A preadolescent has maintained good glycemic control of his type 1 diabetes through the school year. During summer vacation, he has had repeated episodes of hypoglycemia. What additional teaching is needed?
a. Carbohydrates in the diet need to be replaced with protein.
b. Additional snacks are needed to compensate for increased activity.
c. The child needs to decrease his activity level to minimize episodes of hypoglycemia.
d. Insulin dosage should be increased to compensate for a change in activity level.
ANS: B
Most children have a different schedule during summer vacation. The increased activity and exercise reduce insulin resistance and increase glucose utilization. Additional snacks should be eaten before physical activity to increase carbohydrates and protein and compensate for increased activity. Physical activity should always be encouraged if the child is capable. The benefits include improved glucose utilization and decreased insulin requirements. In consultation with the practitioner, insulin dosage may need to be decreased because of improved glucose utilization.
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