How can I manage meal timing before games and practices?

Think about fueling for sport in three categories: Type of activity (anaerobic, aerobic, or mixed-intensity); Duration (how long you will be active); and Stakes (practice, tryouts, or competition). Each combination requires different fueling strategies. Consider how your nutrition choices will influence insulin on board (IOB) going into activity.

How does climate affect blood glucose?

Heat and cold can both affect blood glucose, but responses vary from person to person. Heat acclimation matters — someone who isn't used to training in heat will respond differently than someone who is. Heat increases metabolic demand, meaning your body may burn more glucose and cause lows. Heat stress can also raise blood glucose, depending on the individual.

What is the optimal blood glucose target during physical activity?

Avoid setting a blood glucose target higher than your automated insulin delivery system's programmed target. If your blood glucose rises above that target, the system may give insulin and push you low. Use exercise features (exercise mode, activity mode, etc.) to "weaken" the target and reduce insulin delivery. Work with your health care team to personalize this — different athletes need different targets.

When should we switch to injections during water activities?

Think about what technology works best for your sport and environment. Water can cause devices to loosen or fall off, so injections may be more reliable for some athletes. Consider insulin on board (IOB) when switching. For short activities, think ahead: do you want to return to your automated insulin delivery system afterward, or stay on injections for the rest of the day?

How do gender and age impact blood glucose control during activity?

Blood glucose patterns vary significantly with age. Adolescents often have more variability and less predictable control. Younger children may struggle to recognize or communicate symptoms and rely more on caregivers. Understanding your developmental stage helps guide support and expectations.

If I have limited time to talk with coaches, staff, or my teammates, what should I share about my diabetes?

Keep it simple and approachable — most people genuinely want to learn. Share your emergency plan. For example: "If I pass out, I need glucagon. Here is where it is and how to use it." Invite questions and keep the door open for further conversations.

Fitness

Sports and Diabetes: How to Manage at Different Levels of Competition

Starting the Conversation with Coaches and Advocating at Different Levels

Athletes with diabetes can absolutely thrive with the right preparation, communication, and support system in place. Building strong relationships with coaches and teammates early, educating others, and creating an environment of understanding helps reduce stigma and sets you up for success. By knowing your needs, managing stress, and choosing supportive environments, you can use both preparation and mindset to perform at your best.

Blood Glucose and Diabetes Technology Management in Sports

Blood glucose (blood sugar) during exercise can vary based on factors like starting levels, intensity, duration, and insulin adjustments, so regular monitoring before, during, and after activity is key to spotting patterns. To prevent lows, adjust insulin or eat carbohydrates as needed — especially if levels are below 100 mg/dL — and always carry fast-acting glucose. Because responses differ (and high-intensity exercise may raise levels), using trial and error while tracking results helps you find what works best for your body.

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Sports and Diabetes: How to Manage at Different Levels of Competition

Learn tips for supporting your child or teen with diabetes across all levels of competition—plus how to prepare their coaches, teammates, and school to give them the best support possible.

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Sports and Diabetes FAQs

Adrenaline is one of the body’s “rescue hormones.” When blood glucose drops, your body releases adrenaline to help raise it. Many classic low-blood glucose symptoms — shakiness, sweating, fast heartbeat — are actually adrenaline responses. During stress, competition, or intense emotions, your body releases adrenaline for the same reason: it’s designed to increase blood glucose.

Think about fueling for sport in three categories:

Type of activity
- Anaerobic
- Aerobic
- Mixed-intensity
Duration
- How long will you be active?
Stakes
- Practice
- Tryouts
- Competition
- Each combination requires different fueling strategies. Consider how your nutrition choices will influence insulin on board (IOB) going into activity.

Heat and cold can both affect blood glucose, but responses vary from person to person.

Heat acclimation matters. Someone who isn’t used to training in heat will respond differently than someone who is.
Heat increases metabolic demand, meaning your body may burn more glucose and cause lows.
Heat stress can also raise blood glucose, depending on the individual.

Avoid setting a blood glucose target higher than your automated insulin delivery system’s programmed target. If your blood glucose rises above that target, the system may give insulin and push you low.
Use exercise features (exercise mode, activity mode, etc.) to “weaken” the target and reduce insulin delivery.
Work with your health care team to personalize this — different athletes need different targets.

Think about what technology works best for your sport and environment.
Water can cause devices to loosen or fall off, so injections may be more reliable for some athletes.
Consider IOB when switching.
For short activities, think ahead. Do you want to return to your automated insulin delivery system afterward, or stay on injections for the rest of the day?

Blood glucose patterns vary significantly with age.
Adolescents often have more variability and less predictable control.
Younger children may struggle to recognize or communicate symptoms and rely more on caregivers.
Understanding your developmental stage helps guide support and expectations.

Keep it simple and approachable — most people genuinely want to learn.
Share your emergency plan. For example, “If I pass out, I need glucagon. Here is where it is and how to use it.”
Invite questions and keep the door open for further conversations.