Sports & Activity Guide

Aerobic Exercise (Usually Lowers Blood Sugar)

Activities like running, swimming, biking, and soccer typically lower blood glucose because muscles use glucose for energy.

• Blood sugar can drop during and for hours after exercise
• May need snacks before, during, and/or after activity
• May need to reduce insulin doses for longer activities

Anaerobic Exercise (Can Raise Blood Sugar)

Short, intense bursts like sprinting, weightlifting, or competitive sports with adrenaline can temporarily raise blood sugar.

• Stress hormones (adrenaline) can cause temporary spikes
• Blood sugar often drops later as the body recovers
• May need small correction doses but avoid over-correcting

Mixed Activities

Sports like basketball, hockey, or tennis combine aerobic and anaerobic exercise, making blood sugar less predictable. Close monitoring and pattern tracking help.

Individual Variation

Every child responds differently to exercise. Keep detailed records to learn your child's patterns and adjust management accordingly.

Before Exercise (15-30 minutes before)

• Check blood sugar - aim for 120-180 mg/dL before starting
• If below 100 mg/dL: Give 15-30g of carbs and wait to start
• If 100-120 mg/dL: Give 10-15g carbs before activity
• If above 250 mg/dL: Check for ketones. If positive, don't exercise
• Consider reducing mealtime insulin if exercising within 2 hours of eating

During Exercise

• Check blood sugar every 30-60 minutes for prolonged activity
• Have fast-acting carbs immediately available (juice, glucose tabs, sports drinks)
• If blood sugar drops below 100 mg/dL, take a snack break and recheck in 15 minutes
• Drink water regularly to stay hydrated
• Use a CGM if available for continuous monitoring and trend arrows

After Exercise

• Check blood sugar immediately after and again 1-2 hours later
• Provide a snack with protein and carbs to prevent delayed lows
• Monitor overnight - exercise can cause lows 6-12 hours later
• May need to reduce basal insulin or evening doses on active days
• Track patterns to adjust future activity plans

Fast-Acting Carbs (for treating lows)

• Glucose tablets (15g = 4 tablets)
• Juice boxes (15g carbs)
• Sports drinks (Gatorade, Powerade)
• Fruit snacks or gummies

Pre-Activity Snacks (15-20g carbs)

• Granola bar
• Crackers with cheese
• Half a sandwich
• Banana or apple with peanut butter
• Trail mix

Post-Activity Snacks (protein + carbs)

• Chocolate milk
• String cheese and crackers
• Yogurt with granola
• Turkey and cheese roll-ups
• Hummus and pita chips

Hydration

Dehydration can affect blood sugar readings. Encourage your child to drink water before, during, and after activity. Sports drinks can provide both hydration and carbs if needed.

Inform Coaches & Team

Always tell coaches, PE teachers, and team staff about your child's T1D. Provide written instructions for recognizing and treating low blood sugar.

Medical ID

Your child should wear a medical alert bracelet or have ID visible during all physical activities. Include emergency contact information.

Supplies on Hand

Keep a fully stocked "sports bag" at practices and games with glucose tabs, snacks, testing supplies, extra insulin, and emergency glucagon.

CGM Considerations

If your child uses a CGM, consider protective covers for contact sports. Some CGMs can be shared with coaches' phones for real-time monitoring during activities.

Buddy System

Designate a teammate or friend who knows about your child's diabetes and can help recognize symptoms or get help if needed.

When to Stop Activity

Your child should stop exercising immediately if blood sugar is below 70 mg/dL or above 250 mg/dL with ketones. Treat and wait until levels are safe to resume.