Diabetes Medical Management Plan

*Please complete a Diabetes Medical Management Plan (DMMP) Form and Return to the School Health Office*

Required Supplies at School (provided by family)

• Glucometer
• Glucometer strips
• Lancets
• Alcohol wipes
• Insulin syringes/insulin pens
• Insulin
• Ketometer and strips
• Simple sugars to treat lows (juice, glucose tabs, etc.)
• Complex sugars (15 Gm) such as crackers, pretzels, etc.
• Glucose gel
• Glucagon
• If using a pump: two back up sets of pump supplies (ex. Batteries, tubing, sites, adhesives, vials to refill)
• If wearing a glucose sensor – replacement supplies x 2 (should it come off during the school day).
• Any other supplies needed