Sports, Exercise, and Diabetes

en españolDeporte, ejercicio y diabetes

Diabetes doesn't have to get in the way of exercise and sports competition. A number of 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 Kids With Diabetes

Exercise can offer kids with diabetes:

• Better health for life. Exercise strengthens bones and muscles and reduces the risk of heart disease and some types of cancer.
• Greater physical abilities. With exercise, kids can gain better coordination, balance, strength, and endurance. Exercise can increase energy levels, too.
• Better response to insulin and better blood sugar control. Exercise makes insulin work better in the body, which helps someone with diabetes keep their blood sugar levels in a healthier range.
• Weight management. To reach and maintain a healthy weight, just eating right isn't enough — people need to exercise. Exercise burns calories and builds muscle, which in turn helps the body burn more calories. And in people with either type 1 or type 2 diabetes, having too much body fat keeps insulin from working as well to control blood sugar levels.
• Life experience. When kids get out of the house and go outdoors or visit a gym, they get a chance to meet new people and have new, interesting experiences. If they try a sport, they also learn about teamwork, sportsmanship, and competition.
• Increased confidence. Exercise helps boost kids' self-esteem and confidence. By mastering a skill, improving physical abilities, or helping a team, kids see what they're capable of achieving.
• A mental boost. Exercise can help relieve tension and stress, encourage relaxation, and improve mood. Exercise can even help clear the mind and make it easier to pay attention.

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 sports physical before they start playing a sport. For kids with diabetes, it's important to talk with the doctor before starting any new exercise routine 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, being in good physical condition, and well-controlled diabetes. If diabetes problems happen 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.

Keep 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

When kids with diabetes exercise, they can have low blood sugar, called hypoglycemia, or high blood sugar, called hyperglycemia.

Low blood sugar can happen during or after exercise. It happens when the body uses up much of its stored sugar, especially if insulin levels are still high after 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 may also have to be addressed before or during exercise. The muscles need more energy during exercise, so the body responds by releasing extra 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 make a person pee more, which can lead to dehydration, especially when someone loses even more water through sweating and breathing hard during exercise. Other signs of high blood sugar include excessive thirst, tiredness, weakness, and blurry vision.

Another reason why kids with type 1 diabetes shouldn't exercise if they don't have enough insulin in their blood is because ketones may build up. If ketone levels get very high, a child can be 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 extra insulin to get your athlete back on track.

The doctor will probably want your child to check blood sugar levels before starting to exercise. The diabetes health care team will explain which blood sugar levels need attention before, during, or after exercise, and 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

Here are a few general exercise tips:

• Adjust blood testing schedules. Your doctor will outline any changes in the frequency or timing of blood sugar tests when your child exercises.
• Take insulin on schedule. Your doctor might recommend adjusting the insulin dosage for exercise or sports. If your child injects insulin, try to avoid giving injections in the part of the body most used in that sport (like injecting the leg right before soccer practice). This could cause the insulin to be absorbed more quickly, increasing the chances of hypoglycemia. If your child wears an insulin pump, be sure that it won't be in the way for exercise and won't get disconnected or damaged. Talk to the doctor about what to do if your child needs or wants to take off the pump during exercise.
• Eat right. The health care team will also help you adjust your child's meal plan to provide the extra energy needed during exercise. For example, they might recommend extra snacks before, during, or after exercise. Encourage your child to stick to the recommendations and explain the consequences of not doing so, like low blood sugar. Hypoglycemia can interfere with your child's sports performance and ability to participate. Kids — especially teens — may be tempted to try strategies like carb loading before running or reducing calories or water to get down to a certain weight for wrestling. These behaviors can cause problems because they can increase the likelihood of either hyperglycemia or hypoglycemia.
• Bring snacks and water. Whether playing football at school or swimming in your backyard, your child should always have snacks and water on hand. Some quick sugar will help if blood sugar dips too low and drinking water will help prevent dehydration.
• Pack it up. If your child will be exercising away from home, pack testing supplies, medicines, a medical alert bracelet, emergency contact information, and a copy of the diabetes management plan. It helps to keep these things in a special backpack or other bag so that you don't have to pack and repack them every time your child goes out.
• Tell the coaches. If your child plays organized sports, tell the coaches about your child's diabetes and give them written instructions so they can respond to problems. They should also understand that your child might need to take steps — like having a snack or taking insulin — to control diabetes before, during, or after a game.
• Take control. Kids with diabetes need to take control of their own health. This can be a challenge when they're in a group of kids being supervised by an authority figure like a teacher or coach. But managing their diabetes properly may mean interrupting a teacher or coach, and that's OK. Kids should feel free to stop playing a sport or exercising to attend to their diabetes needs, like eating a snack for low blood sugar symptoms or checking blood glucose levels.

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 enjoy the many rewards that exercise and sports bring!