Medical conditions: Diabetes policy and procedure

This policy and procedure guides how Early Learning Victoria centres manage and support children with diabetes.

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Early Learning Victoria is committed to the safety, health and wellbeing of children in its education and care, including children with type 1 diabetes. We are committed to providing all staff with the information, training and skills they need to support children with diabetes and respond effectively in an emergency.

1. Scope

This policy applies to children, families, staff, management and visitors of Early Learning Victoria centres. This includes volunteers, students on placement and contractors or labour hire employees of Early Learning Victoria.

2. Policy statement

This policy describes procedures to be implemented at Early Learning Victoria centres to:

  • ensure that staff know how to safely and effectively manage diabetes, including administering medication
  • raise awareness of diabetes and appropriate management among all staff through education and policy implementation
  • ensure that staff have professional development opportunities to support children with type 1 diabetes and reduce the risk of emergency situations and complications for the child
  • work with families to ensure each child enrolled at Early Learning Victoria with type 1 diabetes has a current Diabetes Action and Management Plan, Risk Minimisation Plan and Communication Plan to keep them safe.

This policy should be read in conjunction with:

  • Administering medication policy and procedure
  • Administration of first aid policy and procedure
  • Management of medical conditions policy and procedure
  • Incident, injury, trauma and illness policy.

2.1 Requirements

Under the Education and Care Services National Law Act 2010 (the National Law) and Education and Care Services National Regulations 2011 (the Regulations), Early Learning Victoria must ensure that:

  • this policy and procedure are adhered to, and reviewed annually
  • all staff members and other adults at Early Learning Victoria centres have adequate knowledge of diabetes and procedures to be followed in a diabetes-related emergency
  • families understand their obligation to provide any equipment, medication or treatment, and have a Diabetes Action and Management Plan (created in consultation with the child’s diabetes medical specialist team)
  • at least one educator with current first aid qualifications is in attendance and immediately available at all times that children are being educated and cared for
  • children living with type 1 diabetes are not discriminated against in any way and are able to participate fully in all programs and activities at Early Learning Victoria centres.

3. Background and information

Type 1 diabetes is an autoimmune condition that occurs when the immune system damages the insulin-producing cells in the pancreas. The condition is treated with insulin replacement via injections or a continuous infusion of insulin via a pump. Without insulin treatment, type 1 diabetes is life-threatening.

4. Actions and procedures

4.1 Responsibilities of families

Families are responsible for:

  • reading and complying with the Medical conditions: diabetes policy and procedure and the Administering medication policy and procedure
  • informing staff, either on enrolment or on initial diagnosis, that their child is diagnosed with diabetes
  • providing a completed enrolment form for their child that includes medical information and written authorisations for medical treatment and ambulance transportation
  • providing their Early Learning Victoria centre with a current Diabetes Action and Management Plan prepared specifically for their child by their diabetes treating team. This should be updated annually, or more often if the treatment regimen changes
  • working with the nominated supervisor to develop a Risk Minimisation Plan and Communication Plan for their child
  • working with educators and staff to assist them to provide the most appropriate support for their child
  • providing their Early Learning Victoria centre with any equipment, medication or treatment, as specified in the child’s individual Diabetes Action and Management Plan
  • ensuring that all prescribed medication is always available to their child when attending an Early Learning Victoria centre, noting the child will be unable to attend if their prescribed medication has not been provided
  • ensuring that a parent or authorised nominee is always contactable by phone or within a reasonable time (30 minutes) when the child is attending the centre.

4.2 Responsibilities of staff

Diabetes Action and Management Plan

Upon enrolment, or when a child is diagnosed with diabetes, Early Learning Victoria in conjunction with parents and the child’s treating medical team must develop a clear, tailored Diabetes Action and Management Plan to support the child’s diabetes care needs.

The Diabetes Action and Management Plan must be completed and signed by the child’s diabetes treating team before being provided to Early Learning Victoria by the child’s parents or carers. To ensure all relevant parties have been consulted and agree with the stated plan of care, the Diabetes Action and Management Plan must be signed by the parent or carers, diabetes treating medical team and the nominated supervisor.

Early Learning Victoria has a legal obligation to consult with families about the needs of their child and what reasonable adjustments are to be made. Reasonable adjustments must be discussed with families during development of the child’s Diabetes Action and Management Plan. These consultations should occur on an ongoing basis through regular meetings.

Risk Minimisation Plan

It is important to consult with families to determine which strategies are appropriate for reducing risks related to the child’s diabetes. The nominated supervisor, in partnership with the parent or carers, must develop a Risk Minimisation Plan using Attachment 1. Separate risk management plans should be developed for day-to-day diabetes management at the centre and for excursions, as the risks are different.

Communication Plan

At enrolment, or upon diagnosis, the nominated supervisor must develop a Communication Plan in consultation with families to encourage and ensure ongoing communication between families and staff about the management of the child’s medical condition (see Attachment 1).

Signs and symptoms

If a child becomes unwell, staff must follow the guidance in the child’s Diabetes Action and Management Plan.

Hypoglycaemia (Hypo)

If a child or staff member is wearing a continuous glucose monitoring (CGM) device, it will sound an alert when they are below their target range. Symptoms can vary between each young person. If caused by low blood sugar, the child may:

  • tremble, or feel dizzy, weak or hungry
  • look pale and have a rapid pulse
  • sweat profusely
  • feel numb around their lips and fingers
  • have a change in behaviour – becoming angry, quiet or confused, or be crying
  • become unconscious or have a seizure.
Hyperglycaemia (Hyper)

If caused by high blood sugar, the child may:

  • feel excessively thirsty
  • need to urinate frequently
  • feel tired or lethargic
  • feel sick
  • be irritable
  • complain of blurred vision
  • lack concentration
  • have hot dry skin, a rapid pulse or feel drowsy
  • have the smell of acetone (like nail polish remover) on their breath
  • become unconscious.

Emergency response

A diabetic emergency may result from too much or too little insulin in the blood. There are two types of diabetic emergency:

  1. Very low blood sugar – hypoglycaemia (or ‘hypo’), usually due to excessive insulin.
  2. Very high blood sugar – hyperglycaemia (or ‘hyper’), due to insufficient insulin.

If a child suffers from a diabetes-related emergency, the centre staff must:

  • ensure an educator remains with the child at all times
  • follow the guidance in the child’s Diabetes Action and Management Plan
  • immediately dial 000 for an ambulance if the child does not respond to steps in the Diabetes Action and Management Plan or symptoms are severe
  • continue first aid measures and follow instructions provided by emergency services.

In a serious medical emergency, the nominated supervisor must contact the child’s family as soon as possible. Once the medical emergency has been managed, the nominated supervisor will work Early Learning Victoria central staff to report the incident as per the Incident, injury, trauma and illness policy, including documenting the incident as soon as practicable in the Incident, injury, trauma and illness record.

Incident reporting

If a child experiences a medical emergency, Early Learning Victoria centre staff will complete an incident report (see the Incident, injury, trauma and iIlness policy). The nominated supervisor will work with Early Learning Victoria central office to:

  1. notify the Regulatory Authority of serious incidents online through the NQA IT System, if required
  2. record the incident appropriately (using, for example, the Incident, injury, trauma and illness record or EduSafe Plus for staff-related incidents).

Staff will be offered a debrief after each incident. An emergency can cause distress not only for the child, but for staff and other children, especially if the event was life-threatening.

5. Resources

Legislation and standards

  • Disability Discrimination Act 1992
  • Education and Care Services National Law Act 2010
  • Education and Care Services National Regulations 2011
  • National Quality Standard, Quality area 2: Children’s health and safety
  • Occupational Health and Safety Act 2004
  • Occupational Health and Safety Regulations 2017
  • Privacy and Data Protection Act 2014
  • Privacy Act 1988
  • Public Health and Wellbeing Act 2008
  • Public Health and Wellbeing Regulations 2009
  • Administering medication policy and procedure
  • Administration of first aid policy and procedure
  • Anti-bias approach policy
  • Duty of care policy
  • Incident, injury, trauma and illness policy
  • Management of medical conditions policy and procedure
  • Medical conditions: Epilepsy and seizures policy and procedure
  • Medical conditions: Asthma policy and procedure
  • Eating and drinking: Health, nutrition and food safety policy and procedure
  • Staffing Overview Policy

Training

Attachments

Definitions

Blood glucose meter: A compact device used to check a small blood-drop sample to determine the blood glucose level.

Continuous glucose monitor: Continuous glucose monitoring (CGM) is a means of measuring glucose levels continuously, in contrast to a blood glucose meter that measures a single point in time. A CGM system sensor is inserted into the skin separately to the insulin pump and measures the level of glucose in the interstitial fluid (fluid in the tissue). The CGM receiver and/or compatible smart device can usually be set to send custom alerts to the user when certain glucose thresholds are reached, or if levels are changing rapidly, reducing or eliminating the need for blood glucose finger-prick tests and enabling early intervention to prevent the person becoming ‘hypo’ or ‘hyper’.

Hyperglycaemia (high blood glucose): Hyperglycaemia occurs when the blood glucose level rises above 15 mmol/L. Hyperglycaemia symptoms can include increased thirst, tiredness, irritability and extra toilet visits. It can affect thinking, concentration, memory, problem-solving and reasoning. Common causes include but are not limited to:

  • taking insufficient insulin or missing insulin doses
  • eating more carbohydrates than planned
  • common illnesses or infections, such as a cold
  • excitement or stress.

The child’s Diabetes Action and Management Plan will provide specific guidance for preventing and treating a high glucose level.

Hypoglycaemia or hypo (low blood glucose): Hypoglycaemia refers to having a blood glucose level that is lower than normal – that is, below 4 mmol/L, even if there are no symptoms. Neurological symptoms can occur at blood glucose levels below 4 mmol/L and can include sweating, tremors, headache, pallor, poor coordination and mood changes. Hypoglycaemia can also impair concentration, behaviour and attention, with symptoms including a vague manner and slurred speech.

Causes of hypoglycaemia (hypo) are:

  • taking too much insulin
  • delaying a meal
  • consuming an insufficient quantity of carbohydrate at a meal
  • undertaking unplanned or unusual exercise
  • illness.

It is important to treat hypoglycaemia promptly and appropriately to prevent the blood glucose level from falling even lower, as very low levels can lead to loss of consciousness and possibly convulsions. Never leave the child alone during a hypo episode.

The child’s Diabetes Action and Management Plan will provide specific guidance for services in preventing and treating a hypo.

Insulin: Medication prescribed and administered by injection or continuously by a pump device to lower the blood glucose level. In the body, insulin allows glucose from food (carbohydrates) to be used as energy and is essential for life.

Insulin pump: An insulin pump is a small battery-operated electronic device that holds a reservoir of insulin. It is about the size of a mobile phone and is worn 24 hours a day. The pump is programmed to deliver insulin into the body through thin plastic tubing known as the ‘infusion set’ or ‘giving set’.

Ketoacidosis: Ketoacidosis is related to hyperglycaemia. It is a serious condition associated with illness or very high blood glucose levels in type 1 diabetes. It develops gradually over hours or days. It is a sign of insufficient insulin. High levels of ketones can make children very sick. Symptoms of ketoacidosis may include high blood glucose levels and moderate to heavy ketones in the urine, with rapid breathing, flushed cheeks, abdominal pain, sweet acetone (similar to paint thinner or nail polish remover) smell on the breath, vomiting and/or dehydration. It is a serious medical emergency and can be life-threatening if not treated properly. If symptoms are present, contact a doctor or call an ambulance immediately.

Type 1 diabetes: An autoimmune condition that occurs when the immune system damages the insulin-producing cells in the pancreas. Type 1 diabetes is treated with insulin replacement via injections or a continuous infusion of insulin via a pump. Type 1 diabetes is not linked to modifiable lifestyle factors. Currently, there is no cure – nor can Type 1 diabetes be prevented. Type 1 diabetes can be life-threatening.

Type 2 diabetes: Type 2 diabetes in children is a chronic disease that affects the way your child's body processes sugar (glucose) for fuel. Type 2 diabetes occurs more commonly in adults. If a child at your service is diagnosed with type 2 diabetes, please refer to the Management of medical conditions policy and procedure.

6. Authorisations and review

This policy is the responsibility of Early Learning Victoria. Contact: ELV@education.vic.gov.au

It was approved by the CEO, Early Learning Victoria, Department of Education on 29 November 2024.

Early Learning Victoria regularly reviews its policies and procedures. This policy is due for review on 29 November 2026 unless changes in legislation or Department of Education policy require it to be reviewed sooner.

Reviewed by Director, Strategy and Planning, Early Learning Victoria.

Education

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