Our daughter was diagnosed with type 1 diabetes at 12 months of age. I’ve been reading more about the impact of exercise on blood sugars. How do you assess the effect of exercise in a child so young? What is considered “exercise”? She obviously isn’t participating in any formal athletic activity, so how can I know how a walk to the park, some time running around outside, or climbing, etc. will affect her levels (other than by constantly interrupting her to test)?

Any activity can have a blood glucose lowering effect, just like planned exercise. This can be quite difficult to assess in an active two year old, particularly as frequent testing is not always easy in a child so young. Ideally, if you could pattern her blood sugar response to a few of the most common activities, by checking before and after about a half hour of activity, you would have a sense of what the activity does to her blood sugar. You could then use this knowledge to predict her typical response, and, most importantly, prevent hypoglycemia without necessarily having to test every time. We can understand the challenge this presents.

Although this will vary per individual, in general you can estimate that a half hour of moderate activity will burn off about 15-30 grams of carbohydrate with regard to effect on blood sugar. Therefore, to maintain blood sugar levels, you will need to provide a snack to that effect. You should be aware of what the relation of the activity is to the last meal or snack, as this might affect the glycemic response. In addition, activity at the time of a peak in insulin (or immediately after a pump bolus) may cause blood sugar levels to drop more quickly. You’ll need to be aware of these issues, and adjust accordingly.

Lastly, take advantage of the experience and support of the true experts, the many parents of children with diabetes who frequent this website. No doubt they have many tips and strategies to share.

DMW