Managing Baseball and Diabetes
My son Ryan, age 13, has had diabetes for five years now. From the very beginning, we were determined not to let diabetes stand in the way of anything he wanted to do. And what he wants to do is play sports.
Before I go any further, let me add this disclaimer. What I'm going to tell you is how it works for us. Every diabetic child is different, as you know. These things may not work for you. Diabetes is a series of trials and errors. Sometimes more errors, it seems. I guess we tend to be a little more liberal in our outlook on diabetes, because we refuse to let it control us. We control it. Period. Yet, Ryan still remains in good control. His last two A1C's were 6.5, which indicates the level of his control.
We've found that if Ryan is in good control, we can be more flexible with his diet and schedule and it won't affect him greatly. But if he's not in control, any little thing sends his blood sugars sky high. You need to know how certain things affect *your* child. Try something. If it works, wonderful! If it doesn't, try something else. What works one day may not work the next. Trial and error. But don't let it control you! That's so important.
There's no doubt about it. Playing organized sports makes controlling diabetes a real challenge. But it can be done. There were times when Ryan would have baseball practice for eight (yes, eight!) hours a day. Or, he'd practice until 11:00 at night. The key is to be prepared. For anything, at any time. All the time.
Let's say Ryan has a game at 8:00 p.m., and he has to be at the park at 7:00 p.m. We take his blood sugar around 5:30, give him his insulin (Ryan's on two shots of NPH and R a day), then eat supper at 6:00. No problem or major change in schedule. I don't generally lower his night time NPH because of a ballgame. Though baseball can be a strenuous sport, his morning blood sugars after a game usually don't indicate the need for decreasing the NPH. As a general rule, before a game, I usually cut back the R by one unit, to help eliminate the possibility of having a low during a game. Another point: before games or strenuous exercise using the *legs*, we don't inject his insulin in his thighs. Instead, we use the abdomen. If he injects in the leg and goes outside and runs, the insulin in that warm appendage will get into the blood stream faster, possibly causing him to have a low blood sugar.
If he has a game at 6:00 p.m., things get a little tricky. He has to be at the park at 5:00, which means we'd have to eat supper so early. So, we flipflop his supper with his nighttime snack. We test his blood sugar before we leave for the park, and give him something to eat (this is his "night time" snack). We do *not* give him his insulin at that time. The reason is that the snack will never be as large as a meal, and I don't want to run the risk of his having a low blood sugar on the field. I don't do anything if his blood sugar is high, unless it's extremely high, and he doesn't eat a snack at that time. After the game, he takes his blood sugar and has his injection. I cut back on the R in that injection, but I generally don't cut back on the NPH. Then, he eats supper.
No matter when the games are, we always make him test his blood sugar again before he goes to bed. If his blood sugar is under 90, he gets another snack--a starch and a milk, at least.
Remember that exercise not only affects the blood sugar at the time it's happening, but it also affects the blood sugar for around eighteen hours afterward, if I remember correctly. Watch your child carefully after strenuous exercise. Make sure he gets plenty to eat, and always check his blood sugar before he goes to bed. The severely low blood sugars that Ryan has had have always occurred after several days of strenuous exercise. But that's another topic for discussion later
During the game, we let Ryan drink regular soft drinks, not diet. There's nothing worse for a parent to be on the bench watching her child play second base, wondering if he's low. Did he just wobble a little when he caught that ball, or was the glare of the lights in his eyes? We operate on the philosophy that it's best to prevent a low blood sugar from happening versus treating it after the fact.
So, this is one of those times that he can drink regular soft drinks, and he loves it! At all day practices, or days when several games are played almost back to back, we'll give Ryan a candy bar either before the games start, or in the middle. Because of the exercise, the candy doesn't affect his blood sugar. In fact, it's wonderful knowing that it's keeping him from being low.
Like I mentioned before, baseball games don't indicate the need to decrease Ryan's night time NPH. But, certain sports do. When he roller skates, we always cut back his night time NPH by around 3 units, as well as cutting back on his R as well. This is one of those times that you have to try it and see if it works, making adjustments along the way. Because it worked for us last year doesn't mean it'll work this year.
Ryan always has little boxes of raisins or glucose tablets with him at all times. This means he carries something in his bat bag to ballgames. His coaches always know that he has diabetes, but he's at the age where he doesn't want any of his buddies to know. We try to respect his feelings, as long as we can make sure he's well taken care of. And I always have boxes of raisins and glucose tablets in my purse, even more during baseball season. There have been many times when he gets low, we treat it, he gets low again, we treat it, and he gets low yet again. Be prepared. Don't just have one of anything. Have several. Lows can come in spurts, believe me.
Another difficulty during ball season is the erratic schedule due to games or practices. One night he may practice at 5:00. The next night, he has an 8:00 game. Then the next night, he may practice at 6:00. So, we don't have a regular time to eat meals. It's not ideal, but we do the best we can, and it's never presented problems. Obviously, if he generally takes his blood sugar at 5:30 in order to eat supper at 6:00, if he takes his blood sugar at 4:00, his reading will probably be higher. But we have found that it averages out in the end, and things are back to normal the next day.
When Ryan is grown, he won't look back on his childhood and think of the things he wasn't able to do because he has diabetes. It makes things a little tricky for us as parents, but we can handle it. We can handle anything for our child.
So here are the "rules":
- Before a game, TEST!! Give a snack if needed.
- If insulin is given before a game, consider lowering the dosage.
- Make sure he gets something to eat or drink during the game, such as a regular soft drink.
- Make sure he has something to pull up a low with him at all times.
- TEST after the game.
- Give a hearty snack before bedtime.
- TEST again! If his blood sugar is below 90, give a starch and milk, at least.
- Watch him closely afterward for signs of a low blood sugar.
- Most importantly, let him have fun!
If you have any questions or comments, please let me know.
Last Updated: Wednesday March 16, 2005 16:44:54
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