My daughter is 14 and has had Type 1 since first grade. She has been very active in sports, specifically soccer. She is now at a point where she must increase her endurance. She has been informed that when she tries out for her team in high school she will be asked/told she must run for one or two hours in order to show her endurance. She wears a pump. Is there any training regimen she can be working now?

First of all I would like to commend your daughter for being active in sports. Secondly, you stated that your daughter was informed that when she tries out for the soccer team in high school she will be asked to run for one or two hours. I am wondering if practice will actually last one to two hours in length and include drills, patterns of play as well as expecting team members to run a mile or two.

In any case, I see no reason why your daughter cannot participate in soccer. Most likely your daughter engages in some type of Physical Fitness testing in school where students are expected to run a mile. This is a good place to start for building endurance. Let’s now talk about training. The major objective of training is to cause the body to adapt in order to improve performance in a specific task (in this case endurance in soccer). Factors that need to be focused on are frequency and length of workouts, type of training, speed, intensity, duration, and repetition of the activity as well as competition. Remember these factors may vary.

There are three principles I would like to introduce you to.

The Principle of Progressive Overload: To enhance physiologic improvement effectively and to bring about a training change, a specific overload must be applied. By exercising at a level above normal, a variety of training adaptations take place that cause the body to function more efficiently. The appropriate overload can be obtained by manipulating or playing with a combination of the following: frequency, intensity, and duration. (Example: walk a mile, jog a mile, run a mile and eventually run 5 miles etc.).
The Principle of Specificity: The training program must stress the physiological systems that are critical for optimal performance in the given sport in order to achieve specific training adaptations.
The Principle of Disuse (“Use it or lose it”): Most athletes would agree that regular endurance training improves your ability to perform more work for longer periods of time. However, if you stop training, your state of fitness will in fact drop to a level that only meets the demands of daily use.

Lastly, when it comes to exercise and the insulin pump, stay as simple as possible. It is best that you work with a diabetes educator or someone who is certified in teaching about the pump. Here are some tips to help you and your daughter:

Check her blood glucose at the time of exercise.
Follow snack guidelines (if blood sugar less than 150 mg/dl, eat a snack)
Disconnect the pump 1 hour during exercise.

Remember the individual who is on the pump does not have long term insulin on board.

PL