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4 tips to help children with diabetes enjoy winter sports


Posted on by Margaret R. D'Arcangelo, MD


Downhill and cross-country skiing, sledding, ice skating, ice hockey and snowboarding are all great ways for kids to have fun and be active over the winter. But if your child has diabetes, you may have some concerns.

Share these 4 tips to help your child enjoy winter activities while maintaining good control of his or her diabetes.

1. Check your blood sugar often

When you are active, you may be at greater risk of a low blood sugar. You burn a lot of energy doing winter sports. Your body needs fuel (sugar) to keep warm and to help with your activity. Test every 1-2 hours.

2. Keep glucose meters and insulin warm

Glucose meters are not always accurate when they are cold. The listed operating temperatures for most meters start at 40-50 degrees Fahrenheit. Keep your meter with you under layers of clothes, or leave it at the ski lodge.

Insulin also needs to stay warm (between 40 and 86 degrees Fahrenheit). If you wear an insulin pump, carry it under layers of clothes, close to your body. If you use insulin bottles and syringes, or pens, leave your supplies at the lodge (or in a warm place) so they are available when you stop for lunch or a snack.

3. Never engage in strenuous activities alone

If you do have a low blood sugar other people need to know. Always play with a buddy, and wear your medic alert necklace or bracelet. The ski patrol or medics can’t help if they don’t know your condition.

4. Plan ahead to stay on top of your dietary needs

You don’t want to have a low blood sugar as you are going up the ski lift (or if you do, you want to be able to treat it immediately). Carry a snack. Glucose tablets or juice are the best since they provide quick energy.

Make sure you eat breakfast and stop for lunch. While you may want to make “just one more” run, don’t overdo it. Better to stop and eat rather than spend a chunk of the day recovering from a low blood sugar.

While frequent checks during the day can help you catch a low during the activity; remember, you can have a “delayed low.” This means your blood sugar can drop anytime from 4-24 hours after you’ve been active. Your muscles need to replenish their stored energy, called glycogen.

  • Prevent a delayed low by eating extra carbs before you exercise, or reducing the amount of insulin prior to exercising. You may even have to do both.
  • Eat a snack within 30 minutes of finishing exercise. This snack should have both carbs and protein (i.e. glass of hot cocoa made with milk, peanut butter sandwich, cheese and crackers, or a small handful of nuts with a piece of fruit).
  • If you are planning an afternoon of winter activity (moderately strenuous) you may need an additional 30 grams of carb for every hour you are active.
  • For those on NPH insulin: Decrease your morning NPH dose by 20 percent.
  • For those on Lantus insulin: Decrease your evening dose by 20% the night before strenuous exercise.
  • For pumpers: Use a temporary basal rate for the duration of activity. Decrease basal insulin by 20 percent to start.
  • It is always best to speak with your healthcare team about other approaches involving insulin adjustments that can help to prevent low blood glucose levels.

Enjoy the winter but do so safely and in good control of your diabetes.

 | LG Health - Pediatric Specialists

Margaret R. D’Arcangelo, MD, is a pediatric endocrinologist with Children’s Hospital of Philadelphia and sees patients at Specialty Care, Lancaster. Education: Medical School-- Pennsylvania State University College of Medicine; Residency, Fellowship—University of Connecticut Health Center.


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