Can my child with diabetes participate in all sports in school or are there some that he or she should avoid?
If your child has type 2 diabetes, which is now not uncommon in children and has recently become more common in adolescent girls than type 1 diabetes, then participation in school sports is an excellent idea, as it will help to control weight and reverse insulin resistance. The only caveat would be concerning his or her medication and how it would be affected by exercise. Most children with type 2 diabetes do not require insulin, but some do take sulfonylureas. Both of these therapies can cause low blood sugar in the face of energetic exercise, especially if prolonged. Therefore, the glucose should be checked prior to significant exercise and periodically during the exercise if greater than an hour or two at a stretch. If the glucose is well controlled before exercise, it is a good idea to provide calories prior to and sometimes during the event, in an amount designed to be readily available and commensurate with the amount of energy consumed during the sporting event. Your CDE can help with planning of calorie intake prior to, during, and after sporting events. If your child has type 1 diabetes, the issues noted above also apply, but tend to be more critical, since children with type 1 diabetes are generally more susceptible to low glucose during physical activity and are on insulin therapy. Interestingly, competitive sports may actually result in increased glucose levels, even though the same amount, or more, of energy is expended as in non-competitive sports. This is because the levels of a number of hormones are raised in the heat of competition and these hormones tend to increase blood sugar levels.