It’s sports sign-up season! Is your kid trying out for the team? From football to swimming to cross-country, each activity poses slightly different considerations when it comes to balancing blood sugar and performance. Gary Scheiner, MS, CDE, an exercise physiologist and director of Integrated Diabetes Services in Philadelphia, explains what parents need to know about how different school sports impact diabetes management.


If your child wears an insulin pump, be prepared for the possibility of “off pump” times during swim meets and practices. Some insulin pumps are waterproof, with sleeker pod styles favored for competitive swimming. When pumps aren’t pool-friendly, however, you have options. For shorter practices, your child may be able to simply disconnect from the pump while in the pool. “Because basal insulin is not delivered when kids don’t wear their pump, you generally don’t want your child disconnecting for longer than an hour,” Scheiner says. Another option is an “untethered program,” where your child switches from the pump to insulin shots for the entire day. “This can work well on swim meet days when your child is in and out of the pool for several hours,” he adds. Before your child dives into a water sport, talk to your diabetes care team about which approaches will work best.

Football, Soccer, Lacrosse, Hockey

At practices, many traditional team sports involve a lot of aerobic exercise (like running laps around the field). But during the game or match itself, kids typically engage in short-duration, high-intensity anaerobic exercise. “During aerobic activity, there is a greater chance for going low. During short bursts of anaerobic exercise, on the other hand, kids may actually see their numbers rise,” Scheiner explains. To stay within range, young athletes can perform extra checks, carry extra snacks and drinks, and fine-tune insulin on practice versus game days if certain patterns begin to emerge.


In a contact sport like wrestling (or the team sports above), continuous glucose monitoring (CGM) sensors and insulin pumps are at risk for being pulled out or broken, and removing gear before matches and tournaments may be advisable. “Like swimming, you can talk to your care team about switching to an untethered program on tournament days,” says Scheiner. Wearing devices during lower-impact team practices may be less risky, but look for specialty sports tape designed to help diabetes gear stay in place (holes in the tape fit different pumps and monitors).

Cross-Country Running

Blood glucose is continuously burned in this prime endurance sport. To stay within range and prevent lows, cross-country runners can carry snacks and sports drinks to refuel, and perform extra checks. “Wearing a CGM during cross-country and other sports can be really helpful to alert to changes in blood sugar,” Scheiner finds. Runners can carry supplies — including a cell phone and low blood sugar supplies in case of emergency — in a special runner’s pack designed not to slow them down.

Track & Field, Gymnastics, Cheering

When it’s time to compete, individual events like high jump and balance beam can trigger a short burst of adrenaline. This extra adrenaline can be a crucial part of performing well, but it can also lead to raised blood sugar levels. Kids involved in these sports should prepare to monitor blood sugars more regularly and respond accordingly.

No matter what sport your young athlete wants to play, Scheiner recommends that parents become aware of delayed-onset hypoglycemia. “This is a blood sugar drop that tends to occur four to ten hours after exhaustive exercise, but it can take place up to 24 hours later,” explains Scheiner. If your child has just played two or three games in a soccer tournament, for example, more frequent checks and adjustments may be needed for several hours afterward to keep blood sugar levels stable.

Taking part in sports is fun, builds self-confidence, and can be a way to teach kids with type 1 better self-management and control — both on and off the field. “What athletes with diabetes tend to learn quickly is that how blood sugars are managed before and after the sport greatly affects the level at which they can play,” says Scheiner. If a child experienced high blood sugar earlier in the day because a bolus was missed, for example, he or she may be dehydrated later at practice and not able to play at their best.

As Scheiner finds, “Wanting to do well at their sport can be a motivator for kids to care for their diabetes all the time.”

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

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