BREWSTER MIDDLE SCHOOL
1290 STONE STREET
CAMP LEJEUNE, NORTH CAROLINA 28547-2520
Phone: (910) 451-2561 Fax: (910) 451-2600
Eric Steimel, Principal
Domestic Dependent Gene Flanagan, Asst. Principal
Elementary & Secondary Schools Dewanda Sholar, Asst. Principal
With your son/daughter having insulin dependent diabetes, our school needs certain information and orders
from your child’s physician along with items from you as the parent. Our goal is to assist your son/daughter
in being successful in managing the diabetes while in school to enable him/her to meet their potential
A written diabetic school plan needs to be developed according to your childs’s needs. Below you will find
some questions to assist your physician and you in giving us the information that will help us meet your
1. Will he/she need the following conditions to support his/her chronic disease?
- bottled water to drink in the classroom
- frequency of going to the bathroom
- glucose tablets (simple sugar tablets) in the School Nurse’s office
- blood glucose testing
- Ketodiastix for checking urine for ketones when ill or blood sugar extremely elevated
- Glucagon available in the School Nurse’s office
2. What is the ideal blood sugar range for your child? If his/her sugar is below the
range (if checked at school by physician orders) or above the range, what procedure needs to be
3. If an acute hypoglycemic reaction develops, what procedure needs to be
4. If blood glucose testing is ordered, at what time does this need to be done?
Prior to lunch and whenever he/she does not feel well?
5. If blood glucose testing shows high number (physician needs to state what is HIGH), what steps
need to be taken at that point?
6. What number can each parent be reached at any time for an emergency?
7. What is your child’s physician name and phone number?
8. What is the current dose, frequency, type of insulin for your child?
Please use this as a guide for what information we need. If there is any other information that has not been
asked, please feel free to inform us.
Johnlyn Morton, RN