DMMP School Form: Diabetes Medical Management Plan Template for Schools

What a DMMP Is — and What It Is Not

A Diabetes Medical Management Plan is a physician medical order set. It is written by your child's endocrinologist or treating physician, not by the school. The DMMP contains the clinical parameters that govern your child's diabetes management at school: insulin-to-carbohydrate ratios, correction factors, target blood glucose ranges, glucagon dosing, ketone monitoring thresholds, and specific instructions for managing hypo- and hyperglycaemia.

The DMMP is a clinical document, not a legal document. This is the distinction that trips up most families. A DMMP by itself is not a Section 504 plan and does not provide Section 504's procedural safeguards. It tells the school what to do clinically; it does not itself establish Section 504 accommodations or the safeguards that apply to them.

To connect the DMMP to disability-related school accommodations, families can request that its relevant instructions be incorporated by reference into a formal Section 504 plan. The 504 plan identifies the accommodations the school must provide under federal civil rights law; the DMMP supplies the student's clinical orders.

What Your Child's DMMP Should Include

The American Diabetes Association's Safe at School campaign and the National Diabetes Education Program's Helping the Student with Diabetes Succeed guide both outline what a complete DMMP covers. Your child's endocrinologist should complete or update this document annually, and whenever treatment changes significantly.

Blood glucose monitoring parameters:

• Target range (typically 80–180 mg/dL for school hours, though this varies by patient)
• How often to check (CGM vs finger stick, minimum check times)
• Thresholds that require action, as set by the treating clinician: for example, below 70 mg/dL for hypoglycaemia treatment and at or above 240 mg/dL (or the DMMP's specified threshold) for ketone checks

Insulin administration:

• Insulin-to-carbohydrate ratio for each meal period
• Correction factor and target glucose for corrections
• Type of insulin and delivery method (pump, pen, syringe)
• For pump users: basal rate settings, site change frequency, what to do if the pump malfunctions or occludes
• For AID (automated insulin delivery) users: which system (Tandem Control-IQ, Omnipod 5, Medtronic 780G), what staff can and cannot adjust, when to switch to manual mode

Meal and snack management:

• Whether the student requires carbohydrate counting or follows a fixed meal plan
• Permission to eat snacks at any time to prevent or treat hypoglycaemia
• Specific instructions for school lunch, classroom celebrations, and field trip meals

Emergency protocols:

• Hypoglycaemia treatment: the fast-acting carbohydrate amount and type, and any follow-up snack, as specified in the DMMP
• Severe hypoglycaemia (loss of consciousness, seizure, inability to swallow): glucagon administration — route (intranasal Baqsimi, subcutaneous Gvoke/Zegalogue), dose, and what to do after administration
• Hyperglycaemia with ketones: fluid access, activity restrictions, when to contact the parent and when to call 911
• DKA warning signs and the threshold for emergency medical services

Physical activity guidelines:

• Pre-exercise blood glucose check requirement
• Glucose range that is safe for activity
• Carbohydrate supplementation before or during activity
• The student's glucose thresholds for activity, carbohydrate use, and any activity restrictions, as specified in the DMMP

The DMMP-to-504 Connection

Once the endocrinologist completes the DMMP, it becomes an attachment to the 504 plan — not a replacement for it. The 504 plan adds the operational and legal layer:

• Who specifically is trained to perform each task listed in the DMMP (names, not just "trained staff")
• Where insulin, glucagon, glucose tablets, and testing supplies are stored in each building and classroom the student uses
• What happens when the school nurse is not on site (trained diabetes personnel coverage)
• How accommodations are communicated to substitute teachers
• The student's right to carry their CGM phone, pump supplies, and fast-acting carbohydrates at all times
• Testing, field trip, and transportation accommodations linked to the clinical thresholds in the DMMP
• Procedural safeguards: prior written notice for any changes, the right to request a review, and the right to an impartial hearing if disputes arise

This layered structure is what gives a family actual enforcement power. If a school fails to follow the DMMP as incorporated into the 504 plan, the family can pursue remedies through the school's 504 complaint process, the state education agency, the Office for Civil Rights, or federal court under the A.J.T. v. Osseo Area Schools standard.

Getting the Form Completed

Most children's hospitals and paediatric endocrinology clinics use a standardised DMMP form. If your child's provider does not have one, the ADA provides a model form through its Safe at School resources, and many state diabetes associations offer state-specific versions.

Bring the blank form to your child's next endocrinology appointment — or send it ahead so the physician can complete it during the visit. Request that the physician specify the monitoring, treatment, and escalation instructions appropriate for your child; clinical thresholds and carbohydrate amounts should come from the physician's orders.

The more specific the DMMP, the harder it is for a school to claim ambiguity about what they are supposed to do.

The Medical 504 Plan Toolkit includes structured DMMP integration templates that bridge the physician's clinical orders with the 504 plan's accommodation language — so the two documents work together as a single enforceable system.