Type 1 & Sports

Hi Everyone,

My 12 year old son was (dramatically) dx'd May 8, 2009 - so we have been learning and living with all that is type 1 for a little over a year now.

Last summer he was still in his honeymoon, and would crash low after 20 - 30 minutes of swimming, even though we religiously made sure he was above 140 before exercising. Have been happily surprised so far this summer, since he seems to be a lot more predictable with exercise and blood sugar #'s.

In January we had a miserable Omni Pod trial that was due to a number of things, but probably mostly because the nurse educator DID NOT LIKE THE POD and scared him with stories of teens coming in with the Pod duct taped on, that they fail and fall off easily and she only approved the upper rear end for placement since he is lean (but certainly can pinch an inch on his arms and stomach for injections). So that's the long way of me saying we are still on MDI's.

I've agreed to sign Matt up for Fall Football because I made a deal with myself that I would not hold him back with anything because of his having type 1. But I'll be honest and say that I am PETRIFIED and fear I may die of stress on the sidelines worrying he'll go low. Or that I'll be THAT MOM who stays at every practice to make sure he has enough Gatorade, etc to keep him high enough to play. (In reality I won't do this, but if I can't get my "mind right" may really die of stress)

I would love some advice from anyone who has their t1 child in rigorous sports and how they plan and handle things. This is such a huge stress and practice doesn't even start until late August.

THANK YOU!!

Amy,
My 7 yr old was also dx last July. He was already signed up for tackle football by the time we found out and I, with the advice of the hospital was not going to change things for him either. We tested him prior to practice, if he hadn’t eaten dinner yet, I pre-carbed him. If he did eat prior to practice I decreased the dinner insulin dose slightly so that his bs remained slightly higher than the range. If he didn’t eat dinner I also tested him an hour into practice and had him drinking gatorade throughout. We had no issues with him going dangerously low except once and it was only slightly, had him sit out for a few minutes and eat a snack, retest and was fine. He ultimately quit prior to the games starting which I’m not sure if it had anything to do with the diabetes, but he did have alot going on all at once so I have to assume it was part of the reason. We are trying it again this summer now that he’s actually giving his own injections and has better control and we will be on the Animas pump by the time it starts.

That’s not to say I won’t still be stressed out. I don’t think that ever goes away as a mom with a t1 child. My sister’s son was dx at 18 mos old and is now 11, very active in sports throughout the year and she still stresses about it. So I’ve just accepted that this is our life now and I always have a bottle of wine in my fridge! Best advice until you feel a little more comfortable with his activity…test away!

Amy,

David was diagnosed at age 10 in 2003. He just turned 17. He has played competitive hockey year round since his diagnosis. He also has played competitive soccer, but does not play yearly, just not as interested. More recently he added in Rugby on his high school team and training and participation in a 10K run as part of his school, personal fitness program. I don’t think that there is a T1 Mom out there that does not feel some anxiety when our kids try new sports. David tried basketball camp one year and as much as he likes basketball did not return the following year as he found the day long camps were just too much. He has stayed away from day long hockey camps for the same reason.

What pump is your nurse educator in favour of? Will she do a trial on the pump she favours? While the initial first few months pumping involve a huge learning curve, I think that you will find as your son heads into puberty that a pump will really help him. David wears a minimed paradigm pump. Omnipods were not an option, don’t know if that is because we are in Canada, or if it is because the nurse educators training was done through minimed, in any event, he had his pump training during March break the year he’d turned 14 after a year and a half wait for training. Don’t know what we’d have done without it these past few years.

Cheryl

Thank you! It’s great to have the perspective of another type 1 Mom – and you’re right. The stress will never go away - and it’s a great plan to test away the first practices -then maybe I can get a pattern of predictability going so I’ll (he’ll) know just to drink Gatorade a lot and add in some other carbs after a certain amount of time. I don’t know why this has me so freaked out - but should maybe also take the wine advice and try to relax some… :slight_smile: I hope your son enjoys football this year!

That is great your son has been so athletically active! It gives me hope that all will be OK - and that the worst case scenarios that flash through my mind will slow down a little. I don’t expect them to go away - but it gets exhausting sometimes.

Re: the Omni Pod --> we got the all clear from his Endo, and then we had to go to the hospital diabetes center for a group Pump Training - followed by individual sessions with the nurse educator and nutritionist. In the group they covered all pumps (except the Omni Pod – and I raised my hand to make sure we were in the right place – we were). After the group session the different reps were there and that DID include the Omni Pod.

So all of our individual training was for the Omni Pod - and we were very excited to start since Matt thought it would give him some freedom, though will admit to being nervous about no Lantus/background insulin. He was bummed out that the nurse said he could only put the Pod on his upper rear end - and then less than 24 hours after she expertly put it on him - it occluded. The one my husband had on (they make the parents do it too) was fine. After that the nurse and Matt both nixed the Pod. We are going to try again at some point though…are hoping for the smaller version to come out soon.

The nurse did speak highly of the minimed and another one (Animas?) but even though Matt has seen other t1 kids with the traditional pump will have NOTHING to do with tubing - so he put all his eggs in the Omni Pod basket. I think the dislike of tubing is because of his traumatic hospital stay at diagnosis - or could just be he would have been that way anyway…

I can’t believe you had to wait a YEAR and a HALF for pump training!!! That must have felt like forever!! But very glad to hear it’s helped your son. I hope Matt ends up on something too - we had a hard time with A1C’s this winter and think it would help him.

This is amazing information - thank you so much!!! All of the advice is well taken by me, and I will definitely be bringing a small cooler, communicating with the coaches (think I’ll call the league tomorrow) and be there for Matt. He doesn’t qualify for school based sports for two more years - but that information is also great to know.

We are t1 buddies and have been true partners in his care – and you hit the nail on the head when you described how your son was at first with not knowing yet how he would react blood sugar-wise. That’s where Matt is right now, and I have a brave face on for him but have been badly wanting more than just a “front” – really want to believe what I am saying to him that we’ll work it out and it will be OK. So again, it’s just like you wrote with all firsts being hard. They are - and realized this when I cried after leaving him at school for the first time after diagnosis. It’s so hard to explain to others - but that’s the beauty of this forum – and so are the gentle reminders of the “obvious” that somehow aren’t always so obvious when you’re in the middle of things.

I would love any information you have to pass on to me! Your response has already gotten my mind in a “can-do” positive direction and I am extremely grateful for that!!

Hi Amy,
I apologize if I am repeating things already said, because I have not read all of the responses. My daughter is 13 yo and was diagnosed last year. She has played soccer since she was 5. I am “that mom,” in that I never leave her alone during practice or the games. I don’t always “hover” anymore, but I will sit in my car during practice as long as I can keep my eyes on her. We have only had one serious low, and I can’t exactly explain why. If I had not been there, she would have been in serious trouble. I just had a feeling that she wasn’t acting right. No one else would have noticed. So that made me realize to trust my gut not to leave her. I keep an emergency soccer bag with me that has glucose tabs, M&Ms, Juicy Juice, Airheads, etc. I realize one day she will be off on her own, but it gives me piece of mind during soccer to always be there. Besides, she has never complained. In fact, I think it makes her feel safe knowing I’m there. Good luck!

This is great - and for some reason felt that if I were “that mom” then I’d be holding him back and not trusting him - but hearing for you and others here has made me realize it’s OK and I can be discrete and not interfere or make him feel uncomfortable!! I really don’t know why all of this is so hard for me to get in my brain, and so much appreciate knowing what has worked for you and your daughter. : )

Another great idea and think I will do that with an information sheet for the coaches. And you are right – I would be there anyway for games but wasn’t (am not) sure what other parents do at practices, so thought it may seem out of line for me to be there. It’s going to ease my mind greatly knowing I’ll be there and am lucky that I have a flexible work schedule/can work at home if I need to, so it will work out.

Actually just talked to Matt about all of this and he was visibly relieved when I told him I’d be there and that I’d heard all of these great tips for making it work. I also let him know that your son wasn’t sure at first what his blood sugars would do (just like he doesn’t know) and this was a gem of a piece of information. Me saying that out loud and also telling him that now your son now knows with some predictability how things will go, has gone a long way in our house tonight. THANK YOU!

Amy,

I just posted a really short video on my page of David’s rugby that you can show to your son. David is in grey wearing the #12 jersey and put a huge hit on an opposing player before losing control of the ball. I look at rugby as being the not so bright version of american football where the boys aren’t smart enough to wear protective gear and helmets. David loves the physical aspect of the game, which I am sure your son will love about football.

David is the same as Lee’s daughter above, he carries an emergency pack with supplies, including glucose tabs every single time that he leaves the house. The pack is slightly longer and taller than a sandwich box and holds all of his supplies including a glucagon injection kit. For hockey or other sports he always brings juice or a powerade or gatorade or something really fast acting as well as he is not a fan of glucose tabs. If your son has no difficulty with hypo unawareness then he will have no difficulty managing and enjoying his sports. It is just a matter of learning what works best for him. He might find that he runs low at times and runs high at others and will just have to figure things out as he goes, keeping in mind that high BG’s post game can drop really quickly, so waiting them out a bit first is often the wisest course of action to follow.

Tell him we’ll be cheering him on and looking forward to posts of a few photo’s or videos of his games.

Cheryl

PS By calling Eli Lily we were able to get a plastic case to hold the glucagon injection supplies, to replace the lousy cardboard box that the pharmacy provides. It is about half the size of the cardboard box and makes it really easy now to carry around the glucagon as part of the regular, out the door, emergency pack. We got this tip through a discussion on the tudiabetes web site for carrying glucagon.

My 12 year old daughter is an avid tennis player and we have had to come up with a game plan for her since tennis usually sends her very low. When she arrives at the courts she always checks her BG. If her BG is below 150, she puts in a temp basel which is a 30% reduction that will last for the length of time that she will be playing plus an additional 2 hours. If she is above 150, she will check her BG every 30 minutes and then set the temp basel when the BG is below 150.

She always carries Gatorade on to the court and will sip a little on each change over. We find that one bottle over two hours will keep her BG around 100 to 120. Regarding Gatorade, she has learned to slowly sip on a regular basis and to use water to quench her thirst. At a minimum she will check her BG every 60 minutes. She also has learned that if she misses four or five easy shots in a row that it is time to call a medical timeout and check her BG. As a general rule, the sloppier the tennis the higher the odds that she is going old.

If she is playing a USTA tournament we always check in with the USTA official to alert them that she is type 1. USTA rules prohibit parents from coaching during a match but players are allowed to communicate with parents about medical information. Before the match begins, I will alert the parents of the girl that she is playing about her condition and tell them there may be the need for a medical timeout and that she and I will communicate during that timeout about her BG and what actions may need to be taken. My daughter will also communicate the same message to her opposing player. To date, these communications, have prevented either the player or the player’s parents from thinking we were playing some type of game to obtain a competitive advantage.

The moral of the story is to test, test and test and to have a steady supply of carbs available. I am certainly that “Dad” and happy to be there.

This is great! Thank you so much for the support and all of the awesome advice!! I can’t wait to see the video and show Matt too :slight_smile: We’ll be watching this evening. Hearing all of these details really means the world to both of us.

Thank you! I have learned so much in a short day - and no longer worry about “smothering” Matt or making him feel different. Yesterday I felt that being “that Mom” would hinder Matt’s independence - but now realize it’s OK to want to be there and to help him learn how his body will react – while making sure he feels safe enough to play. This is so important for both of us. For some reason my brain wasn’t processing everything correctly…and I was stuck in fear.
Your strategy sounds great and I like the part of sipping the Gatorade slowly while quenching thirst/staying hydrated with water. Hearing from you and the others has really given me a boost of confidence and strength – and Matt knowing that I’ve learned things from other parents who have their children in active sports has also done the same for him. We are both relieved and thankful.

My 16 year old son plays ice hockey which the Diabetes Athlete’s Handbook by Colberg classifies as an Endurance - Power Sport along with American Football. She makes sugestions for all different types of sports.

We have different regimes for practices and games that we have had to develop through trial and error. He usually goes up during games and down with practices unless they are very competitive. The things to vary are the circulating insulin on board from the prior meal(because the fast acting insulin stays in their system for 3-4 hours), starting BG (we do 160 for practices and 140 for games), carbs during the activity (either gatorade or candy)
and less insulin for the meal after (we never correct for highs after a game because it is usually due to adreneline and stress and will come down on its own).

My son always drops low about 6 hours after a game so we try to have him high at that point especially if it is at night. Our CDE had us do tests each hour on several occasions to find this trend and now we program his pump to accomodate this drop. On the pump we can also reduce basal by 50% and not have to eat/drink carbs during the activity although we still have them handy along with a glucogon injection just in case.

We have found it better to treat a low early because once he hits 80 his muscles are fatigued in his legs and he does not recover quickly enough to rejoin the game just by eating carbs. Rubbery legs are not a good thing for a hockey player or a football player. (Normally, he would not have low symptoms until he reached 60).

It is worth it! Just start a little high and adjust one thing at a time until you find the perfect combo for him. As he gets older and into high school, the coaches and trainers (we have those in Texas at each school) have some medical training and he will know more about how his body reacts. But even now with my son being a junior, he seems to like knowing we are there in the shadows in case he needs us.

Hi Tonyia! My son is 14, and was just diagnosed on April 1(unfortunately no joke!). He is heading into his first football season with diabetes and I am scared to death. Being a nurse, I always think of the worst case scenarios. I stumbled upon this blog while I was trying to search for information to give to his coaches. I would be so grateful for any help you can give me.

Thank you! Helen

This is also great information - thank you so much. Also think I will pick up the Diabetes Atheletes Handbook!! I hadn’t even considered there would be a book on this for some reason.

Matt has been “training” and did a lot of working out today and we closely monitored his blood sugars, which were actually pretty stable and predictable. I won’t go off of that for each time – but it sure is a nice way to start a trend.

Hearing all of these helpful hints and success stories just fills my heart and gives me a measure of peace. Thank you so much!! Best of luck to your son as well.

I am a 13 year old girl. I am an avid volleyball and basketball player. I have been on the OmniPod for a little while now and noticed a major diffence. When I play volleyball and i miss simple volleys my coach (who is also a diabetic) will pull me out to cheak me. The only issue with low blood sugar is when I run track. I run the 200, 800, and the 2 mile.After the 2 mile my blood drops to a mere 30 sometimes. But that is rare though; i drink alot of G2 to get my blood up and some times the Gatorade.

Amy and Tonyia,

I love what you both wrote. My son was diagnosed at 14 (8th grade) and he is now almost 17 and going into his junior year of high school. His freshman year, he played football, basketball, and volleyball at his high school. All of this was with injections as his docotor wanted him to learn how to deal with his diabetes before going on a pump (he was on injections for 1 1/2 years). I didn’t stay around for practices but made sure I was at every game, both home and away. During games, we have hand signals to remind him to test (I tap my thumb with my middle finger). He also has amazing friends/teammates that would tell him to test if they saw me doing the sign. I am very fortunate as he is very responsible and tests frequently and he can feel his lows. He also always has enough snacks with him if he goes low. We always let the coaches know about his diabetes and that he has to test frequently and may have to sit out to treat his lows and have never had an issue. His club volleyball coach this year could even tell when he was going low before he tested!

After freshamn year, he decided to just stick with volleyball and now plays year round. He is also on the omnipod now. I am sorry you had such poor training with the omnipod. Yes, we have issues occasionally (occulsions, pod falling off) but overall, it has been amazing and has given him so much more freedom. The first few months were rough and we had a lot of issues but stuck with it and am glad we did. We didn’t consider other pumps because of his active lifestyle. He often has all day tournaments and wouldn’t be able to play with a tubed pump on. He would have had to disconnect too many times. With volleyball, he is able to play with the pump on. My son is fairly lean (he is almost 6’8’ and weighs 199 lbs).

Please let you son know the sky is the limit when it comes to sports. My son was the first player in the history of our school to go from the freshman volleyball team to making the varsity team the following year and being a starter. He also went to Texas this summer and participated in the National Junior Volleyball championships and did very well. As you can tell, I am a proud mom.

Good luck!
Hilary (Christian’s mom)

God bless you! OUr 12 year old daughter was diagnosed 7 mths ago! She is very active with premier soccer and fast pitch! One thing we have learned is that if she drinks and or sips G2(gatorade–Low carb) during workouts and games she maintains good numbers during the game and several hours after she doesn’t drop so low! Also our coaches have been great! They know when she needs to check and she then treats if she is low – waits and then she stands by him when she is ready to go back in! I will say – we never leave her there without another diabetes trained grown up! I totally feel your pain! If you have learned any other tips – please let us know!!

oops!!! i ALSO forgot to tell you that we do give less insulin (1unit) before any kind of workout or game! Sorrry! Good luck