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Question:

From Wisconsin, USA:

My daughter is 10 years old with type 1. She has had diabetes for almost 5 years and is on tight control.

I am looking for information to provide a teacher on how much carbohydrates student should eat before exercise (gym class) depending on what blood glucose is and how long (1 hour class) and strenuous exercise (run mile) will be. I want to give them good information because gym class is towards the end of the day and my daughter has to ride a bus for 65 minutes before she gets home.

Answer:

This is really individualized, but I would err on the side of having her blood glucoses be on the higher side. If she is on NPH and you can lower her dose in the A.M., that may be the best so she does not have to eat before class (messy and then often folks do not feel like exercising or running a mile after eating).

Doing her blood glucose test before the gym period is imperative, as is making sure someone she is with knows she has diabetes, especially if she is out running a mile. Anyway, we suggest, for 1 hour of moderate activity, that if blood glucose is 100 or less, consume about 35-50 grams of carbohydrate (usually a Nutrigrain or similar bar and small juice) and if blood glucose is between 100 and 200, have just the juice or a couple of graham crackers. Be sure to test blood glucose after the gym class and keep some glucose tabs with her at all times, especially on the bus.

LSF

Additional comments from Patricia Larsen:

The answer above is right on the money.

  1. It needs to be individualized,
  2. It may be better to have the child's blood glucose on the higher side,
  3. If on NPH you may want to lower the A.M. dose (of course with the recommendation of the physician or diabetes educator),
  4. monitoring blood glucose before and after activity,
  5. carrying a simple carbohydate as well as consuming carbohydrates if need be before the activity.

I believe the November/December issue of Diabetes Self-Management, page 55, 1993 has examples of extra light snacks, light snacks, medium snacks, and medium plus snacks 10 grams - 35 grams of carbohydrate per serving.

There is also another article in Diabetes Spectrum where there's a table that refelcts intensity of exercise and grams of carbohydrate needed for physical education class that may be helpful for the physical education teacher. See:

"Diabetes Care in Schools: Guidelines for Health-Care Professionals Who Care for School-Age Children" by Donna L. Jornsay and Teresa M. Carney. Diabetes Spectrum, Volume 5 Number 5, 1992. Table 1: Classifications and examples of school physical education activities, page 264.

PL

Original posting 30 Sep 1998
Posted to Exercise and Sports and Social Issues: School and Daycare

  
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Last Updated: Tuesday April 06, 2010 15:09:00
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