Children who take insulin are at risk of hypoglycemia during and after exercise. But with good planning and awareness, a child can exercise and participate in sports safely.

Good planning means checking blood sugars before, during, and after exercise. Then, you can keep a record of how exercise affects your child's blood sugars. Remember that each child will react to exercise differently. But, using your records, you usually can predict how your child will react to activity.

Use the following tips for exercising safely:

• Do not let your child exercise if blood sugar is over 250 mg/dL or ketones are present.
• Make sure your child's blood sugar is above 100 mg/dL before exercise to avoid low blood sugar.
• Make sure your child wears identification.
• Make sure your child drinks water so he or she does not get dehydrated.
• Talk with your child's doctor about lowering the insulin dose that your child takes before exercising.
• Inject the insulin before exercise in a site other than the parts of the body your child will be using during exercise. For example, if your child will be running, do not inject insulin in the leg.
• Your child may eat 15 to 30 grams of quick-sugar food (hard candy, fruit juice, honey) 15 to 30 minutes before exercise.
• If your child plays in organized sports, give the coach a list of the symptoms of low blood sugar and instructions about what to do if it occurs.
• Have some quick-sugar food (hard candy, fruit juice, honey) on hand at all times. You can also make sure your child's coach carries quick-sugar foods.
• Watch for symptoms of low blood sugar up to 24 to 36 hours after exercise. This is important especially for children younger than 6 years of age or those who have an A1c less than 8.
• Your child may use a diluted (watered down) form of sports drink during activity to get fluids and sugars.