I totally understand the concern.
The thing is, I know that these lows do happen on our watch too. I mean, I looked at the last 7 days of data from Dexcom, and there are 0 percent urgent lows for the hours he’s with us except for like 3 percent during the hour when he eats breakfast (when he sort of touches down to 55 and then bounces up sometimes), and then like 15 percent!!! urgent low at the noon to 1pm hour, when he’s at school.
But, when I look at the 90-day data, the urgent lows look a little more evenly distributed. There are still times of the day when it’s more common, but not all of them are concentrated in the school hours. Because even though we’re vigilant, sometimes we do miss things as well, and sometimes lows just come out of nowhere. And sometimes alarms don’t work at night, or he has no data for a while and then all of a sudden does, etc. etc. etc.
The other thing I’d say is that it’s not all the school’s fault of course. I mean clearly we have some settings that should be tweaked somehow if they need to treat impending lows every day. Our goal when he started school was to have him need low treatments about 3 times a week, but realistically, he needs low treatments/avoid low treatments at school every.single.day. Once every two weeks he may have a day with no glucose tabs. We are constantly trying to figure out the right balance to make those lows go away but we never have been able to. Setting the target higher doesn’t seem to help because the crashes way overshoot whatever the target is anyways. And when we lower his basal rate he’s hanging out at 300. And when he weaken his carb ratio he shoots up to 300 and only drifts down to 280 or so at lunch time. Anyways, the point is that someone who was happy for their kid to hang out at 170 or 200 all day long probably wouldn’t have as many lows to treat, and therefore wouldn’t spend much time in the urgent low range, and that’s our choice of a tradeoff. If that’s your #1 concern there are definitely ways you can set the care plan to make them much less likely, even if the school is not 100% responsive.
I also think being the squeaky wheel really does help…and it will help you guys as well that the public schools are required to care for your child, which is not necessarily the case with a private school or a preschool.