Sports were always tough for us to navigate as parents of a type 1 diabetic. It literally took us two years of trials and tribulations for us to find a good system. With that said I am by no means a medical doctor and what works for us may not necessarily work for you but I’m a firm believer in sharing knowledge and if this knowledge can help a family out there then that’s a win for me.
Just to be completely transparent this post is about how we prepare for soccer games as a 14 year old athlete so please take in to consideration what activity you will be preparing for and how intense it will be. Luke’s soccer games are high intensity and are two hours long. Preparing for high intensity exercise is different than preparing for low intensity. For example Luke will get adrenaline spikes from things like soccer and basketball games but he will go low walking the dog or mowing the lawn.
The most important tip I learned, way too late in my opinion, is to never have insulin on board during exercise. To the newbies out there that just means having to eat your last meal or snack at least two hours before your exercise. Yes I know this means possibly getting up a lot earlier than you want! Sometimes Luke has to be up and eating by 6:30am for a 9am soccer game, and trust me that’s no easy feat as a teenager, but his game performance is more important to him so he prepares ahead by going to bed a little earlier. When you’re eating your last meal before your activity make sure you eat something that will fill you up because as mentioned you won’t be eating again until that exercise is done. So make sure what you fuel yourself with is nutrient dense, has some protein and fiber. And of course make sure you are drinking lot’s of water. It's also important to make sure you eat something you regularly eat because that way you will get the carb count correct and you will also know how your body will react to the food before going in to your activity. Nothing is worse than having your pump give you a correction just before you start your game.
We don’t need to decrease Luke’s basal on his insulin pump before a game or during the game due to aforementioned adrenaline highs. What works for him is to go in to game scenarios at an in range blood glucose level, maybe just a little above, so once his adrenaline spikes his blood glucose won’t go crazy high. With that said before the game we are always monitoring his levels at least a half an hour before he goes on the field just in case he needs a little snack or sugar if he is on the lower side.
Luke also has to wear his pump during his games, due to his adrenaline spikes, so we make sure his Warrior Hill shirt is clean and ready to go for games. If it’s a cold, rainy Vancouver day he opts for the long sleeve under his jersey but if it’s nice he wears the tank top version.
When he’s on the field we can usually still read his Dexcom, did I mention he also wears a CGM, as he keeps his phone in his soccer bag on the side lines so most of the time we can see his levels through the Dexcom share app (a CGM is a non negotiable for us as Luke doesn’t wake up to his lows in the night).
Luke also keeps a zero sugar sports drink and a regular sports drink on the side lines and he sips what he needs to during the games. He also keeps his low treatments in his soccer bag, along with his nasal glucagon just in case of an emergency.
It's also important to make sure the coach is aware that you or your child are a diabetic and to make sure that they know where you store your emergency supplies in case they need to assist in any way.
After Luke’s game is just as important as before his game. After a high intensity soccer game Luke is obviously starving. We will always take off around 30 carbs of whatever he is eating to make up for the activity and sometimes he also has a free chocolate milk, which is around 30 carbs. A chocolate milk works great, especially if it’s before bed say after an intense practice, as the fat content will keep his blood glucose stable throughout the night. Keep in mind this is what works for us you will have to play around with how many carbs to take off after exercise as everyone is different with how their body reacts to food. With that said we always remove carbs from his meal count after intense exercise even if his blood glucose levels are high from adrenaline. We know that as soon as his insulin hits he drops really fast.
If his game or practice happens at night we will sometimes lower his basal during the night or take his pump off sleep mode because sometimes he will have a tendency to go low. We have the ability to study Luke’s graphs from his CGM so over time we could adjust where we needed to. I recommend starting a sports log and keep notes on how night times go after games, practices etc and even include how blood glucose levels were after meals. You can use this information to tweak pump settings or to know if you have to take off more carbs after games to prevent lows. Basically the more information you record the better.
I know everyday is different with diabetes but I hope some of the stuff we’ve learned as a family along the way can help you out. Don’t let diabetes scare you or your child from doing what they love. Speak to your medical team and come up with a plan you feel comfortable with and get out there and enjoy your sport!