Six weeks ago, my 16-year-old son was diagnosed with type 1. He has run cross country since 9th grade. On the day of every race, three so far, his blood sugar has skyrocketed from 228 mg/dl [12.7 mmol/L] to 300 mg/dl [16.7 mmol/L]. This is right before a 3 mile race. Should he dose for a correction or just run? Also, he is complaining of his legs feeling tight and stiff.

What your son is experiencing is quite common. Blood glucose levels are affected by many variables, including food, exercise, insulin, and the presence of stress hormones. Leading up to and during a race, stress hormones can be present in large amounts, and may contribute to a rise in blood sugar. Once it becomes a consistent/predictable occurrence (as it seems to be), you can offset the anticipated blood sugar rise with a small, conservative dose of rapid acting insulin taken 30 to 60 minutes prior to races. Extra hydration is important as well. Be sure to monitor his glucose frequently so that you and he can fine-tune the insulin dose and avoid hypoglycemia. He will undoubtedly perform better when his glucose levels are within a healthy range during his meets.

Here is an article that explains this phenomenon a bit more.

GS

[Editor’s comment: Be sure to consult your son’s own diabetes team, as well.

BH]