Physical Activity and the Benefits of Being Active

Physical activity is important for all children, including children with type 1 diabetes. There is no reason for a child with diabetes to be excluded from or not participate in sport or any form of physical activity.

Benefits of being active

There are many benefits to physical activity, active children are more likely to:
• Be a healthy weight
• Be happy, relaxed and sleep better
• Maintain healthy growth and development
• Feel good, inside and out
• Have good coordination and be flexible
• Develop good social skills

Physical activity and diabetes

Physical activity may assist with managing blood glucose levels (BGLs) in children with diabetes. Physical activity usually lowers BGLs by making the body more sensitive to insulin. Sometimes BGLs may be higher prior to and following physical activity because of other hormones released during the activity. Rises in BGLs during activity are usually temporary and may be followed by lower BGLs and the risk of delayed hypoglycaemia, 12-16 hours following the activity.

Managing physical activity

There are some important things you need to consider when a child with type 1 diabetes participates in physical activity. These include:

Blood Glucose Testing
Blood glucose testing provides you with useful information about your child's response to exercise and will help you to determine how to manage your child's diabetes during physical activity. It's important to test before, during and after the activity.

Insulin 
Adjustments may be required to your child's insulin dose prior to and following exercise. This adjustment will depend on factors such as type of activity, duration and your child's individual response to the activity. Discuss insulin adjustments for physical activity with your diabetes team.

It's advisable not to give insulin into an exercising muscle as it is absorbed more quickly and may increase the risk of hypos. The tummy is the best place to give your child's insulin.

Carbohydrate Foods
Extra carbohydrate foods may be required before, during and after physical activity. This is very individual and depends on factors such as type of activity, duration, your child's individual response to the activity and BGL. As a guide, one additional serve or exchange of carbohydrate may be required for every 30-40minutes of exercise. Lower GI foods such as fruit, yoghurt, milk or raisin toast prior to exercise may assist in maintaining BGLs during physical activity.(GI)

Hypos
Hypoglycaemia (hypo) or low BGLs may occur as a result of physical activity. It’s important to make sure that your child has a hypo kit readily available when they are exercising (hypos). Teachers and sports coaches need to be aware of the risks of hypos during and following sport and allow your child to treat the hypo immediately and re-treat if necessary. Click here to view The Schools Pack.

Exercise may also cause delayed hypoglycaemia for 12-16 hours afterwards. To prevent delayed hypos, it's important to ensure that your child eats additional carbohydrate following the activity and that bedtime BGLs are above 7mmol/L. Testing your child's BGLs overnight is also advised after strenuous physical activity.

Lowering the insulin dose, giving extra carbohydrate foods and carrying out regular blood glucose testing can reduce the risk of hypos.

Physical Activity & High BGLs
Physical activity should be avoided when your child is unwell or their BGL is over 15mmol/L with the presence of ketones. Exercise at this time may increase your child's BGL even further causing them to feel more unwell.

High risk activities

There are some activities that need a cautious approach when undertaken by children and teenagers with type 1 diabetes. These include: 
• Sports which are solo in nature
• Activities which take place in a potentially dangerous environment such as mid air or in water
• Those which limit the ability to recognise and self treat hypos

High risk activities include rock climbing, flying, abseiling, car and motorbike racing, skiing, swimming, surfing and snorkeling. The older child or teenager with type 1 diabetes may be able to participate in these activities with careful planning.

Sports that should not be undertaken include scuba diving, solo hang-gliding or solo flying.

Encouraging physical activity

Help your child or teenager with type 1 diabetes to be active by:
• Being an active parent
• Turning off the TV more often
• Limiting the time your child spends on the computer and playing video games to 30 minutes each day
• Encouraging active play such as skipping, ball games, bike riding, roller blading or walking the dog
• Finding fun activities that your child enjoys
• Waking your child to and from school if possible
• Being an active family, explore new places - parks, trails, walks and sporting facilities
• Encouraging your child to try new sports and activities like dancing, netball, swimming, athletics, cricket and soccer
• Keeping them active around the house

Source: http://www.diabeteskidsandteens.com.au/living_with_diabetes_8.html