Overview

Children with diabetes can take part in sports just like children without diabetes. Children who use insulin are at risk for low blood glucose (sugar) during and after exercise.

Good planning means checking blood glucose before, during, and after exercise. Keep a record of how exercise affects your child's blood glucose level. Using your records, you can learn to predict how your child will react to being active.

Here are some things you can do to help your child exercise safely.

• Talk with your child's gym teacher and coaches about how exercise affects blood glucose.

  Teachers and coaches may not know the signs of sudden high or low blood glucose. You might need to explain what symptoms your child may have and how to deal with them.

• Talk with your child's doctor or diabetes care team to see if it makes sense to lower the insulin dose that your child takes before exercise.
• Have your child always wear a medical bracelet or necklace.

  You can buy these at most drugstores. Or try a temporary medical ID tattoo. All of these products can help medical personnel give the right care.

• Do some pre-exercise planning.

  Make a checklist that you and your child can follow. Make sure that your child uses it with the gym teacher or coach too.

• Check your child's blood glucose level before, during, and after exercise.
  • Make sure that blood glucose is in the child's target range.
  • If your child's blood glucose is over 14.0 mmol/L, your child may need to drink more fluids. Check your child's blood glucose during the activity to make sure it's going down.
  • You also need to check for ketones when your child's blood glucose is over 14.0 mmol/L. If ketones are present, your child should not exercise.
• Inject insulin before exercise in a site other than the parts of the body your child will be using during exercise.

  For example, if your child will be running, don't inject it in the leg.

• Consider giving your child a carbohydrate snack before unplanned exercise.

  If your child's blood glucose is below the target range before exercise, consider giving your child 15 grams of carbohydrate for every extra 30 minutes of exercise.

  If your child will be exercising very hard and for longer than 30 minutes, you may want to give another 15 grams of carbohydrate from a quick-sugar food. Younger children may need less carbohydrate. Talk with your child's doctor or diabetes care team to see what makes sense.
  
  Have glucose tablets or a quick-sugar food (such as hard candy) or drink (such as fruit juice) close by in case of low blood glucose. Treat the low blood glucose right away. When your child feels better and their blood glucose has returned to their target range, they can return to their activity.

• Make sure your child drinks plenty of water.

  This helps to avoid dehydration. (You can also use sports drinks to give your child needed fluids and sugar.)

• Talk to your doctor about having glucagon (injection or inhaled) on hand.

  It can be used if your child is unable to take anything by mouth or is unconscious.

• Watch for symptoms of low blood glucose for 12 hours after exercise.

  This is especially important to do if it's a new activity or an activity that takes longer than usual, such as a tournament.