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The Summer-to-School Transition – Lorraine Sisto

For day two Diabetes Parenting Week, we have another great guest post from Lorrain Sisto.  Let’s get right into it.

Lorraine is the mother of three children: Colin, Caleb and Lila. Caleb was diagnosed with type one diabetes at the age of three. He is now nine. Lorraine and Caleb both share their stories at You can also find Lorraine on twitter as @colcalli.

Lorraine is currently serving on the Board of Directors of the Diabetes Hands Foundation and the Board of Directors of Diabetes Community Advocacy Foundation. You can also find her co-hosting the DSMA Live Parents Talk radio show every other Monday night with Bennet Dunlap of YDMV.  


I am the mom of three children: a seventh grader, a fourth grader and a second grader. We just finished our first week of the new school year. The kids were readied with new shoes, pens, pencils, folders, notebooks, carbs, glucagon, epipens, and medical forms out the wazoo. The last items are specifically for my middle child, Caleb, who is living with diabetes and a peanut allergy.

Since incorporating diabetes into our back-to-school planning, it seems our summers get cut a little shorter because of the extra preparation that is required. Getting a 504 plan and other instructions updated and printed and meeting in advance with teachers and nurses always seems to steal away a bit of the end of summer fun.

This year we were able to minimize that by meeting with administration last May. At that time, we went through things in detail so that our meetings before school were simple and straightforward – nothing new to discuss, just minor nuances to iron out.

One of the things that is extremely helpful in getting the year started off on the right foot is understanding the daily schedule. This includes recess, lunch and snack times. With this information in hand more than a week before school started, we were able to mimic that routine at home, in a safe and comfortable environment, and work out a few kinks so that the first day of school is about school, not dealing with diabetes.

Another thing that has had a tremendous impact is the role that Caleb now plays in his care. He made great strides in independence last year under the guidance and support of his school nurse. He was readied for the transition to a new school where he’s significantly more in charge of diabetes management. The judgment of a nine year old is incomparable to that of a five year old. Planning for teachers and staff to know precisely what to do every step of the way is no longer as important; Caleb knows what to do. So although diabetes education still needs to take place, the execution is very different and thus the stress level – at least mine – is significantly reduced.

I’m happy to say that diabetes cooperated fully on the first day of school. Caleb had 100% of in-range numbers – a nearly miraculous feat. Diabetes took a back seat for a change.

But diabetes rarely cooperates for long. The next couple of days were less than perfect. As Caleb’s body settled into a new, sedentary routine, his insulin needs rose – around the clock. This was not always the case. When he was younger, there was little to no difference in his dosing for summer days versus school days. As he has grown, he has become much more sensitive to activity and, in the case of getting back to school, the lack thereof.

So we keep detailed notes and a watchful eye. A definite trend has surfaced and tweaks are being made. I’ve gone back to his records from the end of the last school year and can see ratios and basal programs that I changed for the summer that I need to adjust closer to now that he’s in a similar routine.

I’d like to say that after prepping for school with diabetes for seven different years it’s become an easy part of our routine. Although it’s not quite as overwhelming as it was in those early years, it’s still a cause for anxiety. But like with anything in life when you have diabetes in the picture, being proactive with planning and ready to react to changes keeps the anxiety from stealing the joy that another school year brings.


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