Know Your Rights at School

The right of children with diabetes to care for their diabetes at school is based on the Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act, and the Individuals with Disability Education Act (IDEA). These laws provide protection against discrimination for children with disabilities, including diabetes, in any program or activity receiving federal financial assistance. This includes all public schools and day care centers and those private schools and centers that receive federal funds.
There seems to be a lot of confusion regarding the differences between a 504 and and Individualized Education Plan (IEP). To put it simply, a 504 plan is plan designed to deal with medical issues, such as diabetes, while an IEP is a plan designed to deal with educational challenges or special needs that need not be related to a medical treatment plan. A 504 would contain instructions, for example, for blood glucose monitoring, while an IEP would include instructions for additional reading education, should it be needed. Children with diabetes use a 504 plan for accommodations related to diabetes and need not have an IEP unless they have special academic needs.

• Section 504 of the Rehabilitation Act of 1973
• The Americans with Disabilities Act
• Individuals with Disabilities Education Act (IDEA)
• State Regulations
According to this law, parents of qualifying children have the right to develop a Section 504 plan with their child's school. To qualify for protection under Section 504, a child must have a record of such impairment, or be regarded as having such impairment. Schools can lose federal funding if they do not comply with this law. Parents can use these laws to ensure that, while at school, their children with diabetes can fully participate in all school activities, while at the same time caring for their medical needs. This means that the school cannot: refuse to allow a child with a 504 to be on the honor roll, deny credit to a student whose absenteeism is related to diabetes, refuse to administer medication (a school cannot require parents to waive liability as a condition of giving medicine), and determine sports/extracurricular participation without regard to the student's diabetes. Any school that receives Federal funding must comply with IDEA and Section 504 laws. A child need not require special education to be protected. This law prohibits all schools and day care centers, except those run by religious organizations, from discriminating against children with disabilities, including diabetes. Protection under is this law is the same as that for Section 504. IDEA mandates the federal government to provides funding to education agencies, state and local, to provide free and appropriate education to qualifying students with disabilities. This includes children who have diabetes. As with the other two laws, you must show that diabetes can, at times, adversely affect educational performance. The school is then required to develop an Individualized Education Plan (IEP) to accommodate your child's needs. Some states have enacted additional legislation to protect children with disabilities. Contact your state legislature for further information.

What this Means

Any educational facility, school or daycare center, which receives federal funding cannot discriminate in the admission, educational process, or treatment of a student who has diabetes. Provided that the presence of diabetes has been disclosed and verified, and that the student/parents have requested reasonable accommodations, the educational facility is required by law to make the approved modifications which allow the child with diabetes to fully participate and benefit from all school activities and programs.
The student/parents are not required to assume responsibility for the provision of needed accommodations. However, the school can refuse to grant a request for an accommodation that is not specifically documented. School personnel do not have the right to confidential medical information. They need only to know what needs to be done to guarantee equal opportunity for the student. Any individual member of school staff who fails to comply with the approved medical and education plan can be held personally liable.

Responsibilities

• Student or Parents
• School personnel
1. In a timely manner, identify that the child has diabetes.
2. Provide recent documentation that the child has diabetes.
3. In writing, request needed accommodations.
4. Request a meeting to discuss 504 Plan and IEP.
1. Provide written assurance of nondiscrimination.
2. Provide notice of nondiscrimination in admission or access to its programs or activities. Notice must be included in a student/parent handbook.
3. Designate an employee to coordinate compliance.
4. Cooperate in providing authorized accommodations.
5. Request physician's specific recommendations of needed accommodations.
6. Request a meeting to discuss 504 Plan and IEP.
7. Provide grievance procedures to resolve complaints.

What to include in a 504 Plan

1. Medication procedures and dosages (e.g. insulin administration prior to meals, etc.) You will want to note if your child is capable of deciding that amount to be given or provide an alternative such as calling a parent or using a chart to determine amount to be given.
2. Blood glucose testing procedures (when where, etc.). The school does have the right to not allow blood glucose testing in the classroom. However, if you can demonstrate that this procedure will not endanger others (i.e., materials will be disposed of at home and not at school), your school may allow the child to check in a secure area in the classroom.
3. Procedures for treatment of hyper and hypoglycemia.
4. Precautions to be taken before physical activity.
5. Guidelines for meals, snack, special treats, and parties.
6. Contact information for medical assistance (as needed) and parents.

What to include in an IEP

1. The need for repeat of information. Sometimes, if a child has had an insulin reaction or extremely high blood sugar, that child may not be able to concentrate and need additional assistance.
2. The child with diabetes may need to be allowed to take make-up tests if that student has had an insulin reaction or severe hyperglycemia during an exam.
3. Flexibility in attendance requirements in case of health-related absences including physician visits (e.g., allowing students to be on honor roll and qualify for awards, etc).
4. Permission to leave class to use restroom as needed.
5. Provision of adequate time for taking medication, checking blood sugars, and completing meals and snacks.
6. Access to increased fluid intake as needed

DIABETES

There is Type 1
Type 2
Gestational Diabetes

SIGNS OF TYPE 1 DIABETES
Warning symptoms of type 1 diabetes can be mistaken for the flu at first. If your child is urinating frequently, drinking more than usual, losing weight despite having a healthy appetite, or feeling tired all the time, these could be signs of type 1 diabetes. Diabetic ketoacidosis can also develop if type 1 diabetes goes untreated; this condition is highlighted by stomach pain, nausea or vomiting, and a fruity smell on the breath. If you notice these symptoms in your child, call your doctor as soon as possible.
WHAT CAUSES TYPE 1
We don't yet know what prompts the immune system to attack the beta cells and cause type 1 diabetes. Although diabetes is not an inherited disease, genetics does play a role in its development. In fact, experts believe that a genetic predisposition to diabetes, triggered by an unknown environmental factor, may be behind type 1 diabetes development. Researchers are also investigating the connection between type 1 diabetes and other autoimmune conditions such as celiac disease, which are more likely to occur in type 1 diabetics.
DIAGNOSING TYPE 1
To make an accurate diagnosis of type 1 diabetes, doctors use one or more tests to measure the levels of glucose — sugar — in the blood. They distinguish between type 1 and type 2 diabetes by looking for autoantibodies, proteins created by the immune system to attack beta cells. Because type 1 diabetes is normally first seen in children or young adults, parents should have their child tested for this disorder if they notice any of the characteristic symptoms of diabetes, including excessive urination and thirst and unexplained weight loss.
DOUBLE DIABETES
Double diabetes occurs when a person with type 1 diabetes develops insulin resistance, a symptom characteristic of type 2 diabetes. It's a growing problem — in fact, as many as one in three children newly diagnosed with type 1 diabetes may have double diabetes. Obesity is a definite risk factor for double diabetes, and experts believe the increase may be due at least in part to weight gain in type 1 diabetics who are taking insulin but haven't adopted a healthy lifestyle.
UNDERSTANDING TYPE 1
Type 1 diabetes occurs when the body's immune system stops the pancreas from making insulin

ANY AGE?!
Type 1 diabetes can occur at any age, but it usually starts in children or young adults. That’s why it used to be called juvenile diabetes. Type 1 diabetes is different from type 2 diabetes, which is the most common form of the illness.


Type 1 diabetes is not caused by eating too many cupcakes
Type 1 healthy food
Juvenile Diabetes Research Foundation,the American Diabetes Association

TYPE 2
Type 2 diabetes occurs when the body can no longer process blood sugar, also known as glucose. Over time, higher-than-normal levels of sugar in the blood can lead to damage throughout the body, including problems with the eyes, gums, hands, feet, and heart. Although once known as "adult-onset diabetes," type 2 can begin at any age — and more and more children are getting it. People of any ethnic background can develop type 2 diabetes, but some groups, including African-Americans and Hispanics, are at higher risk. Obesity is perhaps the most important risk factor for type 2 diabetes. The good news is that type 2 diabetes is treatable with diet, exercise, and medication.

CAUSES
Although experts don't know exactly why some people develop type 2 diabetes and others don't, we do know which factors can increase your chances. Excess fat, especially around your midsection, creates inflammation in the body and can lead to insulin resistance, a precursor to type 2 diabetes. In fact, four of five people with type 2 diabetes are overweight or obese. Poor eating habits, not getting enough exercise, and your genetic background also play a role

KEEP KIDS FROM DEVELPOING TYPE 2
As many as 45 percent of kids with diabetes have type 2, and there are ways you can help children guard against developing this disorder. Be on the lookout for symptoms of type 2 diabetes, especially if it runs in your family, and have the child undergo blood sugar testing if you notice any signs. Eating the right diet, getting enough exercise, and encouraging healthy weight loss can help improve the whole family's health and prevent or reverse type 2 diabetes.

TYPE 2 EFFECTS MENOPAUSE
Going through the "change of life" takes some adjustment for any woman. But for women with type 2 diabetes, the hormonal changes of menopause can affect blood glucose levels, and menopausal symptoms like dizziness, sweating, and irritability can mimic the signs of both low and high blood sugar.

HEALTHY TYPE 2ERS
There's no need to panic after a diabetes diagnosis. Experts say maintaining a healthy lifestyle when you have diabetes is all about making the right lifestyle choices, including eating right, exercising regularly, and checking your blood sugar often. It's also important to stay informed and ask questions during your doctor visits.

TYPE 2 AND UR SEXUALITY
The nerve damage that often accompanies type 2 diabetes can affect the hands and feet. But many people may not be aware that it can also impair sexual health in both men and women. If you're experiencing sexual dysfunction as a result of diabetes, don't be shy about speaking to your health care provider, since these problems can often be helped.

DEVELOPING TYPE 2
Nearly a third of all people over age 65 have diabetes, and many are also managing other health conditions. But diabetes care doesn’t vary with age. Keeping your type 2 diabetes in check through diet, exercise, medication, and any other guidelines your doctor gives you can help you stay as healthy as possible.
FEMALE & TYPE 2
Women with type 2 diabetes who are pregnant or breast-feeding who cannot keep their blood sugar levels within a target range with diet and exercise. Only one oral diabetes medicine (glyburide) has been studied for use during pregnancy.

LOW BLOOD SUGAR
True Low blood sugar means that the level of sugar in the blood has dropped below what the body needs to function normally, usually below 70 mg/dL.

SELF-SHOT INSILLIN
True To give an injection of insulin, the needle of the syringe is inserted into the skin and the medicine is pushed into the fatty tissue just under the skin.

TYPE 2, EAT RIGHT
For most people diabetes goes hand-in-hand with that other D-word, diet.  And neither one is particularly appealing.  The good news is that the best diet for a person with diabetes is really the same kind of healthy eating that is best for everyone. Rather than cutting out your favorite foods, you just need to learn how to balance moderation, carb control and healthy eating habits.
People with diabetes need to focus on whole foods that are high in fiber and nutrient-dense.  This includes virtually all plant foods, most low-fat dairy products, lean meat and poultry, and fish.  Conversely, it is necessary to keep highly processed foods, which are often full of refined flour and sugar, to a minimum.  This means choosing brown rice over white, whole-grain bread instead of white bread and sweet potatoes over russet or other white varieties.
Typically the choice that gives you the most fiber is the right one.  And for fats, you should chose skim milk instead of whole, ground turkey over ground beef, and olive and vegetable oils in place of butter or lard.  Added sugars should be avoided.  A good alternative to sugar is stevia.  It is more natural than other sugar substitutes and tastes better too.  Agave syrup or nectar is also a good substitute.  It has calories, but they don’t affect your sugar levels.

MEAL IDEA
When trying to maintain a whole foods diet, eating out and convenience foods are usually ruled out.  That means it is time for you to get in front of a stove.  Some good choices for breakfast are quick cooking oats(not the kind in the envelope, the kind in the canister), high fiber cereal with skim or soy milk or an egg white omelet.  Some lunch ideas are a turkey bacon BLT with light mayo on whole grain bread, tuna salad with whole grain crackers, or minestrone soup and a garden salad with grilled chicken.  For dinner you can try recipes like broiled fish over brown rice with steamed veggies, bell peppers stuffed with chopped veggies, chopped chicken and low-fat cheese or veggie pizza on a thin, whole-wheat crust.  Now at first glance these recipe choices might seem pretty bland, but this is your chance to get creative with flavors.  Herbs and spices are a great way to add taste with little or no calories.  Add some cinnamon to your oatmeal.  Throw some spinach and mushrooms in your omelet or spice up fish and meats with lemon juice and garlic.
A diagnosis of diabetes presents a unique opportunity to shift your diet and lifestyle choices in a positive direction. Your body will thank you every which way — how you look, how you test at home and in the doctor’s office, and how you feel every day.
Generally Type 2 diabetic patients need 1500-1800 calorie diet per day to promote weight loss, however calories requirement may vary depending upon patients age, sex, activity level and body weight.  Half of total daily required calories should come from carbohydrates. One gram of carbohydrate is about 4 calories. A diabetic patient on a 1600 calorie diet should get half of these calories from carbohydrate. In other words it will be equal to 800 calories from carbohydrates, it means they need 200gms of carbohydrates everyday.

BIB
http://www.everydayhealth.com/diabetes/type-1/index.aspx