I AM writing in response to the Dec. 12 My Word, "Insulin in schools must be given by qualified personnel."

The author, president of the California School Nurses Organization, provides unsubstantiated horror stories of what might happen if someone without a medical degree were to administer insulin, a procedure that she makes sound very ominous.

As a pediatric endocrinologist for 30 years, my response was "balderdash." In the time it took me to read the piece I knew that tens of thousands of doses of insulin were administered across the country and only a very tiny percentage were given by health care professionals.

They were given by people with diabetes, parents, friends and baby-sitters of children with diabetes — and even many children. Yet, the author seems unaware that the foundation of modern diabetes management is lay people — not medical professionals — administering insulin.

The author was thrilled that a Superior Court judge struck down an agreement between the American Diabetes Association and the California Department of Education that would have allowed trained nonmedical school personnel to administer insulin when a school nurse isn't present.

My colleagues and I were appalled — and frightened.

We know that children with diabetes must successfully manage their diabetes to avoid complications like heart disease, amputation and blindness. This requires immediate access to insulin before meals and at unpredictable times when blood sugar levels are higher than what is acceptable.

We would like to see more nurses in our schools, but California has but one school nurse for every 2,700 students, one of the worst ratios in the country. School districts in financial crisis aren't adding positions. Even in the rare school with a full-time nurse, the nurse isn't there during field trips and extracurricular activities. But the child's need for insulin is still there — a need that cannot wait for a phantom nurse to show up.

Indeed, insulin is given in school by many people other than the school nurse. Parents or their designees — all unlicensed — can administer insulin in school.

Baby sitters, aunts, uncles and grandmas — even siblings — show up to give injections with no assurance they have been properly trained. The nurse organizations that brought this lawsuit do not object to this, yet will not let school staff members, many of whom have diabetes themselves, volunteer to give an injection after they have been trained.

That is, they object to the most reasonable solution to the problem and the one supported by the leading organizations of people with diabetes and diabetes health care professionals — one that is working well in over 30 states.

As a result, some children will face long delays or go without insulin altogether during school, putting them at increased risk of severe complications. Sometimes they will be in school sick when they should be thriving. Some parents will be forced to quit their jobs to be on call to administer insulin; I've had parents of patients be fired and end up on welfare.

Parents of children with diabetes and diabetes health care professionals are not mistaken about what is in the best interests of children with diabetes. We are not mistaken when we say that they are vulnerable children — not pawns in the battle to fund more school nurses.

Dr. Francine Kaufman is the director of the Comprehensive Childhood Diabetes Center and the head of the Center for Endocrinology, Diabetes and Metabolism at Childrens Hospital Los Angeles, and the former president of the American Diabetes Association.