Recess in the winter?

My son Leo (almost 4) just started preschool this fall and we've been handling all the nerves that go along with it. Right now, when Leo goes out to recess, we ask that his teachers carry his kit, which has testing suplies, snack bars, fast acting carbs, insulin and of course glucagon. Now that we are full into winter, recess is presenting a few problems. First of all, he sometimes drops 100 points from the time they test (about 10 minutes before he goes out) to the time he comes back in. On average, this is about 45 minutes. We just started using a CGM, but it has only alarmed once, and he didn't hear it! So any suggestions as to how to handle cold weather would be great! My real question is that I read that the test strips, meter and insulin and glucagon, should NOT be exposed to really cold temps. and his school goes out as long as it is 13 or above.  We're having his teachers take his kit and keep it under his coat. But now we're wondering if even that is too cold and might hurt the strips. On the other hand I cannot imagine him outside and not have his kit nearby. Suggestions??? What do you all do??

Does he ALWAYS drop so significantly or just some days? Can he check and eat a quick 15 carb snack (juice box or fruit snack) to help prevent a low while outside? This could be problematic if somedays he stays steady and others he drops 100pts. Could lead to some highs, though I generally feel better correcting those later if I know they were caused because I was trying to prevent a low (at least I did!)

How far away are they from a door/room where the supplies could be kept safely? I'd guess with a pre-school the play yard is relatively small and enclosed and being only 4 yrs, would not be hard to grab your son and carry him back inside if so low he can't walk himself. My sister is a teacher and she has had at least 3 D students and for all of them she has been told - treat if you suspect a low and can't test that minute. Better to treat and correct for a high later than risk prolonging the low. So I guess what I would suggest is just have the teacher carry a snack bar and glucagon and leave everything else inside. Ask them if they would really do the test outside anyway at 13 degrees? (I would have to be pretty far away from indoors to do this - but that's just me.)  Or would they just walk inside if your son said he felt low or if the teacher thought he looked low - they could give him the snack bar to eat right away and then go in and check things out. Can always call you if they treated and he isn't low and then needs some insulin to cover the carbs.

Hope that helps. I make sure my son (4) eats a snack  before going out in the snow - it does burn a lot of energy.

We don't have to deal with extreme cold as you are, but we do see quick drops in our son's BS when he is swimming (which we still do indoors in winter).  But, regardless of where he is and what we are doing, the only time I take William's "full" kit with is if 1) if will be eating or 2) we'll be far enough away from home that having insulin might be necessary (if we end up getting delayed, etc.).  If we're going to the park or the th Y to swim or anywhere else that is fairly close to home and we expect to be back within a couple of hours, he takes his SPIBelt, which holds a tester, test strips, and glucose.  It fits snugly and securely around his torso, under his clothes, and hold all that he needs to test for and treat a low.

So, you may want to think about what supplies your son is most likely to really need during recess, and just have those items on hand.  He's not going to need insulin, so I would have that kept in the classroom in the "full" kit, and just have a little kit with glucose, etc. with the teacher.  It's a judgement call whether or not you think he will ever need glucagon.  If his drops during recess are fairly consistent, as our son's are when he's swimming, you can start estimating how many additional carbs he'll need for that activity, and have him take glucose tablets accordingly.  For example, I know that William will need to take one glucose tablet every 20-30 minutes to keep us BS in his target range during swimming, so I test him before we start, be sure he's over 100, and then have him take a break every 20-30 minutes for a glucose tablet.  You might check out the book "Think Like a Pancreas" as it might help you figure out more accurately what your son's glucose needs are during particular activities.

I hope that wasn't too confusing.  Basically, decide what supplies your son might really need during recess and have those with him or the teacher; and plan on having him take extra glucose (tablets are very handy) while at recess to keep him from dropping too quickly.  In my opinion, a little high is always better than too low, and a high can be corrected at the next test/meal/snack.  Hope that helps..

Mo

 

HI

We take our bag everywhere!!!  Skiing, sledding you name it.  I wear it strapped diagonally across me when skiing with the kids.  We have had times where the glucometer did not work in the cold - a message comes up and says it is too cold to operate.  When this happens I give him a few skittles and we go inside and in a few minutes it works.  Lucas went skiiing on a very cold day with a cgm - this was fine as he kept the dxcom inside his pants pocket inside his snow pants which never got that cold.  I don't think the cold permanately ruins the strips.  Fot the glucagon, they can just roll the vial in thier hands to warm it - let's hope they don't need it but they should have it in arms reach.  If they don't bring the bag on the playground, in an emergency they will be running to the classroom and trying to figure out where it was last left.  Better to have it attached to a teacher.

The lows could be from cold or just needing a snack BEFORE running around.  Extreme temps raise bg in Lucas - even so, sledding,skiing ,swimming all bring them down.  If he sits in the sandbox on a hot day he runs high or likewise is outside in the cold just watching a game as opposed to playing.  Everyone is different though.

Christine