Kids With Diabetes: Incorporating Exercise Into Their Daily Routine

DIABETES CARE|Aug.11, 2017

Your child is unlike any person, big or small, you've ever met. But add diabetes to the mix, and he or she faces a special set of challenges.

As you well know from the countless visits to the pediatrician, your child's body doesn't produce enough insulin, which is needed to move glucose into cells for energy. Without insulin, blood sugar builds up. Still, your youngster can live a full, healthy life with Type 1 diabetes -- and daily exercise plays a key role.

In today's plugged-in world, physical activity can be tough to incorporate into your child's life. Luckily, the following game plan may make it easier to keep your child both healthy and moving.

1. Find Fun Activities (and Schedule Them In)

The easiest way to keep kids active is to find exercises that actually interest them. Signing them up for a team sport is a great way to establish a routine, though it's not necessary if organized sports are not where their passions lie. Riding bikes, hiking, making up dances to songs, playing tag or games like "Red Light, Green Light" -- really anything that gets them moving for about 30 minutes per day is key for kids with diabetes, says the Mayo Clinic.

To avoid making kids feel singled out and like they need to exercise because of their illness, make it a family affair. It's a fun way to bond -- and it keeps the whole clan in shape. Schedule time every day to establish a family-wide exercise routine. For example, every morning before the kids head to the bus stop, lead the family in jumping jacks. Then, after dinner and before the sun sets, stroll through the neighborhood with the dog.

Certain complications might mean needing to steer clear of certain exercises. The Joslin Diabetes Center notes that people with diabetes who also deal with proliferative diabetic retinopathy, diabetic peripheral neuropathy, and kidney disease may need to avoid strenuous activities, like heavy lifting, high-impact activities, or standing on your head. So, instead of perfecting handstand techniques and pumping iron, consider a brisk walk instead.

2. Check Blood Sugar Often

First, before even lacing up your sneakers, check your levels. If blood sugar is high, make sure there are no ketones in the blood or urine. The Mayo Clinic defines ketones as a blood acid that's produced when there isn't enough insulin and the body begins to break down fat, rather than sugar, as fuel. The Joslin Diabetes Center notes that if there are ketones present, you shouldn't exercise because your body will burn more fat rather than glucose. Besides, the possible resulting dehydration from physical exertion could lead to a serious condition called ketoacidosis.

With Type 1 diabetes, blood glucose levels can change rapidly, so checking regularly — especially within the first four hours after exercise — is crucial. The Joslin Diabetes Center notes it's wise to think about lowering the post-workout insulin dosage. Additionally, don't forget to factor in any sports drinks consumed.

Exercise uses blood glucose for energy, and can continue to burn it for up to 12 hours after the activity is over, or even 12 to 24 hours after if the exercise was intense, according to the Joslin Diabetes Center. This means you may need to check your child's levels even after they've gone to bed, though you can prepare by checking first at bedtime. If levels are lower than 100 mg/dl, you should encourage a small snack before sleeping and potentially consider decreasing the insulin dosage. Then in a few hours, gently wake your child to take another reading until you figure out the rhythm that works best for you two. Because rest is extra-important for children with Type 1 diabetes, it's often easier to schedule physical activity earlier in the day so you don't disrupt their sleep.

3. Pack a Snack Kit

To prepare for exercise, the American Diabetes Association recommends having about 15 grams of carbohydrates before being active if blood glucose levels are lower than 100 mg/dl — especially if your child will be moving around for 30 minutes or more. This could be a granola bar or a cup of skim milk.

But sometimes the pre-workout snack isn't enough to keep sugar levels from dropping. It's smart to have a snack kit on hand even when not exercising, especially as you never know when the need to be active may strike. Along with your child's insulin, throw in a few 15-gram carbohydrate snacks, says the American Diabetes Association — like a quarter-cup of fruit and nut trail mix, a small piece of fruit, or half a turkey and mustard sandwich on whole wheat bread.

4. Keep a Journal

You won't get it right every time — and that's OK. The important thing is to learn from each experience how your child's sugar levels react to different foods and activities. Especially when your child is first starting a new exercise regimen, you should be checking frequently. Document your child's blood glucose levels, foods eaten, and exercises done with time stamps. This way, you'll be able to adapt your future game plan based on what's working and what's not, whether that means switching up snack time or rescheduling a morning jog to an after-school speed walk. (Always consult a doctor before making changes to your child's regimen or if you have questions.)

Remember, kids with diabetes don't need to be limited by their condition. Use strategies like these to easily incorporate activity into their lives while keeping blood sugar spikes at bay -- and get the whole family moving at the same time.