Adolescents with type 1 diabetes are likely attending most middle and high schools. These youth often do not receive the support needed to manage their diabetes during or after school. Nurses (n = 110) from 3 states responded to a survey examining perceptions of barriers to and supports for diabetes management during school and after school activities. Results indicated that adolescents need more support at school. Support could be facilitated by education of school staff; improved communication among youth, parents, school nurses, teachers, and physicians; and more communication from adolescents to others about what they need to manage well in school. Open-ended questions allowed nurses to provide recommendations for supporting youth and ideas for addressing barriers to management at school. Future studies should address ways to enable adolescents to communicate about their diabetes and ways to educate the school team.