Carrying easily absorbed carbohydrate (e.g. fruit juice popper or glucose gel) at all times is another task to be learned and increase a child’s sense of independence.
Exercise and sport may become more active, prolonged and routine, especially if played after school. Insulin doses may need to be adjusted and you may need to experiment with the amount and types of food to learn what suits your child’s needs. For example, dried fruit and crackers are quick to eat.
Reminding your child to have blood glucose levels (BGLs) checked before and after the activity, as well as topping up with carbohydrate foods is important. Talking to your dietitian and/or diabetes educator often helps.
Hypos at school
Although hypo symptoms are individual, mid-morning sleepiness, poor attention just before morning recess, or headaches, are common signs of low BGL’s. It’s important to give a supply of hypo foods to your child and your child’s school teacher. These items could be kept in a separate lunch box in your child’s bag as well as in the class room
It is vital for teachers to understand the need for your child to sometimes eat a snack during class time to treat a hypo. This is best explained to them by you or your child’s diabetes educator.
Initially, fitting diabetes into the school day can be a balancing act. Depending on your child’s insulin plan and school routine, sometimes a before school snack may be necessary to prevent a hypo before recess. At the same time, preventing your child from feeling different by ensuring meals (such as recesses and lunch) are at the same time as the other children is essential. Your diabetes team can help work out your child’s insulin plan around their usual school routine.
Teachers may also be able to pick up the signs of a hypo and treat early if they are well informed.
They also need to be aware of avoiding delays in meal times and most importantly when treating hypos. Packing snacks for your child to eat during the school is one way to ensure they have enough food to eat to prevent hypos. This is particularly relevant if there’s a school day with extra activity planned such as sports day.
Planning for sport and exercise
If extra activity is planned, your child may need additional carbohydrate food prior to the exercise. A general guide is a half to one extra carbohydrate exchange (7-15g carbohydrate) for every 30 minutes of physical activity. However the exact amount needed will be determined by the level of activity and blood glucose response to exercise.
Exercise increases the body’s sensitivity to insulin (increasing the risk of hypos) and this effect may continue for up to 12-16 hours following the activity. There is a lot of variation between individuals regarding these effects, so it is important to monitor your child’s blood glucose levels (BGLs) closely before, during and after exercise.
If regular exercise is expected, such as a sports day at school or swimming on the weekend, you may wish to discuss with your child’s doctor the need to reduce the insulin dosage on these days.
Carbohydrate foods for sport:
- Muesli bar
- Pack of sultanas
- Low fat flavoured milk
- Dried apricots
- Fresh fruit
If your child is involved in an endurance/long sporting event, they may need extra carbohydrate during and after the event to prevent a low BGL. A carbohydrate containing drink such as a sports drink can be handy, providing both fluid for hydration and carbohydrate for energy. Talk to your dietitian about suitable choices.