My 12-year-old son just started playing in a competitive, traveling soccer league and his BGs are going crazy. He was diagnosed 6 years ago and we've never experienced this problem when he played recreational soccer. I've read that providing an additional 33 g. of carb before soccer is recommended, but when I do that before a game his BG ends up around 300 at the end of the game. Another source suggests that adrenaline causes the BG to rise during competitive sports, so a small dose of insulin is needed. I'm not sure what to do. I'm a little nervous about giving added insulin in case he would go low on the soccer field during a game. I should also add that he tends to go low during soccer practice. Any advice will be greatly appreciated.
I was diagnosed around 14 years old and had some similar problems with soccer games. For me, the major problems were that each game was pretty different depending on position played and opponent. Perhaps the 33g of carb is too much or maybe the timing isn't right. I usually find that for exercise I need to try a couple of different things and just record what happens. Record where your sugars are before during and after and keep experimenting. If it's possible, it would be great for him to test BG at halftime or if he gets substituted out (assuming unlimited subs at age 12).
It could be adrenaline as well, but my guess is that it's probably too much carbs or poorly timed carbs.
Someone on this site pointed me to the book "Diabetic Athlete's Handbook" by Sheri Colberg and that's my go to in terms of thinking about what needs to happen with exercise. Since I started using that as a reference it's easier for me to decide what to do for exercise and my numbers have been better.
Also, is he going through a growth spurt? That might explain why things are different now than they were before?
Just some thoughts to maybe help out.
for me (27 yr old male 6'4" 225lbs) I find if I eat really low carb (30-40 g a day) then exercise does not affect me- however I do not think this would be a smart choice for a 12 yr old who is still growing- when I was in high school I would let my BS run high during wrestling practice and then just bring it down after with a small amount of insulin ( yes during sprints and other short duration bursts of energy the body does release glucose that raises the BS , and yes during low to moderate effort (jogging) the body drops BS- this is prob why he goes low during practice because it is not as intense as a game might be) my guess is he is doing a lot of sprinting and this is causing him to go high- what I would do for myself is not change anything play the sport with some form of fast sugar (g-raid, powerbar, gel packs) on hand and treat if needed (check BS before /half time/ and end) remember from short bursts of energy he will become more sensitive to the effects of insulin (i.e. normal is 1 unit drops him 20pts , well after practice and for maybe 8-12 hours 1 unit will drop him 35pts)hope this helps - everyone is a lil different and it just takes time to find out what makes him tick (sleep will effect his BS brkfst the day before will effect him, the bus ride home...anything causes bumps)
Thanks for the helpful advice, Noah. (I just joined tudiabetes -- so nice having others to help you think things through!) I ordered the "Diabetic Athletes Handbook" last week on Amazon and I'm hoping it arrives today. I'm glad to hear you thought it was a helpful book. I'm thinking I might start at gradually cutting back on the pre-game carbs w/o insulin and see where that takes us.
Both my boys (15 and 10) play travel soccer and it's really challenging to manage. I find that the adrenaline of a game shoots their blood sugar up, but it takes much less insulin than normal to address that rise so we are very conservative when correcting for that. The 10 year old is a goalie, which means that some games he gets a great workout - but other times he sees little to no action.
We test before games and at half-time. If they are below 100 we will have them do a 15g max snack but we don't do much more because they are disconnecting to play (their choice). Both are on pumps so they test at half-time and if they are over 240 they reconnect and correct but at 1/4 of their usual correction ratio.
Their coaches know that they must sub for them if the boys call for a sub, and both do that if they feel low. Both boys hate to come out so you know that if they call for a sub it's not just that they are tired :) I watch the sidelines and the coaches wave me over if there's any question or concern.
what type of carbs are you giving? fast carbs (liquid carbs) or slow carbs (starches)? He probably has a lot of hormones that affect his sugars too, but have you considered a CGM system? I swear by mine. During sports where I sweat, it can end up being about 30 minutes behind, but at least I can still use it to avoid the extremes on either side.
chris, i played soccer in college and i am thinking what some of the other respondents said, about maybe you are giving him too many carbs to start, and as Noah, said not correctly timed..i also wear the Dexcom and it is a great tool..b/c ur are measuring his sugar before the game, i am sure, but this doesnt really give you an idea of what the trending is going on..it only shows u that one number, and it is hard to react that single number, not knowing how much insulin is on board, how much carbs are on board and in which direction the BS numbers are heading..so i think the Dexcom can help control this..however in the meantime, you can check his sugars separated by 45min and this might give you an idea of him going high or low, and if he is really going low, then maybe stick with your high pre-carb routine, and then check sugar at half time...with me, as an athlete if my sugar was say flat lining going into a 45 min half, i guess i need about 60 g of carbs for that 45min activity, however with the dexcom i noticed that my sugar did not start dropping until the 22min to 25 min into the game, so basically for this time i needed no carbs because i was using my stored(I WAS NOT WEARING THE PUMP THEN AND USING THE POOR MANS PUMP, OF LANTUS AND HUMALOG) carbs of glucagon..so if you are giving your son 33g of carbs before the game and i think the game is only 60min, and he is probably getting more stuff at 30min half time...i would try to cut back a little on the 33 before and see how that works out..you have to try and guess how many carbs do you think he is burning during this exercise..they say about 1g of carb per minute for a decent heartrate of exercise, mine is at approx 1.4g per minute when i am exercising at a decent heartrate