This is one of the biggest decisions you'll make in the first days. Most young children are happy to have you come in and help them tell their class what diabetes is and what it means, but older children can beg you to be secretive.

A simple rule is that the more people who know the better, and the earlier they know, the better it is for your child. This is true for a number of reasons. First, diabetes is a complicated and dangerous disease. The more people who know your child has diabetes and understands what that means, the safer your child is. Second, diabetes is nothing ever to be ashamed of or to hide from. While a child may claim he just wants privacy, allowing him to start out with a secret sends a dangerous subliminal message that there is some reason he should keep it to himself. Strongly encourage him to be as open about his diabetes from the start as possible.

Telling the News, Little-Kid Style

Smaller children are easy to work with on this. A good idea is to ask the teacher to let you and your child make a presentation that first day back. All the kids will know that your child was in the hospital and that something happened. By explaining what diabetes is and what it means for your child, the children will feel secure and will be able to help your child. Again, Kim Gosselin's book Taking Diabetes to School is magnificent in its simplicity and is the best way to get the message of diabetes across to teachers as well. Have your child read it to the class, and donate a few copies to stay in the classroom.

Allow the students to have a question-and-answer period after your presentation. You might be surprised at some of the questions that arise, and by addressing them, you can put a lot of misconceptions and questions to rest. Expect to hear “Can I catch it?” and “My grandpa had it.” Respond in simple terms and on their level. There's no need for medical jargon here, obviously.

Telling the News, Older-Kid Style

With tweens (ages nine through twelve) and teens, it becomes more difficult to let the world know. Even for older kids, there have to be some minimum requirements. To start, every teacher the child deals with must be notified that your child now has diabetes. This is usually best done in a meeting (particularly in middle school) where teachers can ask questions and voice concerns.

Your child might not like this, but it's best for her that everyone knows what is going on. From there, it is up to your child how much she wants to share with other students. Some children this age feel comfortable presenting their disease and its details as an essay in English class or as a science fair project. Others would rather not discuss it in public. Talk to your child and with your medical team to develop a reasonable compromise.

In the end, the more open your child is willing to be in school about his diabetes, the better the situation is for everyone. In time, he should find that being open and honest about his diabetes will make for less talk, fewer whispers, and fewer questions in the future. Eventually, it will just become part of the school landscape and something everyone around him quietly knows.