My eight year old grandson, diagnosed with type 1 diabetes at age three and one-half, has been running in the 400+ mg/dl [22.2 mmol/L] range for several days now (We think it is a growth spurt, as it has happened before). To get his sugar down, can/should he be allowed to go out and play to help burn off the excess sugar? As long as someone is watching him so he doesn’t crash (he has before), is it safe? Should he remain sedate, playing in the house or watching TV?

It is usually fine to be active and exercise when you have a high blood sugar unless you have moderate or large ketones. Most would suggest taking it easy until the ketones are cleared before doing a lot of exercise, although normal activities are okay when there are ketones. You might want to read more about high blood sugars at this website.

MSB
Additional comments from Lois Schmidt Finney, diabetes dietitian:

I am not aware ot having a child exercise when their blood sugars are that high. We usually say to give the sliding scale of Humalog needed to bring down the blood sugar to at least 300 mg/dl [16.7 mmol/L] and, even then, take it easy with intensive exercise. If there are ketones, extra water should be taken and always check the blood sugar and ketone levels frequently.

LSF

[Editor’s comment: As Dr Brown has pointed out, exercise is safe as long as there not ketones, however, this is probably not the best way to bring down a high blood sugar. My suggestion would be to have your grandson drink lots of fluids (like water) first. Blood sugars should stay elevated in the 400mg/dl [22.2 mmol/L] for several days. This means there is an insulin deficit. You should have your grandson’s parents contact his diabetes team for insulin adjustment as soon as possible.

SS]