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Diabetes

Open the conversation

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If it’s ok with you, can we spend a few minutes focusing on what you and your parents think might be some help for you?

Insight

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Setting the scene for both the child and parent/guardian allows a constructive person-centred conversation around behaviour change. With younger children the emphasis needs to be around short-term goals. The more concrete and specific – the better!

Did you know?

Toddlers and pre-schoolers should spend at least 3 hours per day in a variety of physical activities spread throughout the day including active and outdoor play.

All physical activity counts towards moving more.

Being active is as important as taking medication.

Real impact

Assess impact of the condition

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How does your condition affect your playtime?

Insight

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Living life with a long -term condition commonly affects physical activity beliefs and behaviours. Focusing on this can be a useful way to introduce the topic.

Young children lack experience and their goals are short term. Engaging with parents is key to establishing behaviour change in this age group.

Learning motivational interviewing can help you avoid common pitfalls that sometimes make conversations about behaviour change unrewarding and ineffective. Visit our education section to learn more.

Did you know?

Toddlers and pre-schoolers should spend at least 3 hours per day in a variety of physical activities spread throughout the day including active and outdoor play.

All physical activity counts towards moving more.

Being active is as important as taking medication.

Real impact

Find out what they already know

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What do you know about the benefits children get/achieve from physical activity?”

Insight

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Children relate to other children and peers more readily – than hearing adult advise. Helping them identify how they might benefit from being more active is key. Engaging both the child and parents about what they understand about being more active, allows opportunity for you to more collaboratively share the benefits with them.

Did you know?

Being active has significant positive benefits for children with type 1 diabetes. It can make it easier to manage blood glucose levels and make it less likely to have hypoglycaemic events.

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Brisk walking can count and is a great activity to start with.

Real impact

Exercise helps to decrease fatigue.

Exercise can control my blood sugar.

Make it sociable. Find a buddy – friend/pet/family member

Share benefits

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Is it okay if I share a few things about how moving more has helped other kids?

Insight

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Based on your discussion so far, choose to share the benefits you deem to be most relevant and important to youth. Some benefits are emotional and generalized (e.g., feeling better, having more energy, improved sleep, enhanced fitness levels, happier mood, etc.) and other benefits will be condition specific (e.g., reduce risk of serious life altering complications in the future, etc.).

Did you know?

Being active has significant positive benefits for children with type 1 diabetes. It can make it easier to manage blood glucose levels and make it less likely to have hypoglycaemic events.

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Brisk walking can count and is a great activity to start with.

Real impact

Exercise helps to decrease fatigue.

Exercise can control my blood sugar.

Make it sociable. Find a buddy – friend/pet/family member

Encourage reflection

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What’s most important for you and I to talk about next?

Insight

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Children typically don’t reflect the depth of adults on their own change behaviours.

Focusing on things of particular importance to them will facilitate change in their behaviour. This will allow them to make very short -term goals, which are easier for them to adhere. Ask if they need anything clarifying and what concerns they or the parents might have about how the information applies to them.

Listen and reflect their concerns: ‘you’re worried about X’. Help them to address these issues by sharing the experience of children  ‘other people I’ve worked with have had those concerns, but what typically happens when they get started is…’  or  ‘whilst there is a small risk of X when you get started, this is outweighed by the risk reduction you experience once you have started moving more’. Ask what they think about what you have said.

Did you know?

Being active has significant positive benefits for children with type 1 diabetes. It can make it easier to manage blood glucose levels and make it less likely to have hypoglycaemic events.

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Brisk walking can count and is a great activity to start with.

Real impact

Exercise helps to decrease fatigue.

Exercise can control my blood sugar.

Make it sociable. Find a buddy – friend/pet/family member

Make it personal

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What would be the most important reason for you to become more active?

Insight

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Help kids and parents/guardians to generate and articulate their own reasons, with short term goals in mind. This may or may not be health-related.


Did you know?

Being active has significant positive benefits for children with type 1 diabetes. It can make it easier to manage blood glucose levels and make it less likely to have hypoglycaemic events.

Exercise increases your “happy hormones” so helps improve mood, so whether you’re having a good day or a bad day, get moving and get the hormones working.

Brisk walking can count and is a great activity to start with.

Real impact

Exercise helps to decrease fatigue.

Exercise can control my blood sugar.

Make it sociable. Find a buddy – friend/pet/family member

Summarise without adding anything

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If it’s OK, can I go through what we have been talking about just now?

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“Let’s pause for a second, to make sure I’m getting everything you have said.”

Insight

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Don’t be tempted to impose your own plan at this stage – kids easily fatigue and can become bored with too much conversation and may agree with you just to end the conversation. Summarise the main points of the conversation and find out what they are thinking. Consider adding breaks at this juncture in the conversation to help them refocus and engage if they are less interactive at this point.

This may sound something like: ‘Some of the things that being active would help you are X, Y and Z. You would like to do more of X and that’s where being more active may help’.

Using a summary can be a good way to demonstrate and express empathy, and allows both the child and caregivers know you are seeing the world from their perspective.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

If you have never been active, or not been active for a while, it is important to start gradually and build up gradually

If you are newly diagnosed it is important to monitor how an activity affects your blood sugar levels by checking you blood sugar levels before and after an activity. If an activity lasts longer than 30 minutes, then try to check your blood sugar levels during the activity if you can

Real impact

Physical Activity can help you make new friends through shared interests or joining new clubs in or outside of school

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Physical activity is not just sports – have fun!

Ask the key question

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What do you think you might try out/do next?

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“Getting more active doesn’t always have to be a chore. What are some things you all could do together to become more active as a family/together – that would be fun for all of you?”

THEN move on to planning. Continue to keep the focus on them generating their own ideas for change, rather than telling and instructing. People are much more likely to make successful changes if they develop their own plans.

Insight

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The child and the parents have heard about the benefits of physical activity for someone like them and they have had the chance to consider the benefits they would most like to experience. They have heard their ideas spoken back to them, which can help to reinforce them. Now it’s decision time.

Asking an open question ‘what do you think you will do?’ rather than a closed question, such as ‘are you going to do physical activity?’ helps remind them that they – not you – are the decision maker.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

If you have never been active, or not been active for a while, it is important to start gradually and build up gradually

If you are newly diagnosed it is important to monitor how an activity affects your blood sugar levels by checking you blood sugar levels before and after an activity. If an activity lasts longer than 30 minutes, then try to check your blood sugar levels during the activity if you can

Real impact

Physical Activity can help you make new friends through shared interests or joining new clubs in or outside of school

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Physical activity is not just sports – have fun!

Agree a plan

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There are some things that some, but not all children and parents find helpful when making a plan. Can I share with you some of these with you now and you both can let me know what sounds most interesting to do next?
We could also discuss your plan using new ideas too! Not everything works for everyone – and you both have great ideas!

If they agree, ask them which of these might suit them

Share the relevant resource from the list below with your patient

Activity Wheel

Children can pick an activities which they would like to do and brings an element of fun when choosing what to do. This can be done spontaneously and with the family.

Idea Board

This allows children to be creative and chose what activities that they may have seen on TV or in a magazine and bring them to life.

Reward Chart

The reward chart provides aprogress incentive for children to use with the support of their parents/guardians. When an activity is achieved a smiley face can be drawn or sticker will be received in the appropriate box.

Insight

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At this stage it is important to engage parents when making a plan, as they will need to facilitate any physical activity which occurs. There is not strong evidence around the following in children and a lot of this will have to actioned by parents.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

If you have never been active, or not been active for a while, it is important to start gradually and build up gradually

If you are newly diagnosed it is important to monitor how an activity affects your blood sugar levels by checking you blood sugar levels before and after an activity. If an activity lasts longer than 30 minutes, then try to check your blood sugar levels during the activity if you can

Real impact

Physical Activity can help you make new friends through shared interests or joining new clubs in or outside of school

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Physical activity is not just sports – have fun!

Arrange follow up

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Would you like to come back and talk to someone a little more about this and tell us about all the fun things you have been getting up to?

Insight

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Ongoing support is a key factor of successful behavioural change.

Useful things to organise for people with diabetes may include:

  • A follow up appointment with you or a colleague
  • Onward signposting

Signpost the patient information section, which contains links to physical activity opportunities regionally.

Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

If you have never been active, or not been active for a while, it is important to start gradually and build up gradually

If you are newly diagnosed it is important to monitor how an activity affects your blood sugar levels by checking you blood sugar levels before and after an activity. If an activity lasts longer than 30 minutes, then try to check your blood sugar levels during the activity if you can

Real impact

Physical Activity can help you make new friends through shared interests or joining new clubs in or outside of school

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Physical activity is not just sports – have fun!

Signpost support organisations

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We can also give some information which you can provide to your school, any clubs you might be interested in joining or any other family members so they can understand your condition a little more, and how being active can help

Support organisations
Diabetes UK

Diabetes UK- Physical activity and your child offers advice around planning activities and sport for children with Diabetes.

EXTOD team

Practical website on managing exercise for type one diabetes (EXTOD) established by medical professionals with a peer support network. Provides advice on how to exercise, how to maintain blood glucose in a safe range before, during and after exercise

Juvenile Diabetes Research Foundation

The Juvenile Diabetes Research Foundation provides support

Digibete

Digibete offers information on how to manage Type 1 Diabetes around sports and exercise.

Insight

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Did you know?

It is easier to get moving when the whole family is involved, so look for activities that everyone will enjoy!

If you have never been active, or not been active for a while, it is important to start gradually and build up gradually

If you are newly diagnosed it is important to monitor how an activity affects your blood sugar levels by checking you blood sugar levels before and after an activity. If an activity lasts longer than 30 minutes, then try to check your blood sugar levels during the activity if you can

Real impact

Physical Activity can help you make new friends through shared interests or joining new clubs in or outside of school

Be realistic about what you can achieve and don’t be hard on yourself if you don’t always manage to fit exercise in when planned or if you’re exercise session doesn’t always go as well as you’d like!

Physical activity is not just sports – have fun!

Survey

Public Health England and partners would like to hear from healthcare professionals using the Moving Medicine website. Please follow the link below to participate in our survey. It takes around 5 minutes to complete.

The survey opens in a separate window, and is hosted by Ipsos MORI, an independent research organisation.

If you’ve previously completed this survey, thank you, please close this message.

Click here to take part