In the current era of “zero tolerance,” public school students who have diabetes have been caught in a frustrating crossfire.

On one hand, students with diabetes need syringes for injecting insulin and lancets for testing their blood glucose levels.

On the other hand, many schools, wary of inadvertently encouraging or abetting illicit drug use, have set often harsh or impractical regulations in place to govern how students with diabetes may test or self-medicate.

In some schools, type 1 students must trek to the nurse’s office and give themselves injections while being observed. Both type 1 and type 2 students have to go to the nurse’s office to carry out even a finger stick test to determine their blood glucose level.

At the very least, this routine is highly disruptive, both for the student with diabetes and for those around them. Students and teachers are distracted by the comings and goings of classmates who may have to visit the nurse’s office up to 10 times a day.

For the students with diabetes, the constant interruptions take away from the time they spend learning. These rules single out the students, both for their disease and because there is an unspoken accusation that they could abuse the equipment used to control their diabetes.

Arizona Injects Some Common Sense

That’s why the recent news out of Arizona is so refreshing: Governor Janet Napolitano has signed a law that allows public school students to independently monitor their blood glucose levels in class up to 10 times daily and to use the necessary needles and lancets.

The impetus for the law came from a 2005 federal lawsuit in which a couple sued an Arizona high school for refusing to allow their son to carry monitoring equipment. In the suit, which was later settled out of court, the plaintiffs alleged that the school forbade the use of monitoring equipment under its zero-tolerance policy governing needles.

As well as relaxing the stringent regulation of diabetes-related needles and lancets, the new Arizona law allows volunteers and non-licensed school personnel to administer glucagon in emergencies when students have adverse reactions to insulin.

States Vary, But Federal Rules Set Some Guidelines

Nationwide, there is no uniform set of guidelines governing how public school students with diabetes may monitor or medicate themselves. States and individual school districts set their own policies.

However, federal guidelines do set a minimum standard of conduct, in which schools must accommodate the needs of students with diabetes in some fashion.

The first guideline is a Diabetes Medical Management Plan (DMMP), which describes the medical treatment that the student’s doctor and family have developed. A school may ask questions or offer suggestions about a DMMP, but the plan is basically the doctor’s and family’s call.

Section 504 of the Federal Rehabilitation Act bans school districts that receive federal funds from discriminating against students with disabilities. A Section 504 plan outlines how a school will accommodate or provide services to a disabled student.

Both plans work together: The DMMP describes what must be done, and the Section 504 plan describes how the school will allow it to be done. For example, if a student needs to self-test five times a day (DMMP), the Section 504 plan will list where and when those tests will be carried out.

In most cases, school districts insist on closely monitoring what actions students with diabetes may take. Arizona’s step toward softening previously strict regulations may set an example that other states will soon follow.