Youth with diabetes overcome their fear of exercising and increase physical activity after participating in a sports camp. Practicing insulin and food adjustment while actively participating in basketball drills and games with other kids with diabetes can motivate to adopt desired lifestyle skills.
Guidelines from the American Diabetes Association (ADA) and American Academy of Pediatrics (AAP) recommend all children, but especially youth with diabetes, engage in at least 60 minutes of moderate to vigorous physical activity daily to promote overall health and wellness including blood glucose control. Unfortunately hypoglycemia can occur during and after exercise including at night, and is an all too frequent consequence of moderate to vigorous physical activity in kids taking insulin. The incidence of hypoglycemia is much greater in children compared to adults with diabetes and is not only life threatening but also inconvenient, uncomfortable, and embarrassing--all strong deterrents to exercise in any child or parent of a child with diabetes.
Beyond overall health and wellness, children involved in extracurricular sports and activities have higher graduation rates, improved self-efficacy, greater social network density, decreased depression risk, and exhibit overall “thriving”. Children with diabetes identify sports and extracurricular activities as ways to “feel normal” and help cope with the stress of a chronic disease. Unfortunately, participation in both sports and extracurricular activities is lower in children with diabetes.
Slam Dunk for Diabetes is a basketball camp program for children with diabetes that focuses on building and reinforcing diabetes self-management skills around exercising with diabetes. The goal is to improve confidence to participate in sports and extracurricular activities but also promote “feeling normal” as one out of every two children at camp has never met another child with diabetes. Children in camp interact with other children with diabetes and they learn from each other in a structured, physical, and fun setting.
Children with diabetes ages 5 to 18 participate in either a weekend program (school year) or a 3-4 day camp (summer). Originally more than 60% of children were African American from high-risk, inner city communities in Chicago, Illinois. As the program has grown (Memphis, Tennessee, Rockford, Illinois, Schererville, Indiana, Milwaukee, Wisconsin, Pine Ridge Indian reservation, South Dakota) a more diverse population is participating, particularly Hispanic children with prediabetes and type 2 diabetes.
Children learn the fundamentals of basketball from local coaches and are involved in fast-paced pickup games throughout the 4-5 hour day. Diabetes educators reinforce the importance of diabetes self-management behaviors in promoting health and quality of life, but most importantly, provide hands on experience as children actively adjust and balance their food intake and medication dose based on blood glucose test results. Blood glucose testing is performed by children under the supervision of diabetes educators before, during (every 30 minutes) and after each game, during “teachable moments.” The theme of preventing and treating hypoglycemia before, during and after exercise is central to the entire experience.
Time outs are spent choosing and discussing healthy food choices for meals and snacks, or ways to prevent hypoglycemia on physically active days. Parents are also able to learn and participate. Medical staff conduct education or support group sessions for parents. These sessions emerged over recent years when parents requested the desire to learn more themselves.
Self-reported survey results from parents of camp participants are assessed 6-8 weeks following camp to measure the perceived impact of a physically active camp-type education on 1) the child’s confidence and ability to participate in physical activity without hypoglycemia, and 2) social support from their peers. Over 72 percent reported their child had increased confidence to manage blood glucose during exercise and 60 percent felt their child was more physically active than before camp. Frequency of hypoglycemia was reported to be much less in 42 percent of children and 44 percent of parents felt their child was doing a better job of treating hypoglycemia.
Expanding and standardizing the education curriculum to reach more kids with the Slam Dunk learnings has led the Slamdunk team to develop an age appropriate, web-based education and decision-making program. This animated, interactive, and humorous program for kids with diabetes assesses and guides them on how to prevent and treat hypoglycemia during exercise. Recently the program won the Innovative in the use of Media and Technology Award from the American Association of Diabetes Educators. This program was supported by an educational grant from Novo Nordisk and is available at slamdunk.peptools.com.