How Children With Type 1 Diabetes Can Exercise Safely

Key points about exercising safely for children with type 1 diabetes

• exercise is an important part of managing diabetes - it just needs some planning
• tamariki (children) and rangatahi (young people) with type 1 diabetes can fully participate in physical education (PE) classes and team sports  
• it's important to have good communication between you, your child, the healthcare team and your child's PE teacher or coach
• an insulin plan (specially written for your child) will help to make sure your child has good control of glucose levels during and after exercise

Exercising safely with type 1 diabetes

Exercise is an important part of managing diabetes. It just needs some planning. Encourage and help your child or young person with diabetes to take part in physical activity.

Participating in PE or sports at school

Tamariki and rangatahi with type 1 diabetes can fully participate in PE classes and team sports at school. 

Good communication is important

It's important to have good communication between your whānau (family), your child, the healthcare team and your child's PE teacher or coach.

An insulin plan will help control glucose levels

An insulin plan (written for your child) will help your child to have good control of their glucose levels during and after exercise. Anyone supervising your child will need training to recognise and treat low blood glucose levels. Your child should have easy access to blood glucose monitoring equipment and fast-acting carbohydrate food. 

Exercise and blood glucose levels

Usually, aerobic physical activity (such as walking, cycling, and general play) tends to lower blood glucose (BG) levels. Anaerobic physical activity (such as sprinting, hockey, or weightlifting) tends to increase blood glucose levels. Many forms of team and individual sports (such as rugby or netball) and playground activities are a mixture of aerobic and anaerobic activity

Exercise and hypoglycaemia      

Tamariki and rangatahi with type 1 diabetes are at risk of having low blood glucose levels (hypoglycaemia). This may happen during and straight after exercise. Or, there may be a delay of several hours so that low blood glucose levels may happen during sleep. 

Hypoglycaemia may happen for a number of reasons including:

• increased sensitivity to insulin from exercising
• relatively high levels of insulin in the blood
• a decrease in the response of the hormones which help the body to respond to low blood glucose levels 

Exercise and high blood glucose levels

Exercise can also cause high blood glucose levels (hyperglycaemia).

Hyperglycaemia may happen:

• during high-intensity anaerobic exercise like sprinting
• in tamariki and rangatahi who do not have stable glucose levels
• when emotional stress during competitions may trigger high blood glucose levels

Insulin pumps and exercise

Your child can (and should) exercise while using a pump. 

Talk to your healthcare provider for personal advice about pumps and exercise for your young person. There are many factors that will affect blood glucose levels, including:

• duration and type of exercise
• blood glucose levels before exercise 
• blood glucose during and after exercise
• food options before and after exercise 

In some sports like swimming, martial arts and some contact sports, pumps are usually removed for the safety of the pump. In most other sports, the pump and site can be secured and left on, so exercise can continue safely. 

It is usually a good idea to set a temporary basal rate or temporary target 1 to 2 hours prior to exercise. This will help to prevent low blood glucose levels during exercise.  You may need to continue this after exercise, depending on blood glucose levels. You can discuss this with your young person’s diabetes team for more information and advice.