With diabetes, the places you always felt were safe for your child suddenly appear filled with new obstacles. Arranging playtime can be challenging, but with good planning, a well-thought-out approach, and notes to remind you how and when, you can once again send your child out to play safely, happily, and even if somewhat tethered to you, feeling almost free again.

Check Constantly (At First)

For the first few outings, you're going to need to be in information-gathering mode. Warn your child ahead of time. Let her know that the first few times she does any activity, as benign as it may seem, you're going to be a bit careful. Tell her you'll be checking her before she heads out and right when she comes in at the very least. You may, if she is heading out for an extended period, need her to check her levels midway through the activity and give you a call, or if she is younger, she may need to meet you at some point and you'll check together. Let her know that this will not be forever. Eventually, you and your child will come to know, almost instinctively, how different activities affect her and what you need to do before and after them.

At the start, your child may balk at what she sees as an intrusion on her free time, so be sure to drive home the fact that, with information and in time, you'll be able to set her relatively free again. If she can see an end (of sorts) in sight, she may be more willing to react positively.

You may even want to go out of your way to have your child do some of his playtime activities a few times in the early months. The more you can get under your belt with a real-time understanding of what to expect blood sugars to do, the sooner you can give him a little bit more freedom. This activity might set your child free mentally too. Once diagnosed, some children can think that diabetes is going to limit them in activities and in life. Arranging an impromptu ski day (so you can see how that sport affects your child) can lead him to say, “Hey, I can still do everything I want.”

Carry-alongs

It would be nice to be able to tell your child that she will never have to bring anything along with her as she plays, but the plain truth is she will need to. A general rule is the farther away she'll be playing, the more she'll need to bring.

Kids playing in your yard don't need to carry anything. You are there for them (or another caring adult is) if they need anything. But once they roam beyond that point, they need to pack backup supplies and carbs. It's not easy to carry a juice box, so glucose tabs or sweet candy like Skittles are best. This is a non-negotiable requirement for kids with diabetes who are out playing. Let your child know that if he is more than a few houses away from home and feels low, he should eat the carbs and should head home for a quick check. If he is wrong, it is better for him, in this case, to err on the side of caution.

It's a good idea to encourage your child to carry a meter if she is heading farther away than a few homes as well. This can seem inconvenient, but a child who is encouraged to stop and check when she is not feeling right is a child you'll be able to trust in the future. Find a way for her to carry her supplies easily. Some meters and lancet devices fit right into the zip pocket of a jacket (but be sure the pocket zips; more than a few meters have fallen out of the open pockets of playful children). Other devices fit into small backpacks if your child does not mind carrying one. If your older kid is heading farther away, this is non-negotiable. He simply must carry the tools he needs with him, and you cannot allow him to head far from home without a meter, strips, glucose, and a site change in case of emergency if he is on a pump. Expect a battle if your child is a teenager. Teens hate to be encumbered, but don't back down. The one time she needs it and doesn't have it, you'll regret it, and so will she.

Cell phones are the equivalent of the Apollo moon landing for playtime and kids with diabetes. A decade ago, some parents were astute enough to buy walkie-talkies for neighborhood play, but they had little way to keep track of kids who meandered farther. As much as you may not like the idea of giving a younger child a cell phone, you won't regret it. Insist that your child keep her cell phone on at all times while out playing. Promise that as time goes on you'll try not to check on her too often.

For younger kids, new cell phones that only allow them to call a few numbers are available. You may want to consider one for your own peace of mind.

What about medical alert jewelry? Little children, particularly girls, don't mind them at all, but older kids and boys can balk at them. Have your medical team back you up on this: When your child is away from you, wearing a medical alert piece is not negotiable.