Whether your child wants to go for the gold or just go hiking in
your hometown, diabetes doesn't need to get in the way of
exercise and sports competition. Even some accomplished athletes,
from an Olympic gold-medal swimmer to a pro golfer to a Major
League Baseball pitcher, deal with diabetes while competing and
exercising. And your child can, too. Like anyone else, people with
diabetes are healthier if they get plenty of
. Exercise can actually help people manage diabetes better.
How Exercise Helps Kids With Diabetes
Here are some of the general health benefits of exercise and the
specific benefits exercise has to offer for kids with diabetes:
Better health for life.
bones and muscles
and reduces the risk of
and some types of
Greater physical abilities.
With exercise, kids can gain better coordination, balance,
strength, and endurance. Exercise can increase energy levels,
Better response to insulin and better blood sugar
Exercise makes insulin work better in the body, which helps
someone with diabetes keep their blood sugar levels in a
To reach and maintain a healthy
, 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 2 diabetes
, having too much body fat keeps insulin from working as well to
control blood sugar levels.
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.
Exercise helps boost kids'
and confidence. By mastering a skill, improving physical
abilities, or helping a team, kids learn about what they're
capable of achieving.
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 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 child's 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. It's
best to take a positive attitude, and let your kid 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.
What Happens When Kids With Diabetes Exercise?
When people with diabetes exercise, they can experience low
blood sugar, called
, or high blood sugar, called
Hypoglycemia can occur during or after exercise, when the body
has used up much of its stored sugar, especially if
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
High blood sugar levels may also have to be addressed before or
during exercise in children with diabetes. 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 the person to urinate more, which can lead to
dehydration, especially when the person 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 doesn't have sufficient levels of
insulin in the blood, substances called
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. If
people with too little insulin in the blood exercise, ketone levels
in the blood can rise to high levels, putting the person at risk
for a condition called
, or DKA. If your child has type 1 diabetes, the doctor will tell
you how to test for ketones and, if necessary, you can give your
child 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
Exercise Tips for Kids With Diabetes
Your child's 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 for kids and teens
Adjust blood testing schedules.
Your child's doctor will outline any changes in the frequency
or timing of blood sugar tests when your child exercises.
Take insulin on schedule.
Your child's doctor might recommend adjusting the insulin
dosage for exercise or sports. If your child
, it's a good idea 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
, be sure that it won't be in the way for exercise and that
it 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.
Your child's health care team will also help you adjust your
child's meal plan to provide the extra energy needed during
exercise. For example, the health care team 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. Besides the symptoms it can
produce, hypoglycemia can interfere with your child's sports
performance and ability to participate. Kids - especially teens -
may be tempted to try strategies like loading up on extra carbs
before running or reducing calories or water to get down to a
certain weight for wrestling. These behaviors can result in
problems for people with diabetes because they can increase the
likelihood of either hyperglycemia or hypoglycemia.
Bring snacks and water.
Whether your child is playing football at school or swimming in
your backyard, he or she should always have snacks and water on
hand. Some quick sugar will help if your child's blood sugar
dips too low, and drinking water will help prevent
Pack it up.
If your child will be exercising away from home, pack testing
supplies, medications, a medical alert bracelet, emergency
contact information, and a copy of his or her diabetes management
plan. It helps to leave 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. Give them written instructions so that 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
Kids with diabetes need to take control of their own health. This
can present a challenge at times when they're in a group of
children being supervised by an authority figure like a teacher
or coach. Help your child understand that managing their diabetes
properly may mean interrupting a teacher or coach, and that's
OK. Your child should feel free to stop playing a sport or
exercising to attend to his or her diabetes needs, like eating a
snack for low blood sugar symptoms or checking his or her blood
But no matter how diligent parents and children may be, kids
with diabetes will at some point experience episodes of low blood
sugar. So all kids and teens with diabetes should wear and/or carry
some sort of medical identification (like a bracelet or necklace)
at all times. In addition to identifying your child as having
diabetes, this identification can provide emergency contact
With the approval of your child's doctor, a clear plan for
preventing and managing problems, and some advance preparation,
your child can reap the many rewards that exercise and sports
Steven Dowshen, MD
Date reviewed: September 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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