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Medical Conditions > Endocrine and Immune System Conditions

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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 . 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. 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 , 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 learn about what they're capable of achieving.
• 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 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 hypoglycemia , or high blood sugar, called hyperglycemia .

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 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 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. 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 diabetic ketoacidosis , 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 instructions.

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 with diabetes:

• 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 injects insulin , 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 insulin pump , 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.
• Eat right. 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 dehydration .
• 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 game.
• Take control. 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 glucose level.

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 information.

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 participation bring!

Reviewed by: Steven Dowshen, MD
Date reviewed: September 2007