat a lower carb fast acting source (4 skittles in her case worked, she recommended one glucose tab) to treat the symptoms.  I would think that is an unobtrusive snack. 

Good luck, and let us know how it goes.


Hi Jennifer,

I am the mother of three children two have type 1 diabetes. My youngest and third child has the autoimmune antibodies associated with type 1 diabetes.  Even though they are brother and sister they are not on the same page when it comes to sharing information about type 1 diabetes.  My oldest son is 12 and started 7th grade this year and my daughter started 1st grade.  They both have the 504 plan and they both can check thier blood or eat a snack anytime anywhere they need to in school.  I can understand why your son might not want to talk about and it is his choice, but at the same time once they talk about it and people understand he is not getting special treatment he is getting medical treatment the kids are not so jealous.  That might be part of the issue with the other kids teasing him.  They just see he gets to leave class,eat snacks and in thier eyes do whatever he wants to do.  They are just kids so they do not understand why he does this actually even an adult would get a little jealous if a co-worker could take breaks, eat at the desk and have no consequence.  So I guess what I am getting around to is if he does not want to go into full detail about it he does not have to but maybe have him eat outside the class and not share snacks.  Also, I would suggest a hall pass of some kind with his picture on it really he should not go to far without an escort in case he is to low. He can also work out some type of code with his teacher that he needs to leave to take care of himself.  He really needs to have a specific place to go and another person to check in with when he does leave. Teachers are wonderful but most have more than 30 students so sad to say they can be distracted I would hate for a half hour to go by and your son being confused or passed out somewhere with no one to help him.  Maybe just have the teacher mention he has a special condition that he might need to leave class without going into full detail.  As for it being a distration tell the teacher type 1 diabetes is more than a distration it is a life and death medical condition and that they only deal with it for a few hours a day and your child will deal with it for the rest of his life.  My daughter goes into full detail and we do a presentation at the begining of the year we did in Kindergarten and in 1st grade.  In my daughter's 1st grade class another little girl has type 1 diabetes also.  I spoke with her family before I did the presentation they said ask her if she wanted to be included so I did and she did not want to talk about it I said ok.  After the presentation was about half way over and the kids were like oh so that is why she has that thing in her arm, and that is why you are here for lunch, it made sense to them.  Then low and behold the other little girl raised her hand and said and that is why I get shots I have diabetes too.  The class was intrested in it they looked at the insulin in the vial even smelled it over half of them convinced it smells like stawberries it was done.  Now Lexi doesn't have to explain the snacks or why her teacher has to give her insulin for lunch, no one ask for her food or to share her lunch they know that she can't do that and why she can't.  All the kids were so great about it and the teacher and Lexi have a signal if she feels low or high and needs to check her blood.  I would also suggest a one on one meeting with this teacher and show how many times your son checks his blood and go into full detail with your son's schedule have it written on paper it make an impact.  If this teacher looks at what your child deals with on a daily basis maybe then a couple of time a day getting out class and reaching for a snack will not be a issue.  I am sorry to be so long winded about this but my both my children have had good and bad experiences with school.  My daughter has been on our local news talking about the education that schools need to provide for the teachers.  It can be tough but hang in there it can get better.

My daughter just started 9th grade this year. She was diagnosed at age 7 and we have had a pump for just over 3 years.

We had a very successful 504 meeting and the school used our prepared 504 (we did at home before the meeting) to make things easier. Our daughter also gets to carry her cell phone on her in case she needs help she can call us. (easier to get help to her than her to help). Which is against school policy...but not for her.

Our daughter has fought to "fit in" for a long time and hates any attention related to her diabetes. I can understand, there are enough things going on at that age and who wants to add in another one?

She wont go to the front of the lunch line when she is told too (when fighting a low) because other people give her a hard time and dont understand there is a reason.

She doesnt like her alarms going off on her pump (which I will not let her turn to vibrate because she will just ignore them). She has the CGMS and it will let her know if she goes above 200 or below 70. But so far she has let that one go.

Anyway, People don't understand. There is such a high level of misinformation and just plain ignorance in so many people. Adults and children have told my daughter that if she took better care of herself she wouldnt be diabetic....her 3rd grade teacher reported us to CPS because she was allowed to eat sugar, and we even had a school nurses aide call CPS for gross medical negelct because my daughter had some bruises on her stomach from insert sites....

With all that we have had to deal with, her and I, it makes sense that she doesn't want any more attention for it.

You can call a meeting with all of your sons teachers and explain this to all of them or if its just the one -go in and remind him how awkward high school was for all of us and how hard it would have been to have to deal with a life threatening disease every day of your life on top of that.

I do the mama bear thing too...a lot. If your son is experiencing lows before class he will not be prepared mentally let alone supply wise. The teacher needs  to understand this too.

Good luck...

I am so overwhelmed by the responses to my post, that i cried when i read them all!  You have no idea how nice it is to talk to people who understand what we are going through and are willing to offer their support.  I have to say all of your responses have been very useful!  I contacted the endo and we are cutting out the breakfast shot  and lowering the nighttime Lantus dose.  She feels he is still in the honeymoon stage and that dang pancreas is still pumping out some insulin.  This would be the reason he has been feeling low.  In the past few weeks his sugar has been in the 60s and 70s at his morning check and staying pretty low throughout the day.  We are back to doing the 3am checks. Now i think i should have never stopped doing them, there is no telling how low he has been in the middle of the night! 

As for the teacher, I still have not responded to his email.  I sat down with all of his teachers, the guidance counselor and the school nurse to educate them on type 1, the severity of the disease, and the symptoms of his highs/lows.  This teacher never really commented on the presentation nor did he ask any questions.  We reviewed the 504 and why certain things were included in it and never once did he voice any concerns.  One person did suggest i meet with the principal and discuss everything with her.  The other thing that has given me cause for concern is that Drew dropped to 55 last week during lunch and the nurse did call and let me know, she also fed him the snacks i have left with her (peanut butter crackers, sunnyD, chewy life savers, etc).  What she failed to do was recheck in 15 minutes before sending him back to class.  Now this is in the School Medical plan and the 504 that we have for drew, so i am kinda surprised it happened.  I guess she figured he was Ok so she sent him back.  I was also irate at my son for leaving the nurses office without rechecking...maybe he wasn't thinking straight because he was low?  The nurse says that there are 4 other kids at the school with diabetes, but she didn't say what kind.  I feel like this was a pretty big mistake for her to make, thankgoodness nothing bad came of it!  How offended will the nurse and the teacher be if i call an additional meeting to review what we just reviewed 2 weeks ago?  They all have a copy of the 504 too, so it amazes me that i would have to have this discussion with them again.  I found it interesting that I have not heard from the guidance counselor in reference to this.  Wonder what her response was?  I would love to go back to school and get a law degree so that i can fight for Diabetics everywhere!  Or anyone with a chronic illness! 



Check with your diabetes educator I bet they would be more than willing to go to your sons school and educate the staff about type I diabetes and the every day challenges let alone the importance of treating the highs and lows appropriately and with due diligence as it can lead to life threatening situations! I've read about all of you and the battles and I thank god my school district is so accomamateing. They have bent over backwards to assist us and Dani (my 12y/o daughter), she has explicit instructions from her principle that if she has any BG issues to tell the teacher and if the teacher says wait a minute or after (blank) she is to grab a student and leave the class and go to the nurses station and her bus driver is a type I also. They call if she's above 200 or below 70 and they also call to verify corrections. When we drop in they don't asked surprised or even put off they welcome us and ask if there is anything they can do.

Good luck with every thing!



As an outside observer, I would say you were/are over-reacting to the note from the teacher. I agree with whomever suggested that you either follow up with a meeting or at least a phone call with the teacher to address his concerns. Then you both get immediate feedback on each others suggestions and can agree on the solution.

Actually, reading the email I think he is trying to be helpful, in making suggestions that he feels might make it easier for your son. For example if he is  carrying the snacks in his backpack vs. in his locker, then he can just step out into the hall to check his BG, eat one quickly vs. going all the way back to his locker. IMO, I think it is fair to have him step out to the hall to eat vs. eating in class. 

It sounds like his teacher wants him to succeed, and he is only pointing out that the D is affecting more than just the snacking in class. As for him not asking questions when you gave your presentation - he may have thought it would be no big deal, but now that class is in session, seeing that it is and what you set up to manage it is not working as well as maybe it could be. Try to take the suggestions as just more information on how to better manage his D not that your kid is a bad kid.

One rule of thumb I read regarding Lantus doses was that your BG shouldn't change more than 40 pts up or down overnight. If it does this 3 or more days in a row then it is time to call your endo to discuss dose changes and go back to some middle of the night checks. So I am glad you endo was lowering it - I hope this helps.

I am sure it is REALLY hard for Drew right now. If he was stressed about school and being picked on for other reasons, then D could just be putting him over the edge. It has not been that long since he was diagnosed, so he is probably still coming to terms with it. That said, I agree you need to make sure that he is also being responsible for his care - like checking his BG after treating for lows (sounds like you are on that one!) and checking a lot more. Could you make a rule for him that he has to check before each class or every other class and then check his meter when he gets home?

Please don't take this post to be critical of you or judging you. I do not mean it that way. I just know that for me, I often appreciate an outsiders perspective before I can think about something rationally that I have reacted to strongly emotionally. So I hope this helps and doesn't hurt!


Becky,  I think I was freaking out a little too much also.  The mama bear came out before i really read the email.  Between being nervous about the Drew starting school with D, trying to get Drew's dad to pay his 1/2 of medical bills (2 yrs and counting!), my dog tearing his ACL (just last week), one of my back molars cracking, the other one breaking in half (two weeks ago), and the company that employs me merging with another company (hope i keep my job), I am just completely overwhelmed and quick to react.  I have started doing some cardio and yoga to try to keep the stress level down.  The last thing either drew or I need is for me to be freaking out all the time!  I am sure this too will pass, i am just hoping i survive it with my sanity intact or at least have some fun while i slowly lose my mind!!!  I have been doing the single mom thing for 15 years, this is not our first serious illness, and I am making the company I work for a lot of money....so I am sure it will all end well.  I appreciate having everyone's feedback and support.  I am on this board hoping to learn from people who have been through it and made all the mistakes already.  You guys are truly a fountain of knowledge.  I wasn't aware that the BG shouldn't go up or down more than 40 points at night....I think we will prob have to lower the lantus dose again.  I will contact my diabetes educator this week and see if she can go and meet with some of the teachers and the nurse.  I will contact the teacher this week also.  My son has already switched to eating outside of class before he goes in, and I told him he better be en pointe everytime he steps in that room!   I am interested to see if the teacher has noticed any difference?  Hopefully!!!


It is okay to have a break down once in a while. I agree with you trying yoga or other outlets.  Another tip you might already be doing it.  Keep a little journal nothing fancy just a little note pad maybe even talk to your son and do it together.  This has been handy for us.  Two and a half years after my son's diagnosis it still brings comfort and reassurance of how far both my kids have came since the first day.  The first few months can become a blur really quick it is good to show in just a few months how much he has learned and also show how much he has been able to teach others.  It is a big responsibility having diabetes and can get overwhelming at times so it is good to have a reference point that is why I suggest a journal.  It is unfortunate but it is a constant that he will educate people all through his life about the seriousness of this disease.  I hope all goes well with the teachers I do agree you should have another meeting with the school.  You can request or download a School Toolkit from the JDRF website also the American Diabetes Association has came out with a new power point presentation you can download or request this was made for teachers and schools.  I would start off the meeting by going over any questions or behavior the teachers are concerned with. This way it is out in the open and it starts off with everyone being on the same team no one being defensive.  Then listen to their concerns and explain if you can why your son might be behaving that way.  We always have at least two meetings one before school starts and then one after a couple of weeks after school started.  The teachers will have questions or concerns it can be overwhelming or scary to them also.

Good Luck hope this helps.





Hey Jennifer,

Don't worry about being the freak-out Mama Bear. I think we all get that way to a degree! And it sounds like you have so much on your plate that if you add to it 'stressing out about me stressing out' then it will put things over the top! Anyway, it sounds to me like you actually have a very good plan in place and have made some excellent decisions (like setting up the initial 504 and now contacting your endo and making some adjustments). It's just so tough to muddle through it and get to the right place. Backing off on the insulin will probably make a huge difference to him. You'll just have to watch for signs when the honeymoon is over.

My son is a junior and almost 17 and we have our own host of issues. He was diagnosed in June of 2007, so most of his friends know that he has diabetes and they accept it. However, that doesn't for one minute mean that any of them think about his diabetes or what he should or shouldn't be doing. They are good kids, but mostly pretty self-centered! And of course, kids in his classes who he is unfamiliar with don't necessarily know about it. My son had been going very high recently and we have completely changed his care plan. Because of this he also is finding that he needs snacks during school for the first time ever. He is carrying them in his backpack with him. He has only eaten in class once or twice but basically shrugged it off when someone commented (like, haha I get to eat and you don't). I think it was a defensive move on his part! If your son can eat between classes, that may help. Mine also does not want to get excused early in order to get to the front of the lunch line, so he is also carrying some lunch in his backpack. (He wouldn't dare carry a dorky lunch box!)

It is really tough, but hang in there. I think you've already done the most important thing, and that was calling your endo. Another thing you may want to do (and this is a broader issue, not just for your son), is see what kind of mandatory training your county's educators must have regarding health issues. I spoke to a group of principals last year regarding the local JDRF campaign and was surprised to find out that they have mandatory training regarding type 1 diabetes. It basically consisted of an online education session followed by a quiz. I was really glad to learn that every teacher had to have some knowledge of diabetes, but also disappointed that none picked up on my son's symptoms before diagnosis! But then again, neither did I.

Just wanted to add one more supportive voice and wish you the best.

My son is 7 and 1/2 y/o and he's in third grade. He was diagnosed when he was in first grade (6y/o) and the one thing that helped him understand and got comfortable with his condition in school is to tell and explain the whole class about his condition. No secrets.. You'll be surprised how broad and understanding kids could be. The good thing about his school is that teachers really understand and coordinate with his needs. So then when he need to snack, the teacher would let anyone eat as they finish their work. They even tell the teacher if my son starts acting weird or once they notice something different in his behaviour. What I am trying to do right now is convince them to let my son check his bs and bolus during snack time in the room by the teacher's table just so he doesn't have to leave class and go to the office clinic.

I'm a mother of a 12 year old boy type 1, who was dx a year ago.  I've been though the 504 plan two times now.  I'm going to comment on the part about being secretive.  There are two ways of looking at this.  Telling vs. Not telling. Just remember; there are consequences of not telling. Don’t let it be at the expense of your Childs welfare.

New to type one and school year; I had the meeting with Counselor, Teacher, and Nurse.  I ask about the gym teachers, the art and music teachers, lunch room staff etc... I was told.  It's on an as need to know basis etc... (I'm thinking my Son is in the class and they need to know; right?) So.... my son has a low in the lunch room one day while eating.  Feels it coming on, doesn't get better so he heads to the nurse.  Walks past a teacher that is working in the lunch room and says I don't feel good, I'm going to the nurse.  Makes it to the office starts rummaging though their cupboards, eventually lost consciousness. I was told office staff thought he was a kid that was drunk.  So by not telling; he passes teachers, students, other staff members and falls and crashes in the office.  Until the staff was notified; they thought the kid was drunk at school.  NEAT huh!!! If we would have been able to tell people, that teacher might have been able to make sure he got to the office or thought to get him a juice in the lunch room, etc.  (my son thought he would have to pay for the juice and knew he couldn't stand in line that long). The next day I get a call from the Principal checking on our son and myself.   The nurse then went in to his class rooms and talked to all the kids about diabetes; and what to look for if one of their friends was having an issue.  At first I don't think he was all excited about it; but now he just rolls with it.  We have a wonderful nurse.  She was new to the staff last year and had 6 kids with type 1 diabetesn at our school.  We really broke her in.  They are all about the telling now…. J  Good luck and its ok to be a Mama bear.