Learning Lessons for Managing Type 1 Diabetes with Sports

I love playing sports, especially softball and soccer! And I feel blessed that my daughter Madison loves playing them just as much as I do. But managing Madison's blood sugar during and after a game is like a weather person trying to predict which direction a hurricane will go in. There are so many variables (weather, meal, emotional state, growth spurt) that can trigger it to go in a direction you just wouldn't have thought possible. And last night, Madison's blood sugar dropped way below her norm while she was sleeping all because of playing in a tournament fastpitch softball game, which they won.

For an hour and a half, every kid and parent was on a high, including Madison's blood sugar, which stayed around 230, even after I gave her insulin during the game. I had hoped it was closer to 150 for several reasons. When Madison's blood sugar is above 250, she has a harder time hitting the ball. She also starts getting fidgety out in the field where she's moving and wiggling a lot more than normal. And she also starts getting more emotional.

But last night, no matter what I tried (giving her insulin and having her do jumping jacks) her blood sugar decided to just maintain itself around 230 a result of being ecstatic from hitting a home run, sad from striking out, pitching to a new team, and anxious for the next play. After the game, I let her have a lollipop and decided not to have her check her blood sugar. From past experience, I've found it's not worth having her check her blood sugar immediately after a game unless she feels really low. Usually after she's played a game, her blood sugar will continue to drop for at least 20 to 40 minutes afterward.

When we got home, I had her get ready for bed and then we checked her blood sugar at 8:27 pm. The meter said her blood sugar was 125, a number that is perfect. But something inside me thought she may still drop, so I gave her four Ritz peanut butter crackers, hoping that would keep her blood sugar around 125 throughout the night. But it didn't.

Usually, we don't check her blood again until my husband goes to bed which is around 11:00 pm. But last night, I had this urge to check her one hour later and my jaw dropped and eyes bugged out of my head when the meter showed the number 53. I immediately woke her up and had her drink two juice boxes and eat five Ritz peanut butter crackers. From there, we went into prevention mode and implemented the 15:15 rule. This is a rule where we have to check her blood sugar 15 minutes later, and if it hasn't gone up, then we need to give her 15 carbs and recheck it 15 minutes after that. Basically at this point we're feeding her disease. This is what I hate about the disease. Our endocrinologist said that usually type 1 diabetics will wake up from a nightmare when their blood sugar drops too low. And if they don't, they end up in a coma. 53 was way too low for me.

I've learned a lot about what to do and what not to do with controlling Madison's blood sugar during and after a soccer, basketball and softball game. I hope the following provides a guideline for other parents of type 1 diabetic children.

• For high active sports like soccer and basketball, we've found it's better to take Madison's insulin pump off. Soccer and basketball are two highly active sports, allowing Madison to run around enough for us to take off her insulin pump during the game and practice.
• For low active sports, we've had to keep Madison's insulin pump on. We've found baseball and softball to be low active sports. Madison isn't as active during a softball game, requiring us to keep her pump on.
• During a high active game, we've consistently had to check Madison's blood sugar half way through. We've found that we've needed to give Madison at least a 15 carb juice 30 minutes after the game has started.
• During a low active sport, we haven't had to check Madison's blood sugar as much, if at all. Madison is usually good with feeling her highs and lows. And because she's not running around as much, I haven't been concernd with her blood sugar dropping. In fact, I've been more worried with it going high because she is nervous and not active. 
• Because of last night, after a tournament game, I plan to take Madison's pump off for one hour. This will eliminate basal insulin from entering her body. The excitement and stess during last nights fast pitch tournament game caused Madison's blood sugar to be unpredictable.
• Madison's blood sugar has to be in the 100's for her to play at her best for softball. We've found that if she eats a high protein meal with measurable carbs, we're better able to manage her blood sugar.
• Pizza and pasta an hour or two before a soccer game works well for Madison. But it doesn't for softball. In fact, we've found it's best not to have Madison eat a high starchy carb before a softball game, because she's not active enough to burn it off quickly.
• After a game or practice, a parent should check their type 1 diabetic child's blood sugar an hour after they go to bed, because that is the time period where their body is relaxing and blood sugar is trying to stabilize. In addition, I highly recommend checking it again one to two hours later.
• Always share your child's disease with the umpire, referree and coach. We've had several instances where I've had to call timeout to give Madison a sugar tablet.

I hope you will also share your learning lessons!