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. 2017 Jul;6(3):215–224. doi: 10.21037/tp.2017.05.01

Table 2. Key points: exercise and safety.

Have supplies ready to treat hypoglycemia and train any coaches and supervisors re: glucagon use in case of emergency
Check blood glucose often, including pre-exercise, during any prolonged physical activity and in the post-exercise period
Be aware of the common symptoms of hypoglycemia
Consider insulin adjustments as needed to prevent hyperglycemia, pre-, during, and post-exercise, based on type of planned activity
Be aware of the numerous factors that can influence food effects on glucose levels:
   (I) Carbohydrate content
   (II) Simple vs. complex (fast vs. slow acting)
   (III) Protein and fat content
   (IV) Timing of intake in relation to exercise
Be aware of the numerous factors that can influence insulin effects on glucose levels:
   (I) Site of injection (avoid injecting into the exercising muscle groups)
   (II) Ambient temperature (be cautious with extreme conditions)
   (III) Timing of dose in relation to exercise
Baseline glycemic control helps promote optimal performance. This involves regular visits with pediatric endocrinology and HbA1c checks
Keep any coaches or training staff informed about the athlete’s diabetes
Carry a medical alert tag or identification at all times denoting the diabetes status. Make sure emergency contact information is accessible to any coaches or supervisors
Other general safety advice regarding exercise and athletics:
   (I) Adequate hydration
   (II) Use the proper equipment and technique
   (III) Use the “the buddy system”