Insulin requirements and metabolic control in children with diabetes mellitus attending a summer camp.

The metabolic control of 33 children aged 7-12 (mean 9.8 years), 19M:14F, with diabetes attending a 7-day physically active summer camp was evaluated. Insulin dose was reduced by 20% on arrival at camp, and adjusted daily to maintain preprandial capillary glucose between 4 and 11 mmol l-1 and overnight glucose above 7 mmol l-1. Despite a mean reduction in insulin dose of 33%, hypoglycaemia was common especially in the first few days of camp. This suggests that on day 1 of a physically active camp an empiric reduction of 30% in insulin dose would be more appropriate. However, it is also essential to increase daily carbohydrate intake and New Zealand's national guidelines for the management of diabetes mellitus in summer camps are being rewritten to include this advice. In addition, extra carbohydrate portions must be given simultaneously with insulin dose reduction, especially in physically active camps.