Diabetes at school, by state

Type 1 diabetes at school in Massachusetts

What Massachusetts law and the state’s own guidance say about insulin, glucagon, supplies and phones at school, with each source quoted. Checked 2026-10-06.

Can trained school staff give insulin?

No

Parenteral medications, defined to include subcutaneous injection, may not be delegated to unlicensed school personnel, with exceptions only for epinephrine and pre-dosed glucagon autoinjectors (105 CMR 210.002, 210.004, version in Mass. Register #1562, 12/5/2025). Insulin is not among the exceptions. (mass.gov)

Can trained school staff give glucagon?

With limits

Glucagon is an emergency rescue medication that trained unlicensed school personnel may give, but only in pre-dosed nasal or similar forms or a pre-dosed autoinjector; other injectable glucagon stays nurse-only (105 CMR 210.002, 210.004). (mass.gov)

The American Diabetes Association’s Massachusetts page reads this differently: ADA says no, citing 105 CMR 210.004; the current version (Mass. Register #1562, 12/5/2025) adds pre-dosed glucagon forms to the medications trained unlicensed staff may give.

Can a student carry supplies and manage diabetes at school?

Yes

A school district may not prohibit a student with diabetes from possessing and administering a glucose monitoring test and insulin delivery system, in line with Department of Public Health self-administration rules (Mass. Gen. Laws ch. 71, § 54B). (malegislature.gov)

Does the state publish a diabetes care plan form or guidelines?

Yes

The Department of Elementary and Secondary Education and the Department of Public Health published The Massachusetts Guide for Managing Diabetes in Schools (2011). (archives.lib.state.ma.us (PDF))

Can a student keep a phone for the CGM in class?

Yes

The 2011 state guide has a section on continuous glucose monitoring that describes real-time CGM and its alarms. It does not address phone use, and no state law on phone use at school was found. (archives.lib.state.ma.us (PDF))

Also in Massachusetts

The current 105 CMR 210.000 (Mass. Register #1562, 12/5/2025) defines emergency rescue medications to include those given for hypoglycemia and lists pre-dosed glucagon among them. The Department of Elementary and Secondary Education guide (2011) predates this and says injectable medications other than epinephrine may not be delegated. (mass.gov; archives.lib.state.ma.us (PDF))

Federal law applies in every state

Section 504 and the Americans with Disabilities Act can cover a student with diabetes at a public school in every state, whatever the state law says; a 504 plan is where the student’s care at school is written down. The federal rules, with sources.

Sources, quoted

• mass.gov: “(4) Parenteral medications may not be delegated or administered by training, with the exception of epinephrine or injectable glucagon in an FDA-approved, pre-dosed autoinjector administered in accordance with the restrictions outlined in 105 CMR 210.000.” (checked against an archived copy; the site blocks automated checks)
• mass.gov: “Parenteral Medication means any medication administered in a manner other than by the digestive tract or topical application, as by intravenous, intramuscular, subcutaneous, or intradermal injection.” (checked against an archived copy; the site blocks automated checks)
• mass.gov: “(3) glucagon in an FDA-approved, pre-dosed auto-injector or FDA-approved, pre-dosed forms that are administered through the mucous membranes of the nose, digestive tract, or lungs;” (checked against an archived copy; the site blocks automated checks)
• malegislature.gov: “Notwithstanding any general or special law or regulation to the contrary, a school district shall not prohibit a student with diabetes from possessing and administering a glucose monitoring test and insulin delivery system, in accordance with department of public health regulations concerning a student's self-administration of a prescription medication.”
• archives.lib.state.ma.us (PDF): “To assist schools in developing and implementing policies and comprehensive protocols for care of students with diabetes, the Massachusetts Department of Elementary and Secondary Education collaborated with the Massachusetts Department of Public Health, School Health Services, a working group to develop this publication, The Massachusetts Guide for Managing Diabetes in Schools.”
• archives.lib.state.ma.us (PDF): “Real-time systems have the ability to set high and low alarms, alerting the student that his/her glucose level may be out of range.”
• mass.gov: “Emergency Rescue Medication means a schedule II-VI medication which is administered in the event of an allergic reaction, hypoglycemia, apparent opioid overdose, asthma or other loss of consciousness and/or acute respiratoryevent, in order to prevent imminent death or serious injury or illness.” (checked against an archived copy; the site blocks automated checks)
• archives.lib.state.ma.us (PDF): “Under DPH regulations, 105 CMR 210.000, the administration of injectable medications (other than epinephrine by auto-injector to a child experiencing a life-threatening allergic event) may not be delegated to unlicensed personnel.”

Legal information, not legal advice. Laws change; the source page is the authority when it differs, and this page is rechecked each July. For help with a school, the American Diabetes Association’s legal advocates answer at 1-800-DIABETES (1-800-342-2383).