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

Sick Day Management Tips when Your Child Has Type 1 Diabetes

How Illness Affects Your Child's Blood Glucose

 

Having a sick child can be challenging—getting time off work and securing a last-minute doctor's appointment isn't always easy. But when your sick child also happens to have type 1 diabetes, it presents a separate set of complications relating to insulin and blood glucose (blood sugar) management. This article covers some important considerations to keep in mind the next time your child with type 1 diabetes feels under the weather.

 

Checking Blood Glucose and Ketones
Even the most common ailments, such as a cold or flu, can cause your child's blood glucose levels to rise. Plus, some over-the-counter medications can cause blood glucose levels to increase even more. Complicating matters, your child's blood glucose levels may actually drop too low if he or she is vomiting or has stopped eating.

 

You just can't be certain how an illness will affect your child's blood glucose—that's why it's important to check their levels more often than you normally would. A general guideline to shoot for is to check their blood glucose every 2 to 3 hours, but remember—that's a guideline. Your child may require more or fewer checks, depending on your health care professional's recommendations.

In addition to checking blood glucose levels, you also need to check for the presence of ketones in the urine. In people with type 1 diabetes, common illnesses can lead to diabetic ketoacidosis, a condition characterized by acidic blood caused by the release of too many ketones.

 

Ketones are released when your body doesn't have enough insulin, so it's important to check your child's urine regularly (usually every 4 hours) until there are no ketones detected. If ketones are still present, that's a sign that your child needs more insulin. There are 2 ways to check ketones: using urine ketone strips or a meter that's much like checking blood sugars but with a special test strip.

You can read more about ketoacidosis in our article about type 1 diabetes complications.

 

Insulin Adjustments During Sick Days
Oftentimes, your child may not want or be able to eat when sick. Even so, it's still essential that your child keeps taking insulin when he or she is sick. Without insulin, the body will resort to burning fat for energy, and this can lead to diabetic ketoacidosis.

 

Because illness can wreak havoc on blood glucose levels, you will likely need to adjust your child's insulin dosage. The degree of adjustment is completely unique to your child. Plus, the severity of the illness and treatments used also factor in (remember, some over-the-counter medications can affect your child's blood glucose).

 

Use your child's blood glucose levels as a guide when adjusting insulin. If you have any questions about how to adjust your child's insulin on sick days, call your health care professional.

 

Food and Drink Guidelines
Certain nutritional considerations on sick days may help prevent potentially serious complications of type 1 diabetes. Make sure your child is drinking plenty of fluids, as this will prevent dehydration and ketoacidosis. As a general rule, your child should drink small amounts of liquids—about a ½ cup—every hour. It's best for your child to drink slowly instead of in large gulps. Tea, broth, and of course, water, are ideal options.

 

If your child is unable to eat a normal meal, make sure he or she is taking in a certain amount of liquid or solid carbohydrates to prevent sudden drops in blood glucose. Fifteen grams of carbs every hour is a good amount to shoot for, but always follow the specific recommendations from your health care professional.

 

Below are some good examples of beverages and foods for sick days:

• Sugar-containing beverages (sugar-free liquids may be consumed if blood glucose levels are elevated)
• Fruit juice
• Sports drinks
• Jell-o
• Popsicles
• Broth-based soups
• Saltines
• Applesauce
• Bananas
• Toast
• Graham crackers

When to Seek Medical Attention
When your child has type 1 diabetes and is sick, there are a number of situations that warrant medical attention. If your child is having problems breathing and/or has had at least 3 episodes of vomiting or diarrhea within a single day, call your doctor. Also, if large amounts of ketones remain in your child's urine after several hours, seek medical attention. Of course, if you have any questions or concerns about adjusting your child's insulin dosage, don't hesitate to call your health care professional.

 

Source: http://www.endocrineweb.com