Getting diabetes care for children and youth

Children and youth have the right to reasonable accommodation of a disability.  Type 1 diabetes, even when it is not incapacitating, is considered a “disability” for the purposes of s. 15(1) of the Canadian Charter (2000 SCC 27, [2000] 1 SCR 665, paragraph 50).  You or your child) may not even think of Type 1 diabetes as being "disabled", but for the purposes of accessing appropriate supports and accommodations, it is important to keep this in mind.

Where school, provincial or territorial policies provide special educational services or supports or programs, individual education plans (IEP), individual health care plans to children with disabilities, they must provide them in a non-discriminatory fashion to all children.  Even where there are no existing programs or supports for children with T1 diabetes, schools still have a duty to accommodate. 

In almost all cases, younger children with T1 Diabetes are incapable of managing their care while at school and will require support. They are entitled to reasonable accommodation to the point of undue hardship, meaning that schools or provincial services must show that it is nearly impossible to provide these supports - objections based on the possibility of employee grievances, absolute standards of safety, or "impressionistic evidence" of costs or safety are not sufficient to deny reasonable accommodation.

All children and youth will need assistance with their diabetes during emergency situations, such as during unconsciousness or a seizure. 

Older children and youth take on more responsibility for their care as they become more independent and mature. However we also know that they may still need support in reaching their diabetes treatments goals. Some children and youth can feel isolated or different from their peers, some may begin to show signs of the complications of diabetes from poor diabetes control, others can face learning, mental health challenges, or problems with disordered eating. 

We know that children and youth with T1D can be cared for safely and cost effectively in schools. 

  1. Work with your child's doctor to create a Diabetes Medical Management Plan (DMMP). It is important to have clear details about your child's insulin regimen, how dosage is determined for meals and correction doses, whether your child needs a caregiver to give insulin, whether glucagon is prescribed and other factors in your child's care. The sample diabetes medical management plan covers many details, some you may not even thought about, including medical emergency situations, day and overnight field trips, natural disasters etc. It is important for you to sign this document, to give the school permission, and for the doctor to sign this, as these are part of the medical orders that others simply follow.

    Not all Canadian doctors may be familiar with the supports that are available or whether they can be provided. The DMMP simply needs to document the steps that are the normal part of your child's care. 

  2. Work with school, local and/or provincial health supports, such as public health nurses, school nurses, your diabetes clinic or other health supports available to you, in order to develop an individual health plan that can be followed when at school. Your child will likely need assistance, and this can be provided by teachers, teacher assistants or other school personnel who receive training provided by you, the health team or both. Provincial, territorial or school policies may require training or supervision by a health professional such as a registered nurse.

    Provinces such as New Brunswick and Quebec have policies which support children with T1 Diabetes.  Some provinces, such as British Columbia have policies which hinder proper diabetes care, yet parents there have successfully obtained support when there is a signed DMMP and training of teacher assistants done by local diabetes clinics.

  3. Work with the school to implement the individual health plan. Schools may need time to plan resources and funding, so it helps to do this as early as possible. This may require meeting with your child's teacher, school principal, and/or special education teacher. Your child may be entitled to an IEP, especially if their diabetes effects their learning and they need other accommodations for sick days etc.

    Advocating for and receiving reasonable accommodation for a child with a disability is not always an easy process. We hope the resources here are of assistance. You can reach our advocacy group on the contact us page.