9 year old newly diagnosed cross country runner

My daughter was diagnosed about 4 weeks ago with type 1 diabetes and now is in the midst of cross country running season. Our difficulties are resulting from the early morning runs which she finds difficult after eating. She seems to get "stitches" fairly often. Also, if she has a particularly vigorous run, she often will get hypo episodes mid-morning before (or sometimes after) her snack.

At this point she is "honeymooning" and only receives the slower-acting insulin in the morning with breakfast. She gets a bit of fast-acting at dinner time if her blood sugar is a bit up and then gets a small dosage of slow-acting at night time.

Firstly, given that her blood sugar readings are beautiful in the moring (about 6.0), what can she eat for breakfast that won't cause the cramping when she runs? Is there another time that she could eat? Must she have her insulin and breakfast before she runs?

She is highly competitive and is looking to win these races and the diabetes seems to be creating a bit of a stumbling block. Any suggestions?

[JDRF-Team-gg]

Hi Mammamia!  I am not a medical professional, just the mom of a 17 year old who was diagnosed at the age of 21 months.  My daughter ran track (short distance) and has played soccer since she was five, so I will share some of my experiences/thoughts with you on how athletes can achieve better bg control.  

First off I just want to tell you that I hope things are going alright for all of you.  Only having been diagnosed a month ago, I know how this adjustment period can be.  I hope that if you have specific concerns about your daughter's recent diagnosis that you will visit www.jdrf.org and post your questions there and someone from the online diabetes support team can answer you personally (I volunteer there too, so you can request me if you'd like).  

Now, for the exercise issue.  I can totally understand yours and your daughter's frustration with trying to regulate her bg's.  You certainly don't want her to resent her diabetes any more than she may already.  Being diagnosed at her age can be very disrupting to her lifestyle, but it doesn't have to be.  I need to tell you that you should be discussing the situation with your daughter's endocrinologist as dose changes may be needed on those days when she is running.  I cannot advise you on specific doses, so please run that one by your endocrinologist.  I was on the phone every week with my daughter's endo during her honeymoon period, so don't hesitate to contact them for any reason.  Their bodies are going through tremendous changes at the age of 9, even without throwing diabetes into the mix!  Please run this suggestion by your doctor before trying it;  I am thinking that, depending on her bg when she wakes up, maybe she could drink gatorade to elevate her bg just enough to counteract the activity and then eat a normal breakfast when she gets back home.  How long does her run last?  Is she running with somebody?  Please make sure that whoever is with her knows what to do in the event of a low blood sugar.  She should ALWAYS carry some source of fast acting glucose with her in the event she drops while she's running...glucose tabs or juice box.  Have you looked into power bars? They are making them now with lower carbs and maybe they even have one for runners (for that specific purpose of easier digestion.  

The other thing I think you should be checking out is the insulin pump.  It has proven to be pretty terrific for my daughter, especially when it comes to her physical activity.  The pump mimics the pancreas and really helps to obtain better bg control.  You can do a search online for more information on pumps, as there are many different manufacturers out there.

Please visit the jdrf website and try this one too:  www.childrenwithdiabetes.org.  I hope I have helped in some way.  Good luck to you.

[mammamia]

Thank you so much for your help. We are in touch with our Diabetes team at Sick Children's Hospital in Toronto (one of the best in the world), but the daily adjustments seem to be throwing us a bit. I am still astounding by the fact that a regular training run can lower her bg while a race can raise it. I would assume that this is because of the additional stress of a competition. We are meeting with our diabetes team next week and I will discuss your suggestion with them and let you know what they say.
Just to confirm, she's running with a team and the coaches are aware of her condition. Additionally, she carries DEX tablets and juice if she needs it. We have found the the crashes happen well after the running is over.
The honeymoon is a bit of a crazy time I guess. She has been mostly very stable, but is subject to the odd very high reading that seems to come out of nowhere.
I can't tell you what a comfort it is to hear from someone who has experienced this.
Thanks again.