Playing with Diabetes

[Travis Lassiter]

About a month ago we found out out of the blue that our 14 year old daughter is a Type 1 diabetic. This hit us like a ton of bricks and was quite a shock for us. Over the past month her glucose levels have been all over the place 500 to 70 and back like a roller coaster. In spite of that, my daughter has taken ownership of it and is counting her carbs, taking insulin etc. as she should all on her own with absolutely no issues. She's really been a champ about it. She's told me that it's just another challenge she'll have to overcome in order to reach her dreams.

She was prescribed a FreeStyle Libre CGM yesterday. We hope that the Libre will make it much easier for her to keep track of her glucose levels while playing. I'm here for any and all advice from other parents of diabetics that play travel ball. With our daughter it seems running really makes her glucose levels drop and we worry this summer with the heat and games back to back it'll just get worse. What do you other parents do to combat that? What snacks and meals do you take with you? Do you make your daughter eat a snack size carb and/or protein as necessary between games? If so what have you found that works best?

I apologize for the rambling but really appreciate any advice, do or don'ts, etc., I would truly appreciate. This is all new for us and is scary.

 

[The Man In Blue]

@Travis Lassiter ... your daughter has the right attitude! It just is.

My youngest was diagnosed when she was 8. My wife and I often say she was the best one of our four, because she has that same attitude.

One of the best pieces of advice her endocrinologist gave us was: "Her blood sugar will run high. Her blood sugar will run low. As a parent, you will go insane if you are measuring yourself against those numbers. Accept the highs and lows, and do what you are supposed to do for your daughter, not the numbers. Everything will be fine in the long run."

As far as playing with Type 1 Diabetes, my youngest only played rec so we didn't have some of the challenges you will have. However, I have been around a number of other players over the years as well.

HYDRATION is critical. The times my daughter ended up in the hospital (damn school jumping the gun and calling 911) it was often dehydration or started with dehydration.

The CGM is going to be a life-changer for you. Especially as an athlete, having that constant measuring really allows you to be proactive. A couple of tips on that though:
*For school sports you will need a letter from your state NFHS association allowing her to wear it when playing any sport. It's not a big deal, but don't wait ... get it before she starts school sports. Your school athletic director should be able to help you with this. Her coach will need to keep a copy to produce on demand. If she does not have it, it is very likely an official will not let her play.
*If she is going to wear her insulin pump during the game, make sure it is secured tightly against her body. The clip on the pump and the waistband of her pants/belt are not adequate enough to hold it in place during athletic competition. You will need a special pouch (they make them) or to tape it down (not recommended).

As for snacks ... I believe most pro athletes (yes, there are several!) favor bananas, but I can't say I have researched this one. You will want to make sure you have a variety of things depending on what you are needing (e.g., slow acting vs. fast acting carbs).

If this thread doesn't get much traction, feel free to PM me any time!

PS -- Coaches, this is good information for you to be aware of too!

 

[FP26]

Several years ago I coached a player with Type 1 Diabetes. Luckily her parents were very knowledgeable on the topic, so I did not need to be. That said, I learned from them to pay attention to certain warning signs and then make sure one was nearby in case they were needed. Diet is extremely important, especially on long travel ball weekends. They often packed the items they needed as most concession stands don't offer many good options. The good news is that she played travel ball from 12u through 18u and never experienced any serious problems. Yes, there were times when she would show some warning signs (shaky hands, etc.), but we were always able to act before it got worse. She was also very good about realizing when she was experiencing symptoms and notifying one of us.

 

[HighStrung]

I'm a Type 1 and have coached a young lady who was as well. It can cause some extra worry, but it sounds like she's (and you) have the right approach. The CGM is really the lifesaver in the sports world, I wear a Dexcom but function is the same. As she gets use to her condition she'll start to be able to tell when things are off, but the CGM can give a heads up before it gets to that point, which is invaluable (wish I had it when I started).

With her monitor bluetoothed to your phone you can keep an eye on her during the game without having to constantly ask how she's feeling and making her feel worse or more worried about it. Yes, as others have mentioned, she'll be up, then down, then up and you can drive yourself absolutely nuts trying to chase it, trust me. Then you'll finally get her daily norms dialed in for a few months and outta the blue, you're chasing again even though nothing should've changed. Prepare her for this same thing. Highs make me grouchy, and long term cause problems, but lows are life threatening in the immediate.

Start the day (or game or even practice) a little high if anything, because physical activity can drastically drop glucose levels. Lows for me start with a little jittery feeling, then to pretty shakey, then to profuse sweating with confusion and the shakes bad. The jittery (very slightly) for me is around 70-75, shakey around 60, sweats starting around 50. My experience is even after getting my sugar back up, I'm cold and tired for the next couple of hours after dropping to that 50-55 level. I can approximate what my level is based on how much of these I'm experiencing, but she won't be able to yet. My CGM (I'm sure hers will do the same) can be set to not only alert you to when levels are low, but also when it predicts a low in the near future. Mine will literally say "low glucose in 20min", and I know that if I don't do anything it will be. I make small adjustments to avoid it.

Always, always, always, have something on hand (in her ball bag, in your car, in her school bag, on her night stand) to bring her sugar up, at least until she's learned what lows feel like coming on. Don't over react by eating an entire box of cookies and three cans of Pepsi, but have something available. Lows can be a little scary (nothing like waking up in the middle of the night at 40 for no reason whatsoever), especially for a kid. It's a little easier after she's gone thru a few of them, and trust me she will, but knowing that something is right at hand if it does takes that fear down a lot. You don't have to spend the extra money on the diabetic blood sugar tabs, just grabs some Skittles, Starbursts, whatever candy she likes. I use Lifesavers for minor adjustments, and a can of pop if I'm dropping faster (chug half then wait 15min and see).

How is she being given insulin, pod, pump, or injection? I'm still injection (my choice) but the young lady I coached was pod (neither of us was ready to be hooked to a pump with tubes and such) due to our activity level.

Please feel free to reach out if you want, I'm happy to offer any insight I can. Best of luck and she'll be okay.

 

[The Man In Blue]

Great post @HighStrung!

We used to carry a little tube of cake frosting (the writing gel) in my daughter's bag. It takes a little less time to digest and something we could "administer" which would dissolve if she was "going out" and couldn't chew. Fortunately we never had to use it.

 

[HighStrung]

Great post @HighStrung!

We used to carry a little tube of cake frosting (the writing gel) in my daughter's bag. It takes a little less time to digest and something we could "administer" which would dissolve if she was "going out" and couldn't chew. Fortunately we never had to use it.

Yep, frosting was highly recommend from a fellow diabetic to me as well and I think is a great idea. I did the same thing until I moved to a CGM and also grew more accustomed to understanding how I was feeling. Thinking about it, if it was my kids I'd probably go that route too, wouldn't be my go-to for every situation, but having it could be the difference if they lost consciencness. I still carry a roll of dissolvable tablets in my truck for that same reason.

 

[radness]

Encouraged by this post of people reaching out to eachother!
I have learned from reading this!
Thanku!
Softball Strong!

 

[chinamigarden]

About a month ago we found out out of the blue that our 14 year old daughter is a Type 1 diabetic. This hit us like a ton of bricks and was quite a shock for us. Over the past month her glucose levels have been all over the place 500 to 70 and back like a roller coaster. In spite of that, my daughter has taken ownership of it and is counting her carbs, taking insulin etc. as she should all on her own with absolutely no issues. She's really been a champ about it. She's told me that it's just another challenge she'll have to overcome in order to reach her dreams.

She was prescribed a FreeStyle Libre CGM yesterday. We hope that the Libre will make it much easier for her to keep track of her glucose levels while playing. I'm here for any and all advice from other parents of diabetics that play travel ball. With our daughter it seems running really makes her glucose levels drop and we worry this summer with the heat and games back to back it'll just get worse. What do you other parents do to combat that? What snacks and meals do you take with you? Do you make your daughter eat a snack size carb and/or protein as necessary between games? If so what have you found that works best?

I apologize for the rambling but really appreciate any advice, do or don'ts, etc., I would truly appreciate. This is all new for us and is scary.

my dd was also diagnosed at age 14, she is 22 now. It’s a scary feeling. I don’t have a lot of time right now so later I will read through your post and answer your questions to the best of my recollection.

I just wanted to take a quick minute to say, it doesn’t have to change everything. My dd played 3 sports through HS and played softball until she was 20. She went away to college at age 18 and has lived her life on her terms, as will your dd.

 

[chinamigarden]

So I am going to try to go line by line of what you posted and tell you how we did things.
First of all when my dd was diagnosed the CGM was not an option, so she did finger sticks to get blood draws, for a while she was doing them literally every inning so we could see what pitching did to her levels, the cgm is a huge improvement. My dd used injections for the first 6 months which meant in the middle of a softball season she switched to a pump, which while a much better system for her. We had to relearn some things. But its been a great system for her.

First of all, your dd's attitude of its just another challenge is exactly what you want. I applaud your families commitment to your dd managing her own care. Too many parents want to be 100% in charge and never give their kids ownership of the process. Which means when the kid goes to college they are all of a sudden in charge of their health, on top of everything else that's new and going on.

So about the big swings of blood sugar, your dd is probably in what is oddly called the honeymoon stage, where her body is still making some insulin. Unfortunately this is not consistent so sometimes the body dumps some insulin into her system and other times it doesn't. That will give you highs and lows. Eventually her body will stop being able to make any insulin and this will help even out things.

Exercise will naturally lower blood sugar so during activity you might need to change how you dose, your endocrinologist should be able to give you some guidance. if you are using a pump you can actually temporarily change the base settings to slow down the insulin for a set amount of time. My dd would take her pump off for batting and base-running and when she played basketball and volleyball she took it off whenever she was on the court.

We bought all sorts of snacks and beverages with us to games, and tourneys. My dd liked to eat melon between games so we would usually bring some sort of meat or cheese to go with so she had some other food to go with. We also brought trail mix. That gave her some sweets to balance out lows and some more complex carbs to keep her from crashing later. She likes water, so we brought lots of that and maybe a low cal gatorade type drink. We always had a few juice bags for quick treatment of lows. We also had glucose tablets in every bag, car, purse, drawer...

We carried a small cooling pack in a bag to keep her insulin from getting hot.

Remember that in the short term a bad low is more dangerous then a high. Err on the side of high.

My dd is using the same CGM as your dd, she didn't have it until last year. So her competitive sports career had ended. But its been great for her. She has consistently better A1C numbers since she started using it.

This is a thread I started the first year she was diagnosed. There might be some info there.

cautionary tale of health and sports.

I started to post this is a thread that a parent started about his DD and how she has regressed in pitching and how she is getting emotional about it. I felt it would sound better on its own then in that thread. I am not saying this is likely, but I want to post this advice and story from our...

www.discussfastpitch.com

If you have any questions feel free to ask. You can PM me if you are more comfortable

 

[Travis Lassiter]

@Travis Lassiter ... your daughter has the right attitude! It just is.

My youngest was diagnosed when she was 8. My wife and I often say she was the best one of our four, because she has that same attitude.

One of the best pieces of advice her endocrinologist gave us was: "Her blood sugar will run high. Her blood sugar will run low. As a parent, you will go insane if you are measuring yourself against those numbers. Accept the highs and lows, and do what you are supposed to do for your daughter, not the numbers. Everything will be fine in the long run."

As far as playing with Type 1 Diabetes, my youngest only played rec so we didn't have some of the challenges you will have. However, I have been around a number of other players over the years as well.

HYDRATION is critical. The times my daughter ended up in the hospital (damn school jumping the gun and calling 911) it was often dehydration or started with dehydration.

The CGM is going to be a life-changer for you. Especially as an athlete, having that constant measuring really allows you to be proactive. A couple of tips on that though:
*For school sports you will need a letter from your state NFHS association allowing her to wear it when playing any sport. It's not a big deal, but don't wait ... get it before she starts school sports. Your school athletic director should be able to help you with this. Her coach will need to keep a copy to produce on demand. If she does not have it, it is very likely an official will not let her play.
*If she is going to wear her insulin pump during the game, make sure it is secured tightly against her body. The clip on the pump and the waistband of her pants/belt are not adequate enough to hold it in place during athletic competition. You will need a special pouch (they make them) or to tape it down (not recommended).

As for snacks ... I believe most pro athletes (yes, there are several!) favor bananas, but I can't say I have researched this one. You will want to make sure you have a variety of things depending on what you are needing (e.g., slow acting vs. fast acting carbs).

If this thread doesn't get much traction, feel free to PM me any time!

PS -- Coaches, this is good information for you to be aware of too!

Thanks! You're definitely right about the highs and the lows. We met with the endocrinologist for the first time on Tuesday. She changed her long-term insulin to one, while chemically the same and insurance covered that one, the past two days of using it....she was running constantly high, as in over 500 yesterday, and over 300 today. Needless to say since the only thing that changed was the insulin I was in line to get her old one filled today. Been a stressful day! lol

She takes a 40 oz jug with her to school that she uses all day. Most days I think she drinks enough but I try to encourage her that hydration is key.

She has some patches coming tomorrow to cover and protect the sensor for the CGM. We're gonna start using that after that. Thanks for the tip on the letter. We didn't know that. I plan on speaking to the athletic director and going from there.

Thanks for the advice on the pump, she's still using injections. We were thinking of waiting a while and letting her make the choice.

She's very picky unfortunately when it comes to fruit. She hates bananas and most other fruits. She does like most melons though.

Again thank you for your insight!