My 12-year-old son just transitioned from a recreational soccer league to a highly competitive traveling soccer league and I can't get a handle on his blood sugar. We didn't have this problem with the rec. soccer, but I guess this is more intense exercise. I read in a book that one srategy is to give 33 g. of carb w/o insulin just prior to a game, but I'm finding that his blood sugar ends up around 300 when I do this. I've also read that competitive sports can cause the BG to rise, so some suggest giving a small dose of insulin before games. His BG seems to always fall during practices. Has anyone had a similar experience? I need some advice. I'm a little nervous about giving the added insulin in case he goes low while he's on the soccer field.
My daughter started playing competitive soccer this year and we also find it can be a challenge. Mostly for us though is that she plays better when she is kept under 200. If you document everything from what he ate to the blood surgar levels do you see any patterns? With Allie we know that if we eat within 2 hours of a practice or game we need to reduce the insuline we give her by 1/5th. We also have her check her bs at every break and have either glucotabs or juices on hand to adjust.
good luck
My son plays travel hockey and it took us a while to figure out what was happening with his BG during games and practice. Games and practices are totally different - you are not crazy!
My son is more likely to drop during practice depending on the intensity and the rest time between drills. He takes Gatorade with him on the bench and if he starts to feel low he will switch to it instead of water. He ususally will not temp his basal down during practice unless it is an especially light practice. He then temps down after practice 20% for several hours. He will have a drop in about 6 hours but not too severe because he was not too high.
My son almost never drops during a game and he now never temps his basal down or eats carbs before a game because he needs the insulin. He tries to go into a game at about 125 - a slightly higher target than his normal 100. He only has to watch that he does not drop too low during pregame warmups and skating. If he drops into the 80s or below, he loses muscles strength in his thighs and cannot skate without tripping. As the game progresses, his BG will rise. We try to keep him under 200 for optimal play. At 300, he loses quickness and side vision. If he gets more shifts and less rest, his BG will rise more (more physical exertion). If we have a full bench, his BG is better. He waits an hour after a game to let the adreneline rise subside and then temps his basal 20% and adjusts if necessary.
If he is playing in a tournament or league where there is a rest between periods, he will wash his hands and test. Otherwise,with hockey gloves being such a breeding ground for bacteria, he won't test on the bench. He has worn a loaner CGM at practice and during games so that he knows about what his BG will do in a normal setting. We were on the waiting list for a longer range CGM when it was taken off the market.
We have never given extra insulin before a game because he has had some of his lowest lows with insulin taken with a snack right before pickup basketball and football games with neighbors in our yard after school. The exercise really accelerated it through his body and he crashed.
It is trial and error. Good luck to you and your son.
Hello Chris,
It seems like your son's sports intensity and dynamics have changed and as well as his blood sugar response. It is pretty common to adjust insulin and carbs patterns over time but I know the process of getting it "right" can be a bit overwhelming. Some resources that may be of interest is the book "Diabetic Athletes Handbook" by Sheri Colberg: http://www.shericolberg.com/diabetic-athletes-handbook.asp. I have had diabetes for over 20 years now and I recently started exercising. I just ran a half marathon last June and this guide helped me (with practical strategies) balancing out my blood sugars . Thankfully I was able to maintain my numbers in a normal range during all race.
Also, I would like to suggest you to look it up at DASH Camp: www.dashcamp.org, I am currently volunteering for this Organization and we will have a Camp for young people with diabetes and parents on Sept 29th and 30th at Menlo Park, California. DASH Sports Education is a unique non-profit organization comprised of athletes who have diabetes. DASH's objective is to promote healthy, active lifestyles and sports careers among young people with diabetes by empowering them, their best friends and family members with techniques to manage blood glucose while exercising.
Hope it helps! Sorry any grammar mistakes, My native language is Portuguese and English is my second language.
Best,
Fabiana Couto
My tudiabetes profile is: http://www.tudiabetes.org/profile/FabianaCouto
Thanks for your comments. I needed to know that I wasn't crazy and what my son is experiencing is not unusual for PWD playing competitive sports. We just got home from soccer practice -- he went down to 61 after half an hour and then drank too much gatorade to counteract the low. Now, we're fighting a high BG. This is so frustrating to us -- and I fear that his coach and teammates are getting frustrated with the situation, too. They obviously don't understand the complexity of all of this. I actually think he may have been okay had he drank half the amount of gatorade. I feel like we are making small steps in the right direction. My son wears a CGM, and I'm trying to get him to look at it every so often while he's practicing so we can ward off the lows. Thanks for the help!
No problem. Our CDE recommends 15 gm of carbs every for every 30 minutes of activity. Your son will probably have to eat or drink some carbs every 15 - 30 minutes of practice especially if he shows a downward trend on his CGM. Not much - just a little will help. Much preferable to yo-yoing to 60 then up to 200s.
I know at this age he doesn't want to be different but if he could have his own water bottle with gatorade mixed in, or a gel pack in his pocket that he slurps at water break, it will help keep him in range. Tell him it will improve his performance. I'm sure his legs are rubber at 61.
Hey Chris,
I am Lucas Fogarty former semi pro baseball and American Football player in Brussels Belgium. So the rise in BG due to competitive sports I believe is related to stress levels. Stress causes an increase in BG, the only sport I have experienced this rise in BG before the start of the game is in Basketball. My BG's would go from 150 to 300 in the first half and then in the 4th quarter I would be dropping down to 60's continuing to go low after the game. So exercise is tricky because even when you are done exercising your body is still burning glucose so your BG's trend low up to 4-8 hours after you have exercised, sometimes even longer. I am not sure whether or not your sun is on an insulin pump on not, but one explanation for high BG's could also be due to disconnecting and loss of Basil insulin. I've disconnected for 2 hours while playing basketball and have had ketones while by BG was 80.
In general the sports your son is playing will affect his diabetes control differently and his starting BG and active insulin will play a major role in affecting his BG's. As a rule I prefer to start exercising around 150 and have low supplies and insulin with me just in case. Check at halftime and adjust. When giving insulin, I tend to shy on the 1/2-2/3 of my normal corrective dose, just because when I go low during sports I cannot recover, when my BG is high I can recover, but just not at my peak athletic form.
Your son will have some lows and highs but this is just a part of life. The best thing is to try to learn from the experience. I am not a medical professional, so I would also suggest to chat with your Doctor about this as well. 33 grams maybe too much so maybe try 15, or spread the 33g throughout the sporting event. If he is going low, juice is the quickest. If he is having drastic spikes, you can go with a slower acting low solution like half granola bar or half a sandwich and some juice or orange slices. Hope this helps and if you have more questions please feel free to email or message me on tudiabetes.org
Sincerely,
Lucas Fogarty
Director and Founder
DASH Sports Education
lucas@dashcamp.org
Thanks for all of the great advice! I truly appreciate it. My son wears an insulin pump and a CGM. I think I need to train him somehow to pay more attention to the CGM during practice. I plan to raise the low alert to 100 during practice, so he can hopefully respond to a downward arrow with some gatorade before he actually gets too low. Right now he doesn't disconnect during a game or practice, but I have played around a little with reducing his temp basal. He has practice tomorrow, so I think we'll try a smaller carb (20 g.) snack before practice with the gatorade ready to go during practice. I think I'll have him check his BG half an hour into practice to see where things stand. It's definitely lots of trial and error. I hope we will get the hang of it soon.