By Quentin Van Meter, M.D., Pediatric Endocrinologist
Twenty years ago, if you invited a Type 1 diabetic to your home for dinner, there’s a good chance you would have altered the menu to include sugar-free options. Thanks to improvements in glucose measurement, carb counting and long-acting insulins, today’s diabetics enjoy a normal diet. In kid terms, school-aged children are not restricted from eating whatever their classmates are eating in the cafeteria—of course, healthy choices are always best.
Caretakers who have never dealt with insulin pumps or carb counting—especially those with memories of diabetics injecting themselves six or more times a day in the 70s, 80s and early 90s—are often intimated by the disease. My advice? Relax!
Long-acting insulin, in particular, has changed the landscape of diabetes management. Today’s diabetics lead active lives and adjust their insulin based on what they’ll consume—instead of visa versa.
Before you hit the road for an away game, plan a birthday party or leave the classroom for recess with a diabetic child in tow, here are tips to keep in mind:
- The primary concern for coaches of diabetic athletes is hypoglycemia, or low blood sugar. It’s possible for an athlete to overdose on insulin or under-eat in relationship to his or her caloric needs. Diabetics—or, often in the case of children, their caretakers—usually keep some type of easily digested carbohydrate, like juice or glucose tablets, on hand to counter early symptoms such as pounding heart, dizziness, pale skin or weakness. As a coach of a diabetic athlete, keep a snack like peanut butter or cheese crackers on hand after the quick carbs are ingested and the blood sugar is on the rise. Also, there’s no need to fear rigorous activity! With intense excitement, adrenaline can cause blood sugar to go up instead of down. If an exercise-related drop in sugar occurs, it’s more common to occur after activity stops. That said, be mindful of your diabetic athlete even after a practice or game.
For part-time caretakers or camp counselors:
- If a diabetic teen spends the day playing freeze tag and intermittently snacks on “teen food” like chips and pretzels, come 2 a.m. he may become hypoglycemic as his muscles respond to physical work from the day before. Encourage consumption of a well-balanced meal, especially at dinnertime, and a substantial snack of fat/protein at bedtime. It’s also a good idea to make sure a sleepover guest knows where to find a quick source of easily digested carbs in the middle of the night.
- If you plan to serve beverages like juices or diet soda, go for cans. While diabetics can handle sugary drinks, it’s best—as it is with anyone—to control the volume of consumption. And, individual serving sizes are an easy way to do that.
- Situations that can affect blood sugar include insulin, food intake, exercise, illness, stress and changes in routine. It’s always good idea to carry a portable snack whenever a diabetic student leaves the classroom. This is especially important during fire drills, earthquake drills, field trips, special presentations and assemblies. If your student tells you he or she “feels low,” give the student a quick-acting carbohydrate snack such as fruit juice or regular soda. If your student needs to see the nurse, be sure to send a buddy with them. Never leave a child alone or send him or her anywhere alone when experiencing low blood sugar.
Remember that diabetes is something you want to keep in mind, but not something that should disrupt your teaching, coaching, babysitting or any other care-taking role you may play in the life of a child. It’s always good to stay informed, and don’t be afraid to ask questions of the child or his or parents.
You can also find a wealth of resources here.