Summer fun for children with diabetes

The summer is an active, busy time for children. Parents of kids with diabetes may find the start of the season stressful. The change in routine can throw off diabetes management plans, and higher temperatures can lead to changes in blood sugar levels and dehydration.

Dr. Liliana Burdea, pediatric endocrinologist with Advocate Children's Hospital

Another concern I’ve heard families express is about summertime activity limitations for children with diabetes, particularly those who wear continuous glucose monitors (CGM). The device is attached to the body and continuously monitors blood glucose levels, providing real-time updates. CGMs are placed using a small incision and adhesive tape. Because of the way the device is attached, many parents and children worry that swimming or other water activities are off limits.

Fortunately, swimming with a CGM attached is possible and enjoyable. Swimming is a fun and great exercise for people of all ages. It’s important to remember that while the sensor and transmitter are water resistant or waterproof, depending on the brand, the receiver is not. Receivers should be kept close to the CGM wearer, but not in water. I encourage families to review the manufacturer’s specifications provided with the device.

These are the most common CGMs brands available for kids:

Dexcom G6 and G7: Dexcom G6 sensor and transmitter are water resistant, and Dexcom G7 is waterproof. These sensors may be immersed in up to eight feet of water for about 24 hours.

FreeStyle Libre 2 and Libre 3: These are water resistant and may be immersed in up to 3 feet of water for up to 30 minutes.

Guardian 4: The sensor and transmitter are water resistant to about 8 feet for 30 minutes.

While your child swims, you may not be able to see blood sugar levels due to signal loss. Do not rely on low glucose alerts. Instead, check blood sugars prior to swimming, frequently while swimming and whenever your child doesn’t feel well. Hypoglycemia, or low blood sugar, can occur during swimming. A snack before swimming can help prevent some of the low blood sugars.

Children can enjoy other summer water activities like sprinklers and water balloons, as well. Keep in mind that chlorine and salt water may impact the CGM adhesive’s ability to stick, potentially causing the device to peel off sooner than expected. Wearing a waterproof covering, body adhesive or an armband can help keep the sensor protected.

As long as a child feels well and blood sugars are within target range, all water activities can be enjoyed this summer. Keep safety first — in and out of the water — and make it a joyful summer season.

Children’s health is a continuing series. Dr. Liliana Burdea is a pediatric endocrinologist with Advocate Children’s Hospital.

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