Why Get Kids With Type 1 Diabetes Moving?
Regular exercise is good for everyone, with or without diabetes. But for children and adolescents managing type 1 diabetes, making daily physical activity a regular part of their life can make a big difference in their care. It can:
- Help lower their blood sugar
- Improve their body’s ability to use insulin
- Help them develop healthy habits for the future
Given the current obesity epidemic, teaching all children about the value of physical activity has never been more important. There’s been a lot of talk in the media about the rise in the number of overweight and obese children and the increasing problem of type 2 diabetes occurring in children. However, children with type 1 diabetes may also become overweight or obese. For these children, exercise is very much encouraged as an important part of a weight management program.
Medical studies in children have shown that discouraging inactive time, like hours spent in front of a TV or computer monitor, is an effective way to increase physical activity and encourage weight loss in inactive children.
How active should children with type 1 diabetes be?
Physical activity should be encouraged in age-appropriate ways from the time children are very small through to adulthood.
From birth to age 4: Obviously you wouldn’t make an infant do calisthenics, but infants and toddlers should be encouraged and allowed to safely explore movement and the world around them.
- Toddlers should be physically active for at least 30 minutes a day, with physical activity being largely unstructured play that can last for more than 30 minutes at a time
- Except during sleep, toddlers should not be sedentary (inactive) for more than 60 minutes at a time to encourage motor skill development
- Preschoolers should have at least 60 minutes of structured physical activity daily, along with several hours of unstructured play each day. The physical activity of preschoolers continues to help them develop motor skills and enhances their socialization
- It is important for supervising adults to check the young child’s blood sugar frequently because children this young may not be able to communicate the symptoms of low blood sugar
Young children aged 5 to 11 years and adolescents aged 12 to 17 years:
Recommendations for daily exercise in all children and adolescents with type 1 diabetes include:
- At least 60 minutes of total physical activity every day
- Vigorous-intensity aerobic activities at least 3 days a week
- Activities that strengthen muscle and bone at least 3 days a week
Young children and teens should be physically active as part of their everyday lives, including playtime, games, sports, recreation, and gym class. They should also take part in planned exercise that fits within their family, school, and community activities (such as being a volunteer or part-time after-school employment). Staying active has been shown to lead to better heart health. That’s why many experts advise limiting recreational TV or computer time to less than 2 hours per day.
If you are reading this saying, “But my kid doesn’t do anywhere near that…,” take heart: even kids who go from being completely inactive to doing half of the activity they should (30 minutes a day as opposed to 60 minutes) can still get some health benefit from that level of activity. However, their activity levels need to be gradually increased for both their overall health and diabetes control. Studies show that children with type 1 diabetes who are completely inactive (sedentary) tend to have higher A1C levels than those youths with type 1 diabetes who are more active.
Physical activity and blood sugar
If you are caring for someone living with diabetes, it’s important to know the effect that exercise has on their blood sugar. In general, physical activity lowers blood sugar. However, different levels and types of activity affect blood sugar in different ways. And some can even cause blood sugar to rise.
Short periods of intensive exercise (“anaerobic exercise”) like weightlifting can raise blood sugar levels. If there is a big rise in blood sugar, test for ketones because, in extreme circumstances, these types of exercises may lead to diabetic ketoacidosis (DKA).
Tips for avoiding low blood sugar (hypoglycemia)
Regular physical activity can be very helpful in lowering blood sugar levels. But physical activity can also put your child at risk for low blood sugar.
The combination of too much insulin and exercise can lead to low blood sugar. This may be prevented by lowering your child’s insulin dose for the meal beforehand and/or by giving him or her some fruit juice or a fast-acting carbohydrate snack before exercise.
After very hard exercise, it is important to have a meal with a good amount of complex carbohydrates. Talk to your health care provider about whether it may be necessary to adjust your child's insulin dose after exercise.
Remember to discuss your child’s physical activity plan with their diabetes care team before putting it into practice.
Tips for helping your child get active
If you’re the caregiver of a child or teen, you may feel that they spend too much time on the couch and not enough time being active. It’s hard striking that balance—you don’t want to nag and turn them off to exercise, but you know they need to be active. After all, regular physical activity can mean better blood sugar control and lower cholesterol levels. So here are some ways to get them off the couch and out moving—in a way that makes it seem like fun, not work:
- Set a good example by being active yourself. Remember, kids learn from what they see!
- Provide the gear. Give your teen equipment for physical activity: bats, balls, roller skates, bikes, or whatever will get them moving (just don’t forget the helmets, pads, and whatever other safety equipment they need, too)
- Location matters. Take your teen to places where they can be active, such as parks, baseball fields, or basketball courts. If the weather is cooperating, outdoor play is usually best
- Provide encouragement. Whether your loved one is the team’s MVP or a benchwarmer, remember to be positive about their physical activity and suggest new ways for them to be more active. Kids who are overweight or insecure about their abilities may need to lose weight or build their skills doing other activities before they can confidently play competitive or team sports
- Make it fun. If your child or teen enjoys an activity, it won’t be such a chore to get them to do it. It doesn’t have to be structured. Remember that recreational activities such as walking, running, skating, bicycling, and swimming count, too
- Turn off the TV! After dinner is prime time for TV, but this time can be better spent taking a walk or even a bike ride with your teen. You may even want to designate 1 day a week as “tech-free” and get your whole family spending their leisure time that day doing an activity rather than being “glued” to a computer, TV, or phone screen
Physical activity in disguise
You can also “sneak” physical activity into your child’s or teen’s routine! Examples of this are getting him or her to:
- Do household cleaning and chores requiring “elbow grease”
- Do yard work, whether it’s mowing t he lawn, raking, or planting flowers; if it’s winter, get them to shovel snow
- Walk the dog (or, if you don’t have a dog, get them to take a walk with you around the mall instead)
The Centers for Disease Control and Prevention (CDC) recommends that children and teens be physically active for 1 hour or more each day. As you can see, these activities can range from casual active play to team sports.