Sarah, I live in Washington State and while my daughter doesn't have diabetes she does have other health issues so I'm familiar with the 504 and individual health plan process in Washington schools as we had to go through this when she was younger. Washington is one of those states where anything health related is supposed to go into the medical management plan. The 504 is for equal access to academics. Washington state is actually pretty good about 504's but it's about academics and not health related needs. Your issues are not a 504 problem but more that his health plan wasn't followed. So if I had a very young child with diabetes I would spell everything out in detail in the medical management plan related to his diabetes and not the 504 as that is where everyone expects to find that information. The 504 academic accommodations at that age would be minimal probably absences, parties, bathrooms, water, what to do about missed classroom time. Or at least those are the things I would address at this age.