Its funny (or sad) that as I was researching posts before starting a new post, I ran across my own post from a year ago with many of my current questions. My daughter is now about to start 1st grade. Last year she went to a small private school and it went fairly well with diabetes management. They had no nurse or prior knowledge but were willing to learn. Most of her care fell to her teacher and the office manager. The teacher was amazing and wore a small purse we provided with DD's dexcom receiver showing through a clear pocket and her iphone tucked inside another pocket. She not only responded to alarms but obviously checked it frequently and she texted us for advice through the day. If she noticed DD trending down she would give a few smarties and then text us for further advice for example and then send DD to office for meter test if she continued to go down or was actually low on dexcom. If she was extra high at snacktime (which always fell into her post breakfast spike) she might text about delaying her snack for a little while. It was a small campus and she was never out of range of her dexcom. We did go at lunch to test and dose her insulin but that was largely by choice as I think they would have done it if we had spent the time teaching them. Fast forward to 1st grade and DD is switching to a public school. I am having difficulty imaging how this is supposed to work in a school with a large campus and many students in the classroom. My first concern is who is supposed to hold on to the dexcom/phone and monitor it for alarms or other trends. I suppose it is possible that the teacher will be willing to wear the purse with the dexcom and attend to its alarms at least but I can see many problems with this. Specifically the teacher may not be willing to wear it or even keep it on her desk or may not pay attention to it (and how could I blame him/her with all of their other responsibilities and large class). Even if they are willing I imagine there are times that the class goes somewhere and the teacher does not stay with them such as going to the library or their computer, art or dance class and certainly the teacher will not be at recess or lunch. So am I suppose to buy a belt or something so that my 5 year old can keep the receiver and phone with her all the time? Or have the teacher give the purse to her during the times she will be on her own (recess/lunch). But then am I expecting my 5 year old to be the one to notify an adult if her dexcom alarms??? She is quite responsible but I am not very comfortable with this idea. Number 2 concern is how to handle the alarm or down trend on dexcom. I saw an old post about a chart that varied how many tabs to give depending on number and dexcom trend. I like that idea although it is hard to put in into a chart since we do it by feel right now depending on all the typical variables. I guess I can muddle through this part of it and maybe give a tab in class without testing if she is trending down or borderline low but give a tab then walk her to nurse if she is alarming low and then follow some type of chart like that with the "nurse" who is a health clerk without much skill in diabetes. I know I will need a 504 and I have seen many posts about the issues about walking escorted by adult to the nurse and being allowed to carry phone, test anywhere etc. and I am ok working all of that out. My biggest concern is who is responsible for the actual receiver (and phone) and monitors the alarms (and trends if possible).