My 10-year-old daughter was diagnosed with type 1 on January 16, 2008. She has always been active in sports since age five, in track and field, cheerleading, and, now, soccer. I was told to check her blood glucose before practice and after practice for a couple of weeks during soccer. The numbers were the same, 124 mg/dl [6.9 mmol/L], which is in her target range of 80 mg/dl [4.4 mmol/L] to 180 mg/dl [10.0 mmol/L]. However, she is now honeymooning. As long as she is in her target range, do I just stick to our regular diabetes management program even though she is honeymooning?

You may already have been told that while your daughter is in the honeymoon phase, her body is still producing some insulin. This makes establishing patterns difficult because the insulin delivery is both unpredictable and un-measurable; what happens one day may be vastly different from the next. So, your question is a really good one – how do you establish (and stick) to a program during the honeymoon? The short answer is that you can’t, but there are some things you might try.

The only way to know how her body is reacting to exercise, food, etc. is to check her blood sugar, so the recommendation to check her blood sugar before and after practice is a good one. It’s encouraged even more now because she is still producing insulin and things are unpredictable. One idea is to have extra snacks on hand when she is active. Exercise increases insulin sensitivity, meaning that when the body is active, insulin has a greater effect. Since her body may still be producing some insulin, you want to be prepared for this. Your diabetes team should be able to provide you with specific guidance about snacks.

You might also ask your health care provider if your daughter’s target range should be different when she is exercising. Many with diabetes have different target ranges throughout the day depending on time of day, activity level, etc.

Many of those with diabetes who exercise (myself included) will also check their blood sugar a second time before exercising because that will also provide a direction, something that is just as important as the number. As with all recommendations, these should be discussed directly with your health care provider for their thoughts. Each person with diabetes is different, and, therefore, any idea should be discussed with your health care provider.

Your daughter may be interested in taking a look at our page of Kids’ Voices where she will find both Emma and Taylor are cheerleaders, and Kelly is a soccer player. And, although I know we’re not kids anymore, both Missy Foy and myself (Brian Foster) still act like kids sometimes!

BF

[Editor’s comment: See also our previous questions on Exercise and Sports.

BH]