Newly diagnosed T1 diabetic on overseas school trip

[Hellvelyn]

DH is taking a group of students on a 7 day trip to Spain. He and the students will be travelling to 4 different locations. One of the year 11s was diagnosed T1 diabetic in the summer. This will be her first trip away since. She has a monitor which sends blood sugar readings to her mum's phone and dh and one other staff member will have this too. Parents have been consulted, as has the school nurse.
I feel worried for the child and dh. She will be out of routine - both eating and sleeping. Surely this will be tricky to manage for her when she is so newly diagnosed? It feels like a massive responsibility for dh. On the other hand, her diabetes shouldn't mean she misses out. I work in a school too so am probably over thinking this. Any words of wisdom from mums of teens with type 1please?

I don't have a T1 teen but have been a teacher on overseas trip.
It is a tricky one, I see both sides.

Could you DH request the mother to have a consultation with the student's GP on how best to care for her and a checklist of possible scenarios and action to be taken. This will both serve as reassurance if consultation happens and as precaution for your DH as you requested a medical consult which wasn't granted if any problem happens.

Also a double supply of insulin that isn't in the hand of student, in case she forgets her bag on a bus, loses suitcase or is robbed (especially in Barcelona) .
Maybe also have a old style classic finger blood reader, in case bad connection, wifi or international roaming issues.
Have a log in which your DH writes every time he checks the student's blood and when and how much insulin is being injected.
Doesn't she have an automatic pump?

A word of warning on alcohol. the student must fully understand how dangerous drinking would be for her. Very easy and very cheap to buy alcohol in Spain

DD (10) has T1.

I'd imagine the most tricky bit on the trip will be working out the carb content of food and so on rather than sleep. What kinds of places are they staying? Catered?

Is there any possibility of diabetes training for your DH before the trip?

I have T1 diabetes, there is some huge over thinking here.

A trip to Spain is no different to a few days in London, she just needs to do what she normally does at school, snack in bag, daily checks and meal estimates.

I’ve just got back from a few days in Japan, my diabetes routine didn’t change and my bloods were as I would expect them at home.

I'm a teacher who takes kids abroad. I have students with T1 and other various potentially serious health issues.
When is the trip? The student will presumably have got to grips more or less with what they need to do by then.
General protocol in our school is that the student is expected to take responsibility for their own health. Beyond very basic first aid teachers are not expected to do anything. This is presumably fairly widespread in schools. We also issue written guidelines before any school trip to that effect. We are not responsible for any blood sugar readings etc. Your husband should be given a written protocol confirming his non-responsability and all parents should also have a copy. This is standard in the schools I've done trips for. Even with much younger students than year 11.
I doubt your husband's school would require him, in an emergency, to do anything other than call the emergency services.
(on an aside, if his school does expect more, I'd be contacting the relevant union- totally inappropriate and potentially dangerous)
The only thing that should be his task is to liaise with the hotel about keeping medication in the fridge etc.
One of our diabetic students also had the blood sugar reading sent to her parents' phones- absolute nightmare for all- with faulty readings and messages not getting through, we had an anxious mother sending ambulances to school on more than one occasion when the student was sitting happily working in class.

My daughter managed similar situation without remote monitoring shortly after diagnosis. I was nervous but it was so important she saw she could deal with this. If menus are available before it could help with carb counting and having spare supplies split between different bags is really sensible.The pupils hospital clinic will have had lots of experience of supporting schools and pupils with this scenario .School will probably already have a contact number with the care plan.It is great your husband cares and sees the possibilities for problems but so important that the pupil sees that can get on with life .

I have every sympathy. I've had type 1 diabetes all my life and mine is very brittle and very difficult to control. every emotional thing and carb counting miscalculation and almost everything affects it.

It is a stress to your DH,and will require extra vigilant monitoring by the student in question: testing all the time and just awareness and making sure she always has plenty of Twix / Lucozade / sugary sweets with her. and just extra monitoring.

But on the plus side : what's the worst that could happen ? she may have a very bad hypo your Dh would have to call an ambulance.

she would very quickly recover and would have to be bought home. and yes, all that was that all sounds very traumatic. But, you know that IS the worst absolute worst case scenario.

Is she on a pump, OP? I'd be making sure your dh has asked for a letter to get through customs with medication etc.

You're talking about a libre sensor. They are brilliant and do send info to phones etc. I'd be making sure she has a spare as mine falls off or fails regularly. Plus some extra tape to stick it down if needed.

It will be fine. I'm.type 1 and went on a school trip abroad when I was in year 6.

There is a real panic with some teachers (I'm one) about diabetes and epilepsy in particular. I've even had some voice concerns about teaching them! I was horrified and furious.

Keep lots of emergency sweets. Lots of extra for medication.

My 15 year old is T1 and was diagnosed when 10. He has done various overseas trips and DofE expeditions and all were fine.

For the first couple, his specialist diabetes nurse went into the school and we had a meeting with key members of staff who would be on the trip along with myself and my son which was reassuring for them.

I am sure it will all be fine and a good experience.

Many thanks for all your reassuring words and advice. Her mum is T1 too and apparently fairly relaxed about the trip whilst dad has been over her emergency hypo plan with dh on several occasions and apparently much more anxious.
To answer a few questions - the trip is in 10 days time, I believe she doesn't use a pump, most meals are catered in hotels/hostels, but a few will be more ad hoc.
DH has bought an enormous bag of Haribo for use in a hypo situation. Hopefully all will go OK. I have a feeling that her worried parents are likely to prove the most troublesome but I totally get that. I would be worried if it was one of my dc.

My daughter is 13 and has gone in a 4 day trip in year 7. She's on a 9 day trip this year! Honestly it was fine. It kind of depends on how responsible the child in question is. My only request from teachers was she had to allow her to contact me before bed so I could discuss her activities and what I needed her to adjust before sleeping. I wasn't worried about management in the day as I knew she would be ok...but night time I was slightly as I tend to manage her levels at night...hence I needed that call to discuss. Sounds like she has a Dexcom that sends readings to her phone ...and parents. That's great for management and takes worry away. Have a word to know from parents if she is able to wake in the night in response to an alarm and treat herself. If she shares with friends who look out for her that's a plus.
Saying this I know many parents who are not as "relaxed" and "demanding" so it really can depend.

T1 son went abroad twice yr 9 and 10 and has done all three levels of DofE. I went and spoke to the trip lead in each case before hand and went through every situation. Gist was they’d call an ambulance if they didn’t feel able to cope. We’re happy to check him in the night as we usually do (in loco parentis). First trip the school sent a member of staff just to help him and put him in an adjoining room, after that obv on site. He’s completed gold DofE this year- completely out of usual routine for food, sleep, exercise etc and been fine.

Please get him to meet the parent and student and make a plan based on what that student needs. You can weight food and/or use carbs and cals book if necessary. There are ways and means.

When I was First Aider on a trip to France in such a situation I was provided with Diabetes Training from a nurse. Shown how to administer an epipen. The child in question did her own bloods then showed me the readings. On one occasion I gave her a biscuit as she didn't seem herself then she was fine again. This was the 90s so no digital tech then. It was manageable and her mum was very appreciative that we included her. Much of it was common sense and observation. Hope it all goes well for DH.