Continuous Glucose Monitors (CGMs) are lifesaving for children with T1D.
Many schools refuse to implement this standard-of-care technology, instead relying on children to self-report alarms, teachers to hear alarms in noisy environments, and parents to remotely monitor and alert the school during emergencies. This dangerous practice often means schools wait until a child shows visible signs of distress before taking action, delaying crucial treatment and putting the child in a life-threatening situation.
Laws & Guidelines for Remote Monitoring in Schools
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 in order to remain compliant with the ADA law.
In June 2024, The American Diabetes Association updated their Guidance for the Use of Continuous Glucose Monitoring in School Setting and recommends that:
“School districts should remove barriers to remote monitoring by school nurses or trained school staff.”
“Trained school staff are expected to promptly respond to CGM alarms in the school setting. This may include alarms for hypoglycemia, hyperglycemia, or the rate blood glucose is changing. Trained staff should be able to respond to alarms wherever the child is during the school day. For example, in the classroom, at lunch, or during recess.”
As a provider for a child with Type 1 Diabetes, you may add wording to the DDMP or school orders to indicate that CGM with remote alerts is required at school. This allows an adult or caregiver at school to be aware of critical blood glucose levels that require intervention. It also allows for remote blood glucose checks at scheduled times WITHOUT missed instruction time for the child. Also, "no data" alert lets adults know that the child has left their receiver somewhere, or that there is a problem with the CGM.
This technology gives the tools to the adults responsible for the child during the school day. Type 1 Diabetes is a life long chronic disease that can result in critical and life threatening episodes at any time. This is an additional layer of protection that is a reasonable accommodation.
Please reach out with any questions/concerns to
clinicaladvocacy@followt1ds.org