One day per week, my daughter has lunch at 11:30 am, followed by physical education at 12:00 N, and most likely after eating lunch, her blood sugar may spike and drop after am hour. I’m thinking that having PE right after lunch may not be a good idea since check after school those days are over 300 mg/dl [16.7 mmol/L]. Another option would be to have low carb lunch, and after PE, have additional carb.

If she does PE on a high number, is it likely that her number will get even higher? If we decide to check right after lunch, before PE, and her blood sugar is over 250mg/dl [13.9 mmol/L] should she participate in PE?

You are correct that activity such as physical education in school will likely cause higher blood glucose levels if there is insufficient insulin during that activity. High sugars before activity would go along with inadequate insulin. So, you need to go back to your diabetes team and figure out how to deliver more insulin during those times of the day when exercise is occurring so that there is sufficient insulin to allow the exercise effects to be positive rather than negative. Adjusting food downwards will help respond to the high sugar level itself as would providing more insulin, but the key treatment need is better balancing of the basal insulin availability at those times.

SB