SPORT, EXERCISE AND DIABETES

Diabetes doesn’t have to be an impediment to physical exercise and sports competition. Several professional athletes compete and exercise while coping with diabetes

And your son can do it, too. Like anyone else, kids with diabetes are healthier if they do a lot of physical exercise and this can help them manage their condition.

How Exercise Helps Kids With Diabetes

• Exercise may offer the following benefits to children with diabetes:

•  Better health for your life. Physical exercise strengthens bones and muscles, and reduces the risk of heart disease and some types of cancer.

• Increased physical abilities. With physical exercise, children can improve coordination, balance, strength, and stamina. Physical exercise can also increase your energy level.

• Better insulin response and better blood sugar control. Physical exercise makes insulin work better in the body and this helps people with diabetes keep their blood sugar levels within a healthier range.

• Weight control. To achieve a healthy weight and maintain it, it is not enough to simply eat healthy; you need to do physical exercise. Physical exercise burns calories and builds muscle, and this helps the body burn more calories. And if people who have type 1 or type 2 diabetes have too much body fat, insulin doesn’t work as well to control blood sugar levels.

• Life experience. When children leave home and are outdoors or in a gym, they have the possibility to meet new people and have new and interesting experiences. If you play a sport, you will also know what teamwork, sports and competition are all about.

• Increased confidence. Physical exercise helps increase children’s self-esteem and confidence. By mastering a skill, improving physical abilities, or helping a team, children realize what they are capable of achieving.

• A mental stimulus. Physical exercise can help relieve tension and stress, promote relaxation and improve mood. It can also help to clear your mind and make it easier to pay attention.

Any type of physical exercise is good; from walking the dog or riding a bike, to practicing team sports. To maximize benefits, set your child a goal of 60 minutes of exercise per day, 5 to 6 days a week. Like any other aspect of a healthy lifestyle, new physical exercise habits may be difficult for children to incorporate, but experiencing the benefits of physical exercise can help them continue the program.

Getting ready to exercise

All children should have a sports medical exam before starting a sport. For kids with diabetes, it’s important to talk to your doctor before starting any exercise routine that increases your child’s activity level. Your doctor will let you know about any changes in the routine of exams, medications, or other things you may need to consider due to physical exercise and sports.

Your doctor will probably allow you to start any activity your child wants; after all, physical exercise is an important part of managing diabetes. However, there may be special considerations if your child is interested in some adventure sports, such as climbing, hang gliding, or diving. These sports require a high level of concentration, good physical condition and proper control of diabetes. If diabetes problems occur and affect a person’s ability while playing these sports, serious injuries may occur, so it is important to have the doctor’s permission and proper preparation.

If your child is just starting to exercise or play sports, it’s also important to give emotional support. If a parent is fearful and prevents his or her child from participating, the only thing he or she will do is increase the child’s feeling that he or she is different, fragile, or sick.

Maintain a positive attitude and let your child know that he or she can succeed in sports by working hard (just like any other kid on the team), as long as you take some extra precautions.

When Kids with Diabetes Exercise

When kids with diabetes exercise, the blood sugar level can drop, this is called hypoglycemia, or go up, this is called hyperglycemia.

Low blood sugar can occur during or after physical exercise. It occurs when the body consumes too much of its stored sugar, especially if insulin levels continue to rise after an injection. Signs of low blood sugar include sweating, lightheadedness, tremors, weakness, anxiety, hunger, headache, trouble concentrating, and confusion. In more severe cases, there may be fainting or seizures.

Kids with diabetes may need to monitor their blood sugar levels and take extra snacks to keep their blood sugar levels from falling too low. Or if your child is starting a rigorous physical exercise program, such as training for a sport, your doctor may recommend reducing the dose of insulin to help prevent hypoglycemia.

You may also need to do something about high blood sugar before or after exercise. Muscles need more energy during physical exercise and the body responds by releasing more glucose into the blood. If the body does not have enough insulin to use glucose, the sugar will remain in the blood. When this happens, the person may urinate more and this causes dehydration, especially when they lose much more water from sweating and breathing during physical exercise. Other signs of high blood sugar include a lot of thirst, tiredness, weakness, and blurred vision.

Another reason kids with type 1 diabetes should not exercise if they don’t have enough insulin in their blood is the chance of ketones accumulating. If ketones are very high, the child may be at risk for ketoacidosis.

If your child has type 1 diabetes, the doctor will tell you how to measure ketones and, if necessary, how to give him or her more insulin so that he or she can get back to exercise.

Your doctor will probably want your child to check your blood sugar levels before you start exercising. The diabetes health care team will explain what blood sugar levels require attention before, during, or after exercise and what steps to take to stay active.

Make sure your child knows how to recognize the symptoms of hypoglycemia and hyperglycemia. In both cases, you should stop exercising and follow your doctor’s instructions.

Exercise Tips for Kids With Diabetes

Here are a few general fitness tips:

• Adjust the timing of blood sugar measurements. The doctor will schedule the necessary changes in the frequency or timing of blood tests when your child is exercising.

• Use insulin at the right time. Your doctor may recommend adjusting your insulin dose for exercise or sports. If your child is injecting insulin, try to avoid injections to the part of the body that is most used for the sport (for example, the right leg before a soccer practice). If you do, insulin may be absorbed more quickly and increase the chances of hypoglycemia. If your child uses an insulin pump, make sure it is not an impediment to exercise and that there is no chance of it disconnecting or damaging. Talk to your doctor about what to do if your child needs or wants to remove the pump during exercise.

• Eat well. The health care team will also help you adjust your child’s feeding plan so that he or she has the extra energy needed during exercise. For example, they may recommend extra snacks before, during, and after exercise. Encourage your child to respect the recommendations and explain the consequences of not doing so, such as low blood sugar. Hypoglycemia can interfere with your child’s athletic performance and ability to participate. Kids (especially teens) may be tempted to try strategies such as filling up with carbohydrates before running or reducing calories or water to achieve a certain weight by practicing wrestling. This behavior can cause problems because it can increase the chance of hyperglycemia or hypoglycemia.

• Bring snacks and water. Whether you’re playing football at school or swimming at home, your child should always have snacks and water on hand. If the sugar level drops a lot, it will be helpful to get sugar quickly and drinking water can help prevent dehydration.

• Pack. If your child is exercising away from home, pack the items needed for measurements, medicines, a medical alert identification bracelet, information with emergency contacts, and a copy of the diabetes management plan. It is very useful to keep these items in a special backpack or bag so you don’t have to pack them again every time the child comes out.

• Report to the coaches. If your child plays team sports, tell coaches about diabetes and give them written instructions so they can respond if problems arise. They should also understand that their child may need to take steps (such as eating a snack or injecting insulin) to manage diabetes before, during, and after a game.

• Taking Control. Kids with diabetes need to take control of their own health. This can be a challenge if you are in a group of children supervised by an authority, such as a teacher or coach. But proper management of diabetes may involve interrupting the teacher or coach, and there is no problem in doing so. Kids should feel free to stop playing sports or exercising and do whatever it takes to control their diabetes, how to eat a snack if you have symptoms of a low blood sugar level or control your blood glucose levels.

• But no matter how diligent parents and children are, all kids with diabetes will have, at some point, episodes of low blood sugar. That’s why kids and teens with diabetes should always wear or wear some kind of medical identification (bracelet or medal). In addition to reporting diabetes, this identification may include emergency contacts.

With your doctor’s approval, a clear plan to prevent and manage problems, and some preparation, your child can enjoy the many benefits offered by exercise and sports.

Dowshen, S. [2018]. Sport, exercise and diabetes. KidsHealth. Recovered from: https://kidshealth.org/es/parents/sports-diabetes-esp.html#catsports-psychology