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

A. Reassure the parents that increased physical activity reduces the risk for diabetes: Encouraging exercise is beneficial for children with pre-diabetes as it improves insulin sensitivity, promotes healthy weight management, and helps prevent progression to type 2 diabetes. B. Instruct the family about the need to adjust the insulin dose before exercise: Children with pre-diabetes are not typically prescribed insulin; instead, they manage blood glucose through diet, exercise, and weight control. Therefore, insulin adjustment is not applicable in this case. C. Recommend an increase in caloric intake to avoid excessive weight loss: Pre-diabetes management focuses on maintaining a healthy weight, not increasing calorie intake. Adding unnecessary calories could worsen insulin resistance and elevate blood glucose levels. D. Suggest a less strenuous activity to reduce the risk for dehydration: There is no need to limit the child’s participation in physical activities unless medically contraindicated. Adequate hydration and gradual conditioning are sufficient to support safe participation in sports.