TYPE I AND II DIABETES

There are two principle types of diabetes: type I and type II. With type I, the body is unable to produce any insulin at all, and regular injections of insulin are needed to keep levels of blood sugar as normal as possible. Type 1 is the most common form of diabetes in children: 90–95 per cent of under 16s with diabetes have this type.

However, type II diabetes, previously known as adult-onset diabetes, is on the increase in children. It is rarely seen in people who are not overweight, and scientists predict that as the obesity epidemic spreads so the number of children who develop type II diabetes will continue to grow.

Those with type II diabetes can make insulin, but the body does not respond to it normally so oral medication and/or injections may be needed.

Diabetes increases the risk of developing heart disease, strokes and kidney failure in later life.

Managing diabetes requires a constant balancing of diet, exercise and medication to maintain blood glucose levels as close to normal as possible. Children with both type I (insulin dependent) and type II (non-insulin dependent) diabetes should be encouraged to take part in regular activity.

Exercise is particularly important in keeping blood sugar levels under control and improves the body’s response to insulin. Added to which, regular exercise together with a good diet is the best way to maintain a healthy weight, which can reduce the risk of heart disease in adulthood.

The biggest risk from exercise for children with diabetes comes from hypoglycaemia. Exercise lowers blood sugar, and since diabetics can have low normal sugar levels this can be a problem if it is not managed.

Once again though, with the right precautions and as long as your child is educated about her condition, the benefits of regular exercise for diabetic children far outweigh the risks. The following list of Dos and Don’ts may help your diabetic child get the most from her physical activities:

-Do talk with your doctor about exercise and how to manage your child’s total programme. Some exercises may not be appropriate for her.

-Do make sure teachers, coaches and instructors understand the importance of adhering to your child’s meal and snack plan.

-Do try to make sure she exercises every day at the same time. Be as consistent with her exercise as she is with her mealtimes and insulin injections.

-Do exercise soon after eating – when blood sugar levels are at their highest.

-Do get her to test her blood sugar levels before exercising.

-Do ask her to exercise with a friend if possible and be on the lookout for signs of hypoglycaemia.

-Do give her a small snack or fruit juice to eat or drink 15 to 20 minutes before she exercises if her blood sugar levels are not too high. Get her to carry a fast carbohydrate pick-me-up with her when exercising, just in case.

-Don’t inject insulin into a part of the body that’s being exercised. It will be absorbed faster there.

-Don’t exercise when insulin is working at peak action. If she must, she should eat before she exercises.

-Do make sure adults supervising your child during sports or activities know what to do in case of an emergency.

-Do get her to carry or wear medical identification giving the necessary emergency information.

Choosing suitable activities

A child with diabetes can have a go at any sport as long as she bears in mind the advice about monitoring blood sugar and follows the above precautions. If she has been newly diagnosed, it is best to pick a sport that is ‘continuous’ such as cycling, swimming or walking/hiking since it is easier to calculate and monitor how much energy is being expended and therefore how much glucose will be used.