Replies to This Discussion

Permalink Reply by Patti on January 1, 2012 at 5:54pm

Any chance his PE time could be moved to either first thing in the morning or after lunch? . Instead of juice, we usually use some sort of protein bar, or a combination of fruit and crackers - this seems to have a little more staying power than the juice, and doesn't spike their blood sugar.

Although lowering his basal is an option, it shouldn't prevent him from testing before PE Our endo is adamant that this be done, as they can go low pretty quickly with exercise and they need to be sure they are in range before exercising (or driving for that matter).

My younger son has the same testing anxiety issues in public. We have tried our best to have him overcome this, but for now, have written it into his 504 plan that he is allowed extra time to test and afforded privacy to do so.

Good luck! Patti

Permalink Reply by daneenm on January 1, 2012 at 6:33pm

I would insist on testing before PE unless it is directly after snack or meal time. Having said that, in our experience juice works well for PE because the spike hits just as they are needing it for exercise. The other trick we have been using for swim practice is nursing a small Gatorade over the course of the practice. He could do the same over his PE period. We turn down my son's basal for swim practice, but not for PE - he does not expend as much energy during PE, but he is only in 5th grade. For a middle or high school period, I would likely have him turn down for just the PE hour if the exercise is heavy.

Permalink Reply by Larry D on January 1, 2012 at 6:44pm

One of the challenges of gym is that the amount of physical activity will vary from day to day. Some days are very intense and some days are fairly light. My daughter has learned that at least for her that she needs to test before and after PE and adjust accordingly. We have a plan in place for her which varies according to the intensity of the physical exercise. Unfortunately, at least in our case, testing is not an option.

One day in October I got a call to come to the school. That morning she had a timed one mile run. After the run, she hit a low of 42 and she could not get her BG to rise above 60. I called her endo and directed us to suspend her basal until her BG was over 100. She also suggested that we give her some complex carbs in addition to the simple carbs. I stayed with her until she stabilized and it took almost 3 hours and the consumption of over 200 carbs to get her BG above 100.

For her, on most PE days, a temp basal with a 30% reduction for 3 hours is the right adjustment, but testing allows her to adjust to the specifics of that day.

Larry

Permalink Reply by Sophia'smommyLori on January 1, 2012 at 7:39pm

Hi Amy, Sophia ALWAYS tests before exercise (and sometimes after) but lowering her basal rate an hour prior to activity and for a hour after decreases her lows. It just keeps her from having to take MORE time away from her peers/activity by having to "test, snack, test, ok, you can play now but you only have 5 min left" and it keeps her pretty stable. Hope that helps.

Permalink Reply by Natasha Bowlds on January 1, 2012 at 10:13pm

This is what we do as well. We have a reduced basal for PE, but my son has to check as well. He has to report his blood sugar to the PE teacher - who trusts that my son knows what to do about it, but it keeps him accountable. Have you considered a CGM? That has made a huge difference to how often my son actually checks. If the CGM says he's in the 150-200 range for example, he usually won't check.

Permalink Reply by Tracy Greene Mintz on January 2, 2012 at 8:15am

This is one of the best arguments I can make for insisting on a 504 plan at school. A child with T1D needs a special accommodation so that he or she can have the same school experience as his/her peers. That includes PE, and in some cases PE is a graded class so participation is a must. I also like the idea of identifying 1 or 2 kids in the class to act as a "diabetes buddy" in PE so they can sort of know what to look for in your child and alert an adult. It's not putting a responsibility on another kid, but rather an act of camaraderie and kindness that many kids are perfectly happy and willing to do. This helps dispel some of the 'different treatment' thing, too, when others are vested in the safety of their classmate.
That being said, my daughter also wants to avoid extra testing at school. Her teacher takes a juice out to PE with them and Maxine just sucks it down if she needs it. Then her teacher calls the health clerk to test her after PE. THIS IS IN HER 504 PLAN: SOMEONE COME TO HER SO SHE DOESN'T HAVE TO TRAIPSE ALL OVER SCHOOL TO TEST. She's in 5th grade. When she starts junior high next year, we will switch to a granola bar type thing because PE is longer.

Permalink Reply by Aimee on January 3, 2012 at 11:13am

My daughter has PE before lunch 1 day per week and PE after lunch 1 day per week. We have been giving her an extra 15 carbs in her lunch that are not covered with insulin just on those days. This works for her as she does not go low before lunch; the low happens later in the afternoon. She already has a midmorning safety check every day, so if she is less than 100 before PE she would get a small snack anyway. This works for us. The basal idea sounds great, but if you find that his lows are happening later, you may want to try this approach.

Good luck, this is dificult to manage! I am constantly trying to minimize the time my daughter spends outside the classroom, but still keep her safe.