Can you direct me to literature which would address the benefits of playing on a softball team for my granddaughter who has diabetes? She is nine years old and has had diabetes for two-and-one-half years now. She was allowed on the team officially this summer but was sidelined by her coach nearly the whole time. Her mother and I talked several times with the coach but made little progress. Are there any studies you know of which we might present to the coach and local board in order to enhance my granddaughter’s experience for the next ball season? We feel it is unreasonable to treat her so differently, but need to have some reinforcement and are not sure where to search for affirmation of what to us is common sense!

The American Diabetes Association (ADA) publishes clinical recommendations and guidelines for exercise participation and standards of care. You will find these on the ADA website at http://www.diabetes.org. In particular, pay special attention to the ADA position statement entitled “Care of Children With Diabetes in the School and Day Care Setting”, which outlines the federal laws protecting children with diabetes and provides associated resources. The position statement on “Diabetes Mellitus and Exercise” will also be helpful.

In addition, your granddaughter’s physician can provide her with a clearance letter for exercise participation, which may prove helpful as well. It is more than likely fear of hypoglycemia and related liability issues that are keeping her sidelined, as unfair as that may seem.

My recommendations would be to have a plan in place for good blood sugar management during exercise, including blood glucose monitoring, hypoglycemia prevention and treatment when needed. Talk to your granddaughter’s diabetes team for specific treatment plans in her situation. Your attempts to educate both the coach and your local board are to be commended. We wish you success in your efforts.

DMW