My 14 year old son, who has had type 1 diabetes for five years and has been on an insulin pump for two years with hemoglobin A1c’s in the 6% range, will be playing football. How can he play football and still use the pump? I am looking for practical advice from someone who’s been there and done that. Will he have to go back to injections during the football season, since it is a rough sport and his infusion set will probably be knocked off daily? Maybe he could wear the pump at night (insert it after practice is over) and take injections during the day?

To begin with, I think it is wonderful that your son is playing football. Football is a sport that is anaerobic in nature. It is considered to be a power sport. Most football plays last only 10 to 12 seconds. Power moves occur during plays include the examples of pushing on the offensive or defensive line, throwing the ball, running powerfully with the ball, or blocking. The position your son plays and whether the activity is a game or a practice will determine the changes in food intake and insulin. The position your son plays can greatly affect his blood glucose. If your son plays in a position that requires more running, he may use muscle glycogen differently then if he were just blocking.

More running may lower blood glucose during the activity and require muscle glycogen repletion following the activity. Practices and game also differ in the amount of energy expended as well as blood glucose levels. There tends to be more prolonged activity during practice sessions than in game situation. This prolonged activity during practice session may cause a greater fall in blood glucose levels. Again, in a more recreational setting, running tends to be emphasized more, and play tends to be less intense and shorter in duration. There most likely will be less changes needed to be made in food and insulin.

It is your son’s choice if he wants to wear the insulin pump or not during game or practice situations. It would be wise for you to check with your son’s physician to see if you can sit down with a diabetes educator who is a certified pump trainer and can help your son develop an individualized plan. Remember that each person will react differently to the same situation.
General Guidelines:
For the recreational flag football player who uses the pump: Suspend the pump while playing and drink a sport drink as needed to maintain blood glucose levels.
For a team football player who wears the pump, during afternoon practices of two to three hours: reduce basal rate insulin rates by 25-50%, and consume 15-45 grams of carbohydrate per hour depending on insulin reductions and practice intensity.
For a team football player who removes the pump completely for that length of time: Check blood glucose every hour, reconnect the pump, and give a bolus as needed to correct for any significant rise in blood glucose. Eat additional carbohydrate after play and possibly at bedtime to prevent late-onset hypoglycemia.

Remember, the above guidelines are general. Always speak with your doctor or diabetes educator before making any changes in your insulin, food and exercise routine.

PL