A female adolescent with type 1 diabetes mellitus has been chosen for her school's cheerleading squad. She visits the school nurse to obtain information regarding adjustments needed in her treatment plan for diabetes
The school nurse instructs the student to: 1. Eat half the amount of food normally eaten.
2. Take two times the amount of prescribed insulin on practice and game days.
3. Take the prescribed insulin 1 hour prior to practice or game time rather than in the morning.
4. Eat six graham crackers or drink a cup of orange juice prior to practice or game time.
4
Rationale: An extra snack of 15 to 30 g of carbohydrate eaten before activities, such as cheer-leader practice, will prevent hypoglycemia. Six graham crackers or a cup of orange juice will provide 15 to 30 g of carbohydrate. The adolescent should not be instructed to adjust the amount or time of insulin administration. Meal amounts should not be decreased.
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