SCHOOL CAMP MANAGEMENT CHECKLISTS AND PLANS FOR STUDENTS WITH DIABETES

It is important that any child with diabetes can fully participate in the school curriculum. This involves
school camps and excursions, regardless of whether it is a day event or overnight. For these to be
successful, preparation is paramount. The following guideline includes checklists of things that both
family and whānau need to consider as well as the school. This guide also contains a Camp Management
Plan that relates to a specific camp or excursion. A Camp Management Plan is intended to address the
issues that can arise on camps, primarily around activity levels, different meal plans, and overnight
management. It is anticipated that a different management plan is needed for each event. These should
be used in conjunction with the student’s diabetes action plan (hypo- and hyper-management) that will
already be in place.

Camp staff (volunteer and/or school personnel) need to be familiar with diabetes and the needs of the
student prior to the camp or excursion. This education can be carried out by parent/caregiver or health
professionals. Parents need to meet with school staff several weeks prior to the event to discuss these
documents and an adult must be nominated to be in charge of the safety and health needs of the
student with diabetes.

Key areas for consideration and discussion between families/whānau and schools include:
• Diabetes Education
• Camp Activities – Programme
• Camp Meal Plan
• Diabetes Supplies and Additional Food Supplies
• Contact Details
• Diabetes Emergencies
• School Action Plan

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 Pre-Camp Checklist for Families

Does the student know:

Glucose Levels
How to check glucose levels using their meter and CGM device? Yes No With Support
E.g. using their CareSens Dual BGL meter and a Libre or Dexcom or
Guardian if they are using one?
How to check ketone levels? Yes No With Support
Do they recognise their own hypoglycaemia symptoms? Yes No
How to treat/manage hypoglycaemia? Yes No With Support
How to treat/manage high glucose levels? Yes No With Support

Insulin
How to calculate a food bolus? Yes No With Support
How to calculate a correction bolus? Yes No With Support
How to dial up and give insulin using pens/syringes? Yes No With Support

If using a glucose monitoring device does the student know:

How to respond to arrows? Yes No With Support
When a finger prick is required? Yes No With Support
How to insert a new sensor? Yes No With Support

If a pump user does the student know:

How to suspend and/or disconnect their pump? Yes No With Support
How to give a food or correction bolus on their pump? Yes No With Support
Use temporary basals? Yes No With Support
Troubleshoot pump alarms or errors? Yes No With Support
Change infusion set? Yes No With Support

If “No” or “With Support”, consider whether the student can be upskilled to be able to do these skills or
how these may be managed in a camp setting.

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 Pre-Camp Considerations for Families

Camps require additional planning for families and whānau. This ensures that the student can enjoy a
camp in a safe manner and parents, caregivers, and camp staff can be confident with the plan in place.

Diabetes Education
Staff attending the camp need to have an understanding of diabetes prior to the camp. They don’t need
to know the same amount of information as a parent does, but the more information they have the
more confident everyone will feel. Identifying some friends/classmate who also know that the student
has diabetes and can seek help when needed can be helpful. An adult does need to be identified for
additional supervision that is required.

Camp Activities – Programme

Ask the school to obtain the camp programme. This will typically have been established well prior to the
camp occurring (unless of significant weather changes). Activity levels are usually much higher than usual
when at camp, and therefore adjustments to insulin doses will be required. If you have the programme,
you can discuss with your diabetes team for specific recommendations.

Camp Meal Plan

Similarly to the programme, the camp menu will likely have been established prior to the camp. If you
have a menu you can make informed and educated decisions about carbohydrate amounts and portion
sizes as well as whether adjustments may need to be made (e.g., know your child won’t eat a meal but
will require carbohydrates). If you can provide a pictorial carbohydrate counter or an “app” this can
reduce the pressure for everyone.

Diabetes Supplies and Additional Food Supplies

It is important that you provide all diabetes supplies (and spares) including hypo management supplies.
As well as hypo management, supplies you may need to provide additional carbohydrate containing
foods for activities or to maintain overnight glucose levels.

Contact Details
The camp staff need to know how to contact all relevant parties when at camp. This includes parents and
caregivers as well as the diabetes team and after-hours support numbers if available. Does the camp
have mobile reception at all times? If not, have you got a backup plan for maintaining contact?

Diabetes Emergencies
There needs to be a conversation with the school about how a diabetes emergency is to be managed.
Having an adult trained in glucagon administration is the preferred option. An ambulance should be
called in the case of a severe hypo. Depending on the location of the camp this may take some time to
arrive.

School Action Plan

Ensure that the school has an up-to-date school action plan. This is a personalised flow chart for
managing hypoglycaemia and hyperglycaemia and is based on the insulin delivery device that the
student uses (e.g., injections or insulin pump).

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 Checklist for Schools

Diabetes management does require additional levels of management and oversight. It is important that
there are identified adult/s who can provide this support for the student.

Does a member of the camp staff know:

How to check glucose levels using a meter and GM device? Yes No
How to check ketone levels? Yes No
How to interpret glucose and ketone levels? Yes No
How to treat/manage hypoglycaemia? Yes No
How to treat/manage high glucose levels? Yes No
How to calculate a food bolus dose? Yes No
How to calculate a correction bolus dose? Yes No
How to administer an insulin injection? Yes No
How to supervise insulin injection? Yes No

If the student is a pump user. Does a staff member know:

How to suspend or disconnect a pump? Yes No
How to administer a bolus on a pump? Yes No
How to fill an insulin cartridge and change infusion set ? Yes No
How to use an insulin pen in case of pump failure? Yes No

In an emergency situation, does a staff member know:

How to administer a glucagon injection? Yes No

Pre-Camp Considerations for Schools

Camps require additional planning for school personnel. This ensures that the student can enjoy a camp
in a safe manner and schools as well as parents and caregivers can be confident with the plan in place.

Diabetes Education
Camp staff need to have an understanding of diabetes prior to the camp. They don’t need to know the
same amount of information as a parent does, but the more information they have the more confident
everyone will feel. Identifying some friends/classmate who also know that the student has diabetes and
can seek help when needed can be helpful. An adult does need to be identified for additional supervision
that is required.

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Camp Activities – Programme
Provide the family with the camp programme. Activity levels are usually much higher than usual when at
camp, and therefore adjustments to insulin doses will be required. By providing the programme to
parents/caregivers they can provide specific recommendations.

Camp Meal Plan

Provide the family with the camp menu and expected timing of meals. If the family have a menu they can
provide clearer guidance about portion sizes as well insulin doses. Carbohydrate foods should be served
at every meal and snack time. Ask the parents/caregivers if they can provide a pictorial carbohydrate
counter or an “app” this can reduce the pressure for everyone.

Diabetes Supplies and Additional Food Supplies

Families should provide all diabetes supplies (and spares) including hypo management supplies. As well
as hypo management supplies the family should provide additional carbohydrate containing foods for
activities or to maintain overnight glucose levels. Ensure that food is allowed in the sleeping rooms (this
is a medical requirement).

Contact Details
Know who camp staff can contact to discuss any diabetes concerns whilst at camp. This includes parents
and caregivers as well as the diabetes team and after-hours support numbers if available.

Diabetes Emergencies
There needs to be a conversation with the family/whānau about how a diabetes emergency is to be
managed. Having an adult trained in glucagon administration is the preferred option. An ambulance
should be called in the case of a severe hypo. Depending on the location of the camp this may take some
time to arrive.

School Action Plan

Ensure that the student has an up-to-date school action plan. This is a personalised flow chart for
managing hypoglycaemia and hyperglycaemia and is based on the insulin delivery device that the
student uses (e.g., injections or insulin pump).

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 School Camp Management Plan for Students with Diabetes

This Camp Management Plan is to be used alongside “pre-camp checklists” and the school action plan.
Parents/caregivers should meet with the school to discuss the camp or excursion well before the event.
This Management Plan is completed in consultation with the family and with the diabetes clinical team if
required.

Student’s name: Age: School Year:

RESPONSIBLE STAFF:

Staff name/s:

Staff name/s:

Staff name/s:
Blood Glucose Checking
Target ranges for blood glucose levels (BGLs): 4 – 8 mmol/L
BGL results outside of this target range are common
BGL checks should be done where the student is, whenever needed
Always ensure the student’s hands have been washed and dried before doing the BGL check
Is the student able to check glucose levels? Yes No With Support
Is the student able to identify their own hypoglycaemia symptoms? Yes No
Times to check BGLS
 Anytime, anywhere  Before meals & snacks  When feeling unwell
 Before activity  Before Bed  Overnight _______ pm
 Upon waking  Overnight _______ pm  Any time hypo suspected
 Other routine times
Preferred pre-bed BGL target range:
Management if glucose level is below preferred target range:
Glucose Level: Carbohydrate food to be used: Amount to be given:

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Preferred overnight BGL target range:
Management if glucose level is below preferred target range:
Glucose Level: Carbohydrate food to be used: Amount to be given:

Sensor Glucose (SG) Monitoring

Some students will be wearing a small sensor that sits under the skin and measures glucose levels in the fluid
surrounding the cells (interstitial fluid). A sensor glucose (SG) reading can differ from a finger prick blood
glucose reading during times of rapidly changing glucose levels e.g. eating, after insulin administration, during
exercise. Therefore, LOW or HIGH SG readings must be confirmed by a finger prick blood glucose check. Hypo
treatment is based on a blood glucose finger prick result.
The student is wearing a glucose sensor? Yes No
Type:
• With CGM, a transmitter sends data to either a receiver, phone app or insulin pump.
• With FGM, the device will only give a glucose reading when the sensor disc is scanned by a reader or phone
app. These devices are not compulsory management tools.
CGM ALARMS
• CGM alarms may be ‘on’ or ‘off’.
• If ‘on’ the CGM will alarm if interstitial glucose is low or high.
ACTION: Check finger prick blood glucose level (BGL) and if less than 4.0 mmol/L, treat as per Diabetes Action

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Plan for treatment.
• FGM device does not have alarm settings
USE OF SENSOR GLUCOSE MONITORING AT CAMP
• Sensor glucose monitoring can be beneficial in a camp environment, although staff are not expected to do
more than the current routine diabetes care as per the student’s Diabetes Action and Management plans.
• Staff do not need to put CGM apps on their computer, smart phone or carry receivers.
• Parents/carers are the primary contact for any questions regarding CGM/FGM use.
• Some CGM/FGM devices can be monitored remotely by family members. They should only contact the
school if they foresee a prompt response is required.
• If the sensor/transmitter falls out, staff are required to keep it in a safe place to give to parents/carers.
• The sensor can remain on the student during water activities.

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Insulin Administration
The student will need insulin at main meals and possibly snack times
Type of device Syringe Pen Pump
Is the student able to calculate own insulin dose? Yes No With
Support
Is the student able to administer own insulin? Yes No With
Support
How Much Insulin to Be Administered
Basal Insulin Type: Time: Units:
Bolus Insulin Afternoon
Breakfast Morning Tea Lunch Dinner Other
Tea
Insulin: CHO Ratio
(1 unit: g CHO)
Correction Ratio (1
unit: mmol/L)
Additional Insulin Adjustments/Corrections whilst at camp (including temp basal rates)

Activity
Activity decreases glucose levels and activity levels at camp are usually higher than usual.
Depending on the intensity of the activity, glucose levels may drop quickly or up to 24 hours later.
It is important to check glucose levels during the night following daytime exercise.
It is important to check BGL at least 15 minutes prior to exercise or high intensity activity and respond
appropriately
Vigorous activity should not be commenced if BGL >15mmol/L and blood ketones of >0.6mmol/L
Vigorous activity should not be commenced if BGL <4mmol/L
Preferred pre-activity BGL target range:
Recommendations for insulin adjustments for planned activity. These should be discussed with their usual
diabetes team and family, and individualised as needed:
MDI Reduce the pre exercise bolus insulin dose by 30-50% (start with 30% and increase as needed) if
activity is within 1 hour of insulin injection (for example meal bolus)
Pump Reduce the basal insulin dose by up to 30-50% (start with 30% and increase as needed) from 90
minutes prior to exercise (via temp basal feature)
Recommendations to prevent post-exercise hypoglycaemia:
MDI To prevent post exercise hypo, reduce the nighttime long acting (basal) insulin dose by 20%

Pump To prevent post exercise hypo, reduce the basal insulin dose by 30-50% until 3am (via temporary
basal feature)

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Recommendations for unplanned activity:
MDI Consume 10 – 15g long acting CHO if BGL is 4-7mmol/L and recheck in 30 minutes.

Pump Consume 10 – 15g long acting CHO if BGL is 4-7mmol/L and recheck in 30 minutes.

Additional comments for unplanned activity:

For most children, the target range for glucose levels is 3.9 – 10.0 mmol/L. Provide additional 10-15 grams
carbohydrate if glucose levels are at the lower end of the target range (4.0 – 7.0 mmol/L) to avoid
hypoglycaemia and recheck in 30 minutes. Food ideas include: Small muesli or fruit bar, 2 plain biscuits or
crackers, UHT milk tetrapack or breakfast drink, Le Snaks, small packets of plain popcorn or trail mix.

Additional comments relating to specific exercise on camp, i.e. times of sustained or high intensity activity:
Monitor glucose levels regularly across the day and follow hypoglycaemia treatment guidelines as required.
Ensure snacks are available for those who need additional carbohydrate after treating hypoglycaemia.

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 Food and Meals at Camp
The camp menu should have been reviewed by the parents/caregivers prior to the camp.
Additional long-acting carbohydrate foods should be supplied by the family or be available if a meal/snack is
delayed or activities are intense requiring additional carbohydrate.
Is the student able to count carbohydrates? Yes No With
Support
Does the student have coeliac disease or additional allergies? Yes No
Management of above:

Considerations for meal times when at camp?

DIABETES SUPPLIES - PLEASE ENSURE THESE ARE ALL LABELLED AND PACKED TOGETHER
New vials/cartridges of insulin (2 vials/cartridges
  Container for Sharps Disposal
of each type)
CareSens Dual Meter (& spare batteries) Prefilled Insulin Pens and/or Syringes + Pen
 
+ Finger Pricker (& spare lancets) Needles
 2 Boxes of Blood Glucose Testing Strips  2 Boxes of CareSens Ketostrips (camp supplies)
Glucose Monitoring Device (if using) plus charger
  Pump Batteries or Charger (Clearly Labelled)
(& spare sensor if able to change)
Battery Powered USB Charger for Pump or CGM Dressings/ Tape for Pump or Glucose Monitoring
 
Receiver if possible Device
 Cooler bag for insulin if out in hot weather  Baby-wipes or equivalent
Pump Supplies - sites, reservoirs, etc (if person is present who can change sites). Child and family should
 change the site and reservoir prior to camp, but not immediately before, e.g. please change the night
before, or at least three hours before leaving for camp.
HYPO-MANAGEMENT SUPPLIES
 Fast-Acting Carbohydrate – (10-15g CHO)  Long-Acting Carbohydrate (10-15g CHO)*
 Glucose Tablets  Small muesli bars
 125 ml Juice Boxes  Fruit bars
 _______________________________________ 
 Hypofit Gel  Glucagon Hypokit
ADDITIONAL FOOD SUPPLIED FOR ACTIVITY AND OVERNIGHT SUPPLEMENTS*
 
 
 
*Pre-packaged food is useful in a camp environment

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AGREEMENTS

PARENT/CARER
I have read, understood, and agree with this plan. I give consent to the school to communicate with the
Diabetes Treating Team about my student’s diabetes management at camp.

First Name Family Name Signature Date

SCHOOL REPRESENTATIVE
I have read, understood, and agree with this plan.

First Name Family Name Signature Date

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