The parents of a child with pre-diabetes report to the practical nurse (PN) that the child wants to join a soccer team. What action is best for the PN to implement?

A. Reassure the parents that increased physical activity reduces the risk for diabetes: Regular physical activity improves insulin sensitivity, helps maintain a healthy weight, and lowers the risk of progression from pre-diabetes to type 2 diabetes. B. Suggest a less strenuous activity to reduce the risk for dehydration: While hydration should be monitored, moderate-to-vigorous exercise is generally safe for children with pre-diabetes, and overly limiting activity is unnecessary. C. Recommend an increase in caloric intake to avoid excessive weight loss: Caloric adjustment is only indicated if the child is underweight or losing weight rapidly. Pre-diabetic children usually benefit from balanced nutrition without added calories beyond normal growth needs. D. Instruct the family about the need to adjust the insulin dose before exercise: Children with pre-diabetes are not on insulin therapy. This instruction is not applicable unless the child has progressed to requiring medication, making it inappropriate for routine exercise guidance.