Q: Since his diagnosis two months ago, my 12-year-old son has been more and more frequently sitting on the sidelines during his sports games and school gym classes because he’s anxious about highs and lows. We want to encourage him to participate as he always did before his diagnosis. What can we tell him and the school to get him “back in the game”?
A: The most important advice I can offer to you or any family facing a child’s new diagnosis is that he should take control of his diabetes and not let it control him. He shouldn’t be afraid to be as active, or even more active, than he was prior to his diagnosis; exercise is very beneficial to him, as our diabetes educator emphasized when our daughter Kate was first diagnosed. Once our daughter took control of her diabetes–and it took a few months–everything was so much better. Today, at 12, she is a black belt in karate and plays volleyball, in addition to being an all-around active kid.
Kate has several things she does to make sure she can enjoy a sports game or gym session without worrying that she is going to get low blood sugar in the middle. She checks her blood sugar at least an hour before the physical activity, again immediately before, during (if needed), and also a few times afterward. That way she can make any necessary corrections. She doesn’t play if her blood glucose is below the lower end of her normal range. During exercise, a high blood sugar episode is just as bad in the long term as a low one. Make sure you check with your educator or doctor for the ranges within which it is safe for your son to play or exercise.
Our daughter has left karate classes early when she felt low or “funny,” and your son shouldn’t feel bad or embarrassed to do the same. If he does ever leave during a game, always make sure someone knows why he left early. He should never go off by himself if he’s feeling low/high or knows that he is. Someone else, preferably an adult, should always walk with him to the nurse’s office if the need arises.
Make sure your son always has a few snacks or some juice with him (keep a container of juice tucked away in each of his classrooms), and that his gym instructor or coach knows your son has diabetes and how to recognize symptoms of low or high blood sugar. (Your son may not always recognize his own symptoms.) Always make sure that there is a glucagon kit in the nurse’s office and if possible one in the gym, and that the appropriate personnel know how to administer it. Once your son realizes that there are other adults besides you that can help, he’ll feel safer.
Above all, encourage your son not to feel afraid and to go ahead and enjoy any sport he wants to participate in. He’s definitely not benefiting socially, emotionally, or physically by sitting on the sidelines. He’s probably feeling very different from other kids right now. Have you tried to see if there is any group (provided by the school or through your local JDRF chapter) for kids dealing with chronic illnesses? We have one in our chapter.