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

●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

●Dehydration

●High blood sugars

●Ketones

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.

Of those drownings, 26 were backyard or community pools.

If you believe swim lessons are nothing more than a fun summer activity, think again. The skills children learn in swim classes could make the difference in life and death.

During swim lessons, kids get used to the water and learn important water safety skills. According to Safe Kids Tarrant County, led by Cook Children's, children who don't know how to swim or who are being supervised by adults who can't swim are eight times more likely to drown or fatally drown.

"Children as young as 2 to 3 years old develop the ability to self-rescue during swim lessons, which means that if they fall into a swimming pool, they can turn around in the water and either float on their back until rescued or use the skills they have learned to swim to the side of the pool," said Tyler Emler, action team chair for drowning prevention for Safe Kids. "The sooner children get in the water, the sooner they become comfortable with swimming. If you wait until children are 6-8 years old to begin swim lessons, they won't have the same comfort level as children who have been in the water since they were younger."

Which swim class is best?

When choosing swim lessons for your child, visit local health clubs and recreational centers to meet with swim instructors and educate yourself on the classes offered. 

According to Emler, the most successful classes teach a love for water while also building necessary swimming and water safety skills.

While swim classes should have accommodations in place to assist children who don't acclimate to the water or who aren't reaching swim class goals, Emler notes that parents can help their child's progress by spending family time in the pool and stopping any pressure a child may feel to master skills more quickly. 

Young children who take swim classes in late spring or early summer should return for indoor winter refresher courses every year until they reach 6 or 7 years old. This way, coordination and muscle memory has a chance to develop, allowing children to maintain skills for longer periods of time.

For more information

Learn more about drowning prevention and water safety here. This page gives helpful information on keeping your kids safe during swim season, including proper fit for life jackets, pool safety videos and fences/alarms information.

Dr. Aaron spent her morning on Thursday, July 24, doing interviews with newspaper, radio and three local TV stations.

“I’ve never been one to reach out to the media or certainly get in front of the camera,” Dr. Aaron said. “I’ve had those times where I’ve been asked to be on camera and needed to do that. This is the first time where I’ve ever picked up the phone and called our team and said, ‘Guys, we need to do something. We need to reach out because three in one week … that’s just too many.’”

The mother of a 2-year-old son, the swimming deaths hit way too close for Dr. Aaron. All three children who died were between the ages of 2 to 4 years old. The teams at Cook Children’s involved in the three drowning events met with Cameron Brown, a member of Cook Children’s Pastoral Care and a firefighter, who is specially trained to lead caregivers through a critical incident stress debriefing. To put it simply, they were heart broken.

“This is what we do. This is our profession, but it impacts us,” Dr. Aaron said. “We’ve had great sorrow. That is minimal to what we sense must be happening with these families and close friends. It’s unusual for us to have three cases in one week ... and we still have many weeks of summer left.”

What makes the deaths even more tragic is the fact that most drownings are preventable. Dana Walraven, Cook Children’s Community Health Outreach manager and Safe Kids Tarrant County coordinator, also spent the day with media to discuss drowning prevention steps. Texas has the highest incidence of swimming pool- and spa-related childhood drownings in the United States. All three children who died were pool related incidents.

Drowning is the leading cause of unintentional deaths for children 1 to 4 years of age. The common myth of children splashing, waving their arms around and yelling is simply not true.

“In many drowning situations, an adult was just a few feet away from the pool and didn’t realize anything was wrong because he or she didn’t hear any sounds of distress, such as splashing or yelling,” Walraven said. “Drowning is a silent event that can occur in the time it takes to send a text message. Should supervision fail for any reason, having multiple layers in place helps protect your child.”

Walraven offers these drowning prevention basics:

• Have your children take swim lessons.
• Have the entire family taking swim and safety lessons.
• Learn CPR.
• Provide 100 percent supervision without distractions.
• Use pool and child alarms to alert you if your child gets in the water without you.
• Isolate your pool from the rest of your backyards with a permanent, four-sided fence with self-latching gates to prevent kids from accessing the pool area without adult supervision.

“We realize that it could happen to anyone,” Dr. Aaron said. “It happens very, very quickly. We’re not being judgmental. We feel so strongly about this and knowing how it impacts us we wanted to reach out and raise awareness to the community.”

For more information:

• Drowning prevention
• Water safety
• Vento family story
• Cookchildrens.org/safety
• Backyard and Pool: Household Safety Checklist
• Household Safety: Preventing Drowning