Swimming with Type 1 diabetes checklist
What children with Type 1 must bring with them swimming
As we begin the swimming season, common sense advice is useful in all instances for parents; however, there are situations where children have additional challenges making plans for swim trips and water safety even more important. In my field, children with Type 1 diabetes are one group where awareness and planning are needed to ensure a safe fun time whether at the pool, beach or lake.
Planning and gear is necessary when setting off for a day of water fun, but for kids with diabetes it can sometimes feel like an Everest expedition. Their checklist can include any or all of the items below:
●Blood glucose meter
●Supplies to check blood sugar
●A cooler or ice packs to keep insulin cool
●Insulin injection supplies
●Insulin pump supplies
●Snacks for low blood sugars
Children and their families with Type 1 diabetes deal with additional risks on top of the typical worries that all families deal with. Some diabetes specific risks include:
●Low blood sugar
●High blood sugars
The wisdom and experience of a parent of a child with Type 1 diabetes adds more practical value. I discovered this article on swimming with Type 1 diabetes.
I reached out via Twitter to the mom and author of the article. As the mother of two girls with Type 1 diabetes, she had a lot of good, practical advice, which I endorse and would give to my own patients.
I know it helps to here from other moms. Here are some of the thoughts and tips that she shared about her now older girls.
Importance of swim lessons
My girls passed all of their swim lessons and have reached the level that will safely take them into adulthood ... I still tend to hold the book and scan the water until both are safely drying off on my blanket. Once a mom, well, always a mom.
“Managing” blood sugars
Despite this natural maturity and necessary growth, our family is still cautious with Type 1 diabetes and swimming. We know that blood sugar management during exercise can be tricky on a good day, let alone, on a day of intense swimming, where every single muscle is engaged and active.
Here is a list of strategies that we use to help keep teenager independence while staying healthy with Type 1 diabetes.
1.Check blood sugar before you go into the water.
2.Blood sugar MUST be above 100 mg/dl.
3.If not, BEFORE swimming, eat a small protein and carb snack and do not bolus. Our girls like re-sealable chocolate milk jugs, cheese and crackers or small peanut butter and jelly sandwiches.
4.Swim with a buddy and never alone.
5.Every hour, get out of the water and check blood glucose.
6.If blood sugar is rising, which often happens due to adrenaline during exercise, reconnect the pump and take ½ of the recommended bolus amount. This also helps to avoid ketones from lack of insulin.
7.Stay hydrated. Even if you feel like you are not thirsty, drink 8 ounces of water each time you are checking your blood sugar.
8.Always bring money. If you find yourself eating through snacks, be prepared to purchase carb-laden food from the snack machine or beach shack. This happens more often than not, so I stress this often!
9.Be prepared for lows that might happen an hour or two after leaving the water. With T1d, it’s not just the first event (swimming), but the second, third and fourth events that need proper planning. For that reason, always tuck in more glucose, more meter strips and extra supplies than you think you might need. Chances are, you will need it!
I hope this article was helpful and makes for a better water safety experience.
My gratitude to naturallysweetsisters.com for sharing.
Joel Steelman, M.D., is an endocrinologist at the Cook Children's Endocrine and Diabetes program, which treats infants, children and teens with conditions that are caused by or affect the hormonal balance of the body. We understand the importance of working together and that's how we approach the care of our children.