My 13 year old son, who has had diabetes for three years and has been on a pump for months, plays hockey, baseball, and soccer (two to three teams each). Recently, he was pitching a game and felt very low and dizzy on the mound, and his fruit drink was on the bench. Luckily the inning ended soon after. When he checked his blood sugar, he was 35 mg/dl [1.9 mmol/L]. How do other kids handle situations in sports like these? Should he have asked for a time out? I was angry that he did nothing.

Your son absolutely could have requested a time-out to treat the low blood sugar, and suspended his insulin pump at the first signs of a low as well. Having said that however, those of us with diabetes can certainly empathize with this situation. Every child and adult with diabetes is faced with this internal struggle at some point, and none of us want to call attention to ourselves and our disease, to look “different”.

Your son should work with his diabetes team to find ways to manage his diabetes around exercise so that he reduces the risks for low blood sugar. Monitoring blood sugar more frequently around exercise will assist you and his diabetes team in identifying where changes in basal rates or carb intake may be necessary. From here, he can develop a plan for exercise. On an insulin pump, reducing basal rates, suspending, or even disconnecting the pump for exercise are all options. Perhaps your son would be willing to wear a small belt pack or similar arrangement in which he could stash glucose tabs, gel, etc. Perhaps he would be willing to test his blood sugar while in the dugout between innings, and make necessary adjustments there to prevent hypoglycemia or hyperglycemia.
DMW
Additional comments from Lois Schmidt Finney, diabetes dietitian:

How about keeping glucose tabs on hand in his pocket since juice is pretty hard to carry out to the mound?

LSF