For a lot of families with Type One children, the summer holidays can play havoc with blood glucose levels for a variety of reasons such as the lack of routine, warmer weather, snacking more frequently, perhaps more exercise as kids may be on the go more.
Our Type One daughter is now 7 and I always find adjusting to the school holidays difficult. I often put it down to the more relaxed timings of our day, the later starts and the conflict this has with our basal settings on the pump, things just don’t seem to work anymore. This post covers some important things to consider, whether on pump therapy or MDI and how to best manage all these changes as well as some useful perks of having Type One when going on days out!
What Factors affect Blood Glucose Levels in the Summer Holidays and how to deal with them?
- Lack of routine and varied meal timings.
- More exercise.
- More frequent snacking.
- Holidays, actually being away from home.
- Varied care givers if parents are working.
- Time at friends houses.
So let us take a closer look at each of these.
Hopefully being off for summer holidays means warmer weather. For some Type One children this can cause lower glucose levels than normal whereas for others it can cause elevated levels. The frustrating thing about British weather is that no 2 days are the same so don’t be too hasty in making big changes. However, check the forecast regularly and if it looks like we are in for a prolonged warmer spell than usual you could consider slightly increasing or reducing either the long lasting insulin the night before (MDI) or making changes to basal profiles if on pump therapy to suit your childs needs. Remember to make small changes at a time and always consult your DSN first if you feel you need to or are unsure about how to make these changes. They should always be there to advise you.
Lack of Routine
This is probably the biggest factor that affects my daughters levels. As soon as we are on school holidays, the early breakfast goes out the window. She likes a lazy start and breakfast is not a high priority. As we are on pump therapy, we are constantly striving to reduce the breakfast spike. To do this we normally bolus a good 30 minutes before eating breakfast and also the basal rate is quite high in the time leading up to breakfast. Therefore, if she is late eating breakfast her bloods start to drop due to the extra basal going in and it is hard to estimate exactly when she is going to eat breakfast to give the insulin 30 minutes in advance. For the shorter holidays I don’t change anything but for the summer holidays I normally change the basal profile and shift everything back an hour or two to allow for the later eating time. If you are unable to give breakfast at the same early time you could consider doing the same. The last thing I want is to be waking my daughter up and forcing breakfast on her as I love not needing to rush in the holidays. I take note of what the settings were previously so we can change them back again when she is back at school.
Other things that can alter the routine are more varied timings for other meals so keep close tabs on levels throughout the day. Later bed times can also affect what number they may go to bed on. If they are later going to bed and have been active up until that point they may need an extra snack, drink of milk or supper to give a steady number overnight. Due to my daughters age when at school, tea time (5pm ish ) is normally the last meal of the day but in the holidays she often has supper too.
Being on the go more and outside playing, running round the park, swimming, bike riding all affect our kids glucose levels. Of course this is different for every child and the way we manage it is different depending on whether they are on a CGM or just relying on glucose testing. The important thing is to check levels more frequently throughout the day. Always have a supply of glucose, snacks and other hypo treatment with you wherever you go and try to make sure bloods are at least 7/8mmol before and during exercise to prevent hypos. Consider using temporary basals before prolonged or intense exercise or reducing long lasting insulin if on MDI and you know you have a very active day planned. Also if you know you are going to be on the go straight after a meal, you can reduce the total amount of carbs you bolus for.
More Frequent Snacking
If on pump therapy, where possible keep tabs on what snacks your children are having and bolus accordingly. If my daughter is out playing I will often reduce the total carbs I input by a few grams to keep bloods up and to prevent over bolusing. Snacking on MDI is a little more challenging especially if they don’t like extra injections. You can allow for some snacks in the previous meal time insulin but you obviously need to make sure they have that snack before the levels start to drop around 2 hours after the meal. If your child is particularly active you can use frequent snacks to maintain glucose levels or you can give a variety of low carb snacks.
Preparation is key for holidaying with Type One especially if you are going abroad. Have a read of my holidaying abroad with Type One post here to pick up lots of tips and helpful suggestions. Type of holiday can affect blood glucose levels significantly and carbohydrate counting is often the hardest part about it. All inclusive and buffet restaurants can be particularly challenging. My three essential products to travel with you to help maintain healthy blood glucose levels wherever you go are:
- Carbs and Cals pocket book. There is also a phone app but I always carry a book as sometimes the app is not accessible due to mobile signals.
- Handbag Weighing Scales. These are so useful and compact for weighing things like cereals and pasta to give the best chance of accurate carb counting whilst away.
Varied Care Givers
It’s always a challenge when we can’t look after our children all the time. Perhaps you are relying on school holiday clubs, grandparents, aunties and uncles. No one looks after them like we do. That said we ofter find that people like grandparents often have really good levels because they do things by the book and things like carb counting are calculated perfectly and accurately where we often revert to averaging or carb counting by guesstimating. Either way ensure care givers have the relevant training and knowledge, for holiday clubs perhaps your DSN can help with any extra training that is needed. Where possible make sure one of the parents or regular care givers is reachable for advice and above all make sure they know the urgency of treating hypo’s and how to do it correctly.
We all want our children to be able to live as normal a life as possible. There is no doubt about it that especially younger Type One children do not seem to get as many play date invitations as other kids but where possible try and nurture a few key friendships and make an effort to have their kids round. Take every opportunity to talk to their parents and slowly with time they are generally more accepting and willing to give it a go having your children round to play.
My daughter only has a few friends houses she gets invited to and they need different levels of input from me. She has a CGM which makes life much easier and generally parents just call me if it alerts and if giving food or snacks and I talk through what to do and how to input carbs etc. They also know what snacks they can give if her levels are heading down but not hypo and are confident to give them. Other friends that she really wants to play with I just keep making the effort to invite them round to us instead and work on build that relationship with their parents when they drop off or pick up. It is a challenge letting our little ones go into someone elses care, letting older children grow in their own independance and go out and about on their own and trusting them to bolus for snacks and meals is a challenge on its own but be brave, be confident and trust your children to make good choices because its how they learn. I know my daughter is thrilled when she gets to go somewhere without me and feels like she is a bit more in control of her care and more independant but it takes time!
Use the opportunities of meet ups with friends to educate them about Type One aswell and use the holidays to help improve your childrens understanding aswell. To read more about how to teach kids and their friends about Type One and see some of my useful resources click here.
Illness is one big contributor to blood glucose levels being all over the place. Either low for sickness bugs or high for most other illnesses. I don’t know about you but we normally find as soon as we are on holiday and our bodies wind down, we seem to be susceptible to illnesses going round. Feel free to read more on this topic here in my post Sick Day Rules for Type One. Frequent testing and checking for ketones is always a must for coping with illness and Type One. Hopefully we will all stay bug and germ free this summer!
Type One Holiday Perks for Days Out
There aren’t many perks of having Type One but the biggest one I have found is the often reduced prices for entrance to various places and attractions for children claiming DLA and or parents claiming Carers Allowance along with not having to queue for rides. Here are my top tips to remember when going out for the day with Type One to get the most out of your day:
1. Check Admissions in advance.
Many days out places will offer reduced rates for carers and or disabilities so make the most of these and ensure you are not paying more than you need to.
2. Take Proof of DLA or Carers Allowance.
Not every where always ask for proof but it doesn’t do any harm to have a copy of the paper work with you where ever you go in the summer so you have it if you need it. If you didn’t know you could claim DLA (disability living allowance) for your child then check it out here, it is definitely worth having!
3. Take advantage of Shorter Queues.
Most theme parks and attractions allow special access now for people with disabilities so check out what these are. These can help you to avoid queuing for rides often by entering via the exit of rides.
4. Ask Restaurants for Nutritional Info.
More and more restaurants are offering full nutritional info now and have the menu with carb contents upon request so always be sure to ask just incase.
Great Days out for Type One
SO many places today have really improved their provisions for disabilities so it is impossible for me to list them all but from my experience, here are some suggestions of good places to visit with Type One.
- Theme Parks e.g. Alton Towers, Paultons Park (Peppa Pig World), Flamingo Land.
- Cinema: Children over 8 can have a free carer assist them, under 8 would have a parent with them anyway.
- Most child friendly days out: farm parks etc.
- Swimming pools – often cater really well for people with disabilities and offer free passes for children or carers.
- Disney Land Paris: has amazing provisions for disabilities, check out my detailed Disney post here!
I really hope this post has been helpful for you and helps you on the way to having a fantastic summer break. If you haven’t done already, do sign up to my email list and you can be sure to be first to hear about my new posts and resources. I’ve got lots of preparing for going back to school tips, resources and freebies heading your way over the summer so don’t miss out!