|SSM Cardinal Glennon Children's Medical Center|
Sports, Exercise, and Diabetes
Diabetes doesn't have to get in the way of exercise and sports competition. Even some accomplished athletes deal with diabetes while competing and exercising.
And your child can, too. Like anyone else, kids with diabetes are healthier if they get plenty of exercise, which can actually help them manage their condition.
How Exercise Helps
General health benefits of exercise and the specific benefits exercise has to offer for kids with diabetes:
All exercise is great — from walking the dog or riding a bike to playing team sports. To maximize the benefits, set a goal for your child to exercise 60 minutes a day for 5 to 6 days a week. Like any other part of a healthy lifestyle, new exercise habits might be hard for kids to adopt at first, but experiencing the benefits of exercise can help kids stick to their program.
Preparing for Exercise
All kids need to get a physical before they start playing a sport. For kids with diabetes, it's important to talk with the doctor before starting any new exercise regimen that will really step up your child's activity level. Your doctor will let you know about any changes in testing schedule, medication, or other things you might need to think about for exercise and sports.
The doctor is likely to give the green light to any activities your child wants to start — after all, exercise is an important part of diabetes management. However, there may be special considerations if your child is interested in certain adventure sports like rock climbing, hang gliding, or scuba diving. These sports require a great deal of concentration, good physical condition, and well-controlled diabetes. If diabetes problems occur and impair a person's abilities during adventure sports, there could be a serious injury, so a doctor's permission and proper preparation are important.
If your child is just starting to exercise or play sports, your emotional support is also important. If a parent is fearful and keeps a child from participating, the parent can reinforce the child's sense of being different, sick, or fragile.
Take a positive attitude and let your child know that he or she can succeed at sports with hard work — just like any other kid on the team — as long as a few extra precautions are taken.
When Kids With Diabetes Exercise
Hypoglycemia can occur during or after exercise, when the body has used up much of its stored sugar, especially if insulin levels in the body are still high following an injection. Signs of low blood sugar include sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion. More severe cases can cause fainting or seizures.
Kids with diabetes may need to check blood sugar levels and have an extra snack to prevent low blood sugar levels. Or if your child is starting a rigorous exercise schedule, like training for a sport, the doctor may recommend a reduced insulin dosage to help prevent hypoglycemia.
High blood sugar levels may also have to be addressed before or during exercise. The muscles need more energy during exercise, so the body responds by releasing extra sugar, or glucose into the blood. If the body doesn't have enough insulin to use the glucose, then the sugar will stay in the blood. This can cause a person to urinate more, which can lead to dehydration, especially when someone is losing more water from the body from sweating and breathing hard during exercise. Other signs of high blood sugar include excessive thirst, fatigue, weakness, and blurry vision.
There are other reasons that kids with type 1 diabetes shouldn't exercise if they don't have enough insulin in their blood. If a child has insufficient levels of insulin in the blood, substances called ketones may show up in a urine or blood test. Ketones build up in the blood when the body doesn't have enough insulin to use sugar in the blood for energy, so the body is forced to burn fat for fuel.
When someone with too little insulin in the blood exercises, ketone levels in the blood can rise to high levels, putting the person at risk for diabetic ketoacidosis, or DKA. If your child has type 1 diabetes, the doctor will tell you how to test for ketones and, if necessary, how to give additional insulin to get your athlete back on track.
The doctor will probably want your child to check blood sugar levels before starting to exercise. Your child's health care team will outline what blood sugar levels need attention before, during, or after exercise, and they'll also explain how to take action and get back in the game.
Make sure your child knows how to recognize the symptoms of hypoglycemia and hyperglycemia, which mean it's time to stop exercising and follow the doctor's instructions.
Exercise Tips for Kids With Diabetes
The diabetes health care team will offer specific suggestions to help your child get ready for exercise or join a sport, but here are a few general exercise tips:
But no matter how diligent parents and children may be, kids with diabetes will at some point have episodes of low blood sugar. So kids and teens with diabetes should wear and/or carry some sort of medical identification (like a bracelet or necklace) at all times. Besides identifying them as having diabetes, this can provide emergency contact information.
With the approval of your doctor, a clear plan for preventing and managing problems, and some advance preparation, your child can reap the many rewards that exercise and sports participation bring!
Reviewed by: Steven Dowshen, MD