Young Voices: Allison’s Life with Diabetes
Life with diabetes
These papers are meant to answer all the questions that affect daily living when you have diabetes. It covers a broad sweep from sport to holidays to surgical operations and illness. After reading all papers, you will realize that there are very few activities that are barred to people with diabetes.
Provided that you understand the condition, you should be able to do almost anything you wish.
Sports
My 13-year-old son is a keen footballer and has just developed diabetes. Will he be able to continue football and other sports? If so, what precautions should he take?
Your son can certainly keep on with his football. There is a very well known professional football player who has Type 1 diabetes so, if your son is good enough at the game, diabetes should not stop him becoming another great footballer. People with diabetes have reached the top in other sports, such as rugby, cricket, tennis, sailing, rowing, orienteering, and mountaineering. Certainly all normal school sports should be encouraged. There is, of course, the difficulty that the extra energy used in competitive sports increases the risk of a hypo. Your son should take some extra carbohydrate before a match or any other sports period – he could have a couple of sandwiches or biscuits or chocolate wafers. He will probably need another snack or maybe a sugary drink like fruit juice at half-time, and if possible should carry glucose tablets in his pocket.
He also needs to watch what he eats after the game has finished. The effect of exercise on the body can last well after the exercise has stopped (the muscles are restocking their energy stores with glycogen) and often blood glucose drops 2 or more hours after the exercise period. So he may need a snack then or, if he is due a meal anyway, he may need to eat slightly more than usual. It would also be a good idea to increase the usual bedtime snack if he has been exercising in the afternoon or evening. It’s always best to monitor blood glucose levels in this situation. Another way of preventing a hypo during exercise is to reduce the amount of insulin beforehand. So, if he is playing football in the morning, he could reduce his morning dose of quick-acting insulin by half. It takes trial and error to discover by exactly how much to reduce insulin for a given amount of exercise.
I used to enjoy swimming, but have been worried about going back to the pool since I have been on insulin. What if I had a hypo?
Whilst a hypo during athletics and most team games can be inconvenient, a hypo while swimming can be more serious and you are right to be concerned about it. However, don’t let your concern stop you swimming, just make sure that you are sensible about it. There are certain simple rules that all people taking insulin should follow before swimming – by following them you can swim with complete safety:
• Never swim alone.
• Tell your companions (or teacher if you are still at school) to pull you out of the water if you behave oddly or are in difficulties.
• Keep glucose tablets on the side of the pool.
• Get out of the water immediately if you feel the first signs of a hypo.
If you are a keen swimmer and want to take up scuba diving, then the British Sub-Aqua Club does impose some restrictions.
They require people taking insulin who wish to scuba dive to have an annual medical review, not to have any long-term complications of diabetes, and insist that they always dive with another person who does not have diabetes.
Can I take part in all or any forms of sport?
The vast majority of sports are perfectly safe for people with diabetes. The problem lies in those sports where loss of control due to a hypo could be dangerous, not only to you but to fellow participants or spectators. Swimming is an example of a potentially dangerous sport but, if you take certain precautions (see previous question), it is safe to swim. However, in other sports (e.g. motor racing), the risk of serious injury in the case of a hypo is even greater. The governing bodies of such high-risk sports discourage people with diabetes from taking part. Discouragementdoes not necessarily mean a total ban – the restrictions may vary depending on whether you are on diet, diet and tablets, or insulin. You can always contact the appropriate governing body and ask for their advice, and find out what (if any) restrictions they impose
Are people with diabetes allowed to go parachuting? I want to do a sponsored parachute jump to raise money for charity.
You can probably do your sponsored jump, but it will depend on your current treatment. If you are on diet alone, or on diet and biguanides, restrictions are minimal. If you are on sulphonyl-ureas or insulin the restrictions are much greater – you will need a medical certificate to state that you are well controlled, and you will be permitted only to jump in tandem.
As a 30-year-old with Type 1 diabetes, can I join a keep fit class or do a work-out at home?
Yes, certainly. Keeping fit is important for everybody. Like everyone else, if you are unused to exercise, you should build up the exercises slowly week by week to avoid damaging muscles or tendons. Remember that exercise usually has the effect of lowering blood glucose, so you may need to reduce the insulin dose or take extra carbohydrate beforehand.
I have Type 2 diabetes and am overweight and not well controlled despite a maximum dose of tablets. I have been advised to join an exercise class. Will this be worth the effort?
People with Type 2 diabetes are usually overweight and do not take enough exercise. Lack of exercise is a risk factor for the development of Type 2 diabetes and vascular disease. It has been shown beyond doubt that, if you can change your lifestyle to include regular exercise and improve your fitness, this will have a major beneficial effect on your diabetic control and cardiac risk factors.
I take insulin and jog quite a bit. I would like to try running a marathon. Have you any advice on the subject?
Dawn Kenwright, who has Type 1 diabetes, is a long-distance runner at international level. Dawn resumed training within a few weeks of starting insulin and worked hard to discover by trial and error the effect of exercise/food/insulin on her blood glucose levels. Before running, Dawn has found that she needs plenty of ‘slow’ carbohydrate (in the form of porridge) to maintain her energy levels. During training sessions Dawn wears a bumbag containing glucose tablets and solution, but in competition she cuts back her insulin drastically and just carries glucose tablets.
With careful preparation she rarely needs extra glucose. Dawn warns you to progress gradually from jogging up to a full marathon distance. She stresses that what is right for her will not necessarily suit everyone and makes the point that each athlete with diabetes has to work out their own solution for their particular sport. Diabetes UK produces fact sheets on long distance running and some other sports. Once you have reached the required standard, you should think of joining Diabetes UK’s team for the London Marathon.
