Tiny T1D Warriors: A Guide to a Happy & Safe Nursery Transition

Starting nursery is a big step for any child, but when your child has Type 1 Diabetes (T1D), it can feel even more daunting. New routines, different caregivers, and unpredictable toddler eating habits can all add to the worry. The good new is that with the right preparation and support, nursery can be a safe, happy and positive experience for your child.

Here’s a practical guide to help make the transition smooth for both you and your toddler.

1. Choosing the Right Nursery

Not all nurseries will have experience with T1D, so it’s important to find one that’s willing to learn and work with you to meet your child’s needs.

• Ask about their experience with medical conditions- Have they cared for a child with diabetes before? How do they handle medical needs?

• Check their policies on medication and emergencies- Who will be responsible for administering insulin, checking blood sugar and treating lows?

• Look for a supportive attitude- Even if they’re unfamiliar with T1D, a nursery that is willing to learn and communicate openly is key.

2. Meet With Staff Before the First Day

Before your child starts, arrange a meeting with the nursery team to go over their diabetes care. This should include:

• A clear, written care plan- Work with your child’s diabetes team to create a detailed document covering:

  • Blood sugar checks and target ranges

  • Insulin doses and how it’s administered (e.g., pens, pump)

  • Snack and mealtime routines

  • Emergency contacts and what to do in case of severe highs or lows

• Training for key staff- Ensure at least two or three staff members feel confident managing your child’s diabetes.

• Agree on a communication plan- Decide how you’ll stay updated throughout the day (e.g., a diary, phone calls, or an app).

3. Managing Blood Sugar Checks and Insulin

• Who will check blood sugars?- Some nurseries may need training on finger pricks or CGM readings.

• Handling CGM alarms- If your child wears a CGM, explain what alarms mean and when staff need to act.

• Insulin administration- Will staff give insulin, or will you come in to do it? If they will, ensure they are trained and comfortable.

4. Food and Mealtime Support

• Provide a list of safe snacks- Have a stash of fast-acting hypo treatments at nursery (e.g., glucose tablets, glucose shots, fruit juice (apple, orange, grape) or sweets) as well as any snacks for carb top-ups, if needed.

• Carb counting support- If meals are provided, discuss how to count carbs and adjust insulin accordingly. If this is tricky, you may prefer to send packed lunches.

• Flexible meal times- Toddlers are unpredictable eaters, so staff should know what to do if your child refuses food after insulin has been given.

5. Managing Hypoglycemia (Lows) and Hyperglycemia (Highs)

Nursery staff must be able to recognise and respond to blood sugar fluctuations. Your Diabetes Care team should have these instructions clearly written in the care plan.

• Signs of a hypo (low blood sugar) and how to manage, as per guidance from your Diabetes care team

• Signs of a hyper (high blood sugar) and how to manage, as per guidance from your Diabetes care team

• Emergency protocols- Ensure staff know when to call you, and when to seek medical help, as per guidance from your Diabetes care team

6. Helping Your Toddler Feel Comfortable

• Keep diabetes low-stress- Try not to make T1D feel like a “big deal.” Encourage your child to see it as part of their daily routine.

• Practice role-playing- Play “nursery time” at home so your child gets used to checking blood sugar, eating snacks and telling an adult if they feel funny.

• Introduce a comfort item- If they’re feeling anxious, a favourite stuffed toy or blanket can help them feel secure.

7. Keep Communication Open

• Daily updates- Whether though a diary, an app or quick chats at pickup, staying informed helps you spot patterns and adjust care as needed.

• Regular check-ins- Schedule a review with the nursery every few months to see how things are going and make any necessary changes.

• Trust your instincts- If something doesn’t feel right, don’t be afraid to speak up and advocate for your child’s needs.

Final Thoughts

Starting nursery with T1D may feel overwhelming- not just for your child, but for you too. It’s completely natural to worry about how they’ll cope without you there, whether staff will understand their needs, and how they’ll navigate this big new world. However, with good preparation, a supportive nursery team and clear communication, your child can have a safe, happy and positive experience.

There may be ups and downs, and it might take time to find a routine that works, but you’re not alone. Trust that you’ve put the right steps in place, and know that your little one is stronger and more capable than you might think. This is a big milestone, and with your love and guidance, they’ll thrive- making friends, learning new things, and having lots of fun along the way.

You’ve got this, and so does your tiny T1D warrior!