Schools that remotely monitor T1D CGMs are doing the right thing to keep them safe at school. It’s considered a reasonable accommodation by the US Department of Justice.

By staying up-to-date with current standards of Type 1 Diabetes (T1D) management and embracing technologies like Continuous Glucose Monitor (CGM) follow apps, schools can ensure compliance with the federal Americans with Disabilities Act and Department of Justice mandates, maximize students’ time in class, and provide students with T1D an educational experience equal to their peers. It simplifies nurses’ work and aligns with the current standards-of-care used in T1D management.

What’s a Continuous Glucose Monitor (CGM)?

CGMS are lifesaving devices for children with Type 1 Diabetes. They reduce risks of life-threatening low blood glucose (BG), physical distress, seizures, brain damage, and death.*

CGM devices, prescribed by a healthcare provider, typically include several components:

(1) a sensor inserted under the skin, (2) a transmitter that sends blood glucose data via Bluetooth, and (3) a user’s device (such as a receiver or smartphone) that displays the data. In some models, the sensor and transmitter are combined into a single piece. Caregivers can also access this data through a (4) CGM follow app, which alerts them if glucose levels go outside the safe range (too high or too low). These remote alerts are crucial for timely intervention, especially if the person with T1D is unaware of the issue.

CGM follow apps at school allow school nurses or trained staff to remotely monitor their students’ blood glucose in real time on a smart device. In the event of an emergency, an alarm sounds, allowing for prompt, preventative, and proactive action.

Following Student CGMs is a Reasonable Accommodation Recognized by the DOJ

In 2020, the US Department of Justice (DOJ) addressed this issue when families filed complaints against four school districts for refusing to remote monitor alerts transmitted by their child’s CGM, and the DOJ deemed remote monitoring a reasonable accommodation under the federal Americans with Disabilities Act (ADA).

In each case, the DOJ required that the school provide a device, train staff, and remote monitor CGM alerts of students with T1D, when asked, in order to remain compliant with the ADA law.

Positive Impact of Remote CGM Apps on Schools

  • Peace of mind: CGMs are a technological advancement that nurses report as a "safety net," essential for modern Type 1 Diabetes (T1D) management.

  • Minimize complications: Proactive alerts help keep students' BG levels within range and optimal for cognition, minimizing irreversible complications.

  • Decrease classroom disruption: T1D students spend less time in the nurse’s office for routine BG checks, reducing learning interruptions since staff can simply reference an app.

  • Enhance focus and equity: Following CGMs helps students focus, reduces disparities, and provides proactive, preventative care, especially during times of cognitive impairment, without burdening the child or off-site parents.

LCPS Sets Precedent to FOLLOWT1Ds

As of June 20, 2024, the Loudoun County VA School Board and Office of Student Services changed their stance on remote monitoring CGMs for students with T1D and agreed to use caregiver CGM follow apps.

Watch as they celebrate lifting a barrier that has jeopardized T1D students’ safety and education.

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* Long-term Continuous Glucose Monitor Use in Very Young Children With Type 1 Diabetes.  M. A. Van Name et al., Journal of Diabetes Science and Technology 17, no. 4  (2023): 976–987, “...CGM technology sustained reductions in hypoglycemia”