Shannon Snodgrass PT, Rehab One

The American Diabetes Association estimates approximately 16 million people in the United States have diabetes. Diabetes affects nearly one in 17 people and is a leading cause of death. People who work with diabetic children and young adults, whether in school or in other activities, should become familiar with their needs.

Five to ten percent of diabetics are Type 1 or insulin dependent. Almost half these people are age 20 and younger. People with Type I diabetes do not produce insulin, which is necessary to regulate blood sugar levels in the body. Although regular shots of insulin help keep glucose levels normal, insulin is not a cure.

Diabetic children and sports

Children and young adults are most susceptible to Type 1 diabetes. In fact, it used to be called juvenile-onset diabetes. Traditionally, children with Type 1 diabetes were warned against participating in physical and extra-curricular activities. With proper care and knowledgeable supervision, however, these children can participate.

The key to controlling diabetes is to keep blood sugar levels as close to normal as possible. A constant balance of food, exercise, and insulin is necessary.

Hypoglycemia and hyperglycemia

If imbalance occurs, two emergency situations may arise: hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Food makes glucose levels rise and insulin makes glucose levels fall.

Symptoms of hypoglycemia occur very quickly. These may include drowsiness, confusion and inattention, pale complexion, perspiration, crankiness, headache, lack of coordination, trembling, sudden hunger and dizziness.

Hypoglycemia may be caused by eating too little, excessive exercise without eating or too much insulin.

If a child in your care experiences any symptoms of hypoglycemia, provide sugar immediately. One to two sugar packets, 1/2 cup of fruit juice or regular soda pop or candy equivalent to 6 to 7 lifesavers is appropriate.

If the child feels better within 10 minutes, additional food may be given and normal activities resumed. If no improvement is seen, parents or the child's physician should be notified immediately and more sugar should be given.

Symptoms of hyperglycemia occur gradually over a period of days. These include extreme thirst, drowsiness, lethargy, dry and hot skin, frequent urination, sugar in urine, blood test showing high glucose level, lack of hunger, fruity odor on breath, heavy and labored breathing, blurred vision and possibly even stupor or unconsciousness.

If these symptoms occur, take the child to the hospital.

Daily needs

According to the Juvenile Diabetes Association, a diabetic child's daily routine should consist of regular meals, regular exercise and regular insulin. Glucose levels should be monitored at various times of the day. Additional snacks may be needed to keep glucose levels normal.

Before planned strenuous activity, an extra snack of sugary food may be necessary to avoid low blood sugar. Exercise should not be planned before a regular meal. Children with diabetes should avoid concentrated sweets such as candy, syrups or frostings.

Improper control of diabetes can lead to many types of complications. These problems include heart disease, stroke and cardiovascular disease, all of which can be fatal; kidney disease; eye disease or blindness; and nervous system disorders which can lead to decreased pain sensation, especially in legs and feet.

There is no cure for diabetes. If managed properly, however, children with diabetes can participate in physical activities. It is vital that adults are knowledgeable about their needs. Knowing the facts enables appropriate support and aid.

Shannon Snodgrass is a physical therapist at the Boone Memorial Hospital Physical Therapy Sports Medicine Center. For further information call 304-369-5719