Type of insulin used: Training is required. Here is how the dose is calculated: __________________ Parents label the food with number of carbohydrates and provide a * student’s Always double-check the that allows designated staff to select an appropriate insulin dose. This dose is insulin dose before injecting based on the BG reading and the number of carbohydrates the student will eat. to make sure the appropriate dose has been OR selected and is dialed correctly into the pen. Same steps as above, but with the dose calculated by the glucose meter student’s (only certain meters can do this). The student is able to SYRINGE select the appropriate Parents will send a set number of carbohydrates for snack/lunch each day. dose. Designated staff They will provide an appropriate tool (such as variable dose insulin scale in OR should double-check the Appendix A) to help designated staff select appropriate dose based on the dose. BG. student’s PENS Insulin is given by Parents may send a different number of carbohydrates for snack/lunch each designated staff. A second day (clearly labeled) and will provide an appropriate tool (such as variable dose adult must check the dose. VIA insulin scale in Appendix A) that allows designated staff to select a dose of (This task requires some insulin based on BG. training, but the adult doing it does not need to be a designated staff Parents have the right to adjust insulin dose for bolus calculator sheet member listed in this care or sliding scale throughout the school year as needed plan). INSULIN Parents agree the student * See , can give their own Click on Basal-Bolus Insulin with MDI, then Bolus Calculators for School Lunches insulin, without an adult double-checking the dose.
INSULIN VIA PENS OR SYRINGE Type of insulin used: __________________ Always double-check the insulin dose before injecting to make sure the appropriate dose has been selected and is dialed correctly into the pen. The student is able to select the appropriate dose. Designated staff should double-check the dose. Insulin is given by designated staff. A second adult must check the dose. (This task requires some training, but the adult doing it does not need to be a designated staff member listed in this care plan). Parents agree the student can give their own insulin, without an adult double-checking the dose. Training is required. Here is how the dose is calculated: Parents label the student’s food with number of carbohydrates and provide a * that allows designated staff to select an appropriate insulin dose. This dose is based on the BG reading and the number of carbohydrates the student will eat. OR Same steps as above, but with the dose calculated by the student’s glucose meter (only certain meters can do this). Parents will send a set number of carbohydrates for snack/lunch each day. They will provide an appropriate tool (such as variable dose insulin scale in Appendix A) to help designated staff select appropriate dose based on the student’s BG. Parents may send a different number of carbohydrates for snack/lunch each day (clearly labeled) and will provide an appropriate tool (such as variable dose insulin scale in Appendix A) that allows designated staff to select a dose of insulin based on BG. Parents have the right to adjust insulin dose for bolus calculator sheet or sliding scale throughout the school year as needed * See , Click on Basal-Bolus Insulin with MDI, then Bolus Calculators for School Lunches