Parents and guardians need to take an active role in ensuring that children with diabetes are exercising frequently and appropriately. Parents should schedule a pre-workout checkup with an endocrinologist or pediatrician before enrolling the child in a new sport or exercise program. The physician will review the child’s diabetes care plan, which includes general information such as diagnosis date and emergency contacts, as well as:

• Instructions on how and when to check glucose (blood sugar) levels
  
  
• Instructions on how and when to take insulin and/or antidiabetic agents
  
  
• Glucose guidelines, including the acceptable range for exercise
  
  
• A schedule of meal and snack times, including any necessary adjustments for exercise
  
  
• Instructions on how to handle a complication such as hypoglycemia or insulin shock

The pediatrician will also discuss appropriate activities with the adult and child, and remind them about exercise precautions specific to diabetes.

Parents and guardians should notify certain school staff or youth leaders, such as nurses, teachers, coaches, scout leaders and church group leaders, of their child’s condition. It is a good idea to provide all relevant personnel with a copy of the child’s diabetes care plan.

Additionally, the parent should make arrangements with staff regarding the storage of the child’s diabetes equipment and supplies, such as insulin administration devices (e.g., insulin pen), glucose meters and ketone test strips. If glucagon is to be administered in case of a hypoglycemic emergency, the appropriate personnel should be trained in how to inject this medication.

Some children do not enjoy or seek out exercise. Parents and guardians can promote physical activity of diabetic children in a variety of ways. These include:

• Speaking with the child’s school about increasing scheduled active time for students
  
  
• Involving their child in activity programs with community organizations
  
  
• Volunteering to help revitalize community playgrounds
  
  
• Encouraging the child to enroll in dance or martial arts classes, or trying out for a team sport.
  
  
• Replacing computer and television time with active family time, such as a family bike ride
  
  
• Walking the child to school or encouraging bicycle riding
  
  
• Planning family vacations that involve physical activities, such as walking tours or horseback riding
  
  
• Praising their child for performing household chores such as mowing the lawn, raking leaves or shoveling snow
  
  
• Setting a good example for the child by exercising regularly, eating a nutritious controlled-calorie diet and practicing other good health habits