The Diabetic Athlete

Wednesday, December 2, 2015 - 08:00

More than 382 million people worldwide, and 10 million Canadians, are living with Diabetes Mellitus, more commonly known as diabetes. There are three different types of the chronic disease, but most athletes seem to have either Type 1 or Type 2 diabetes. Type 1 is when the pancreas fails to produce enough insulin for the body, and Type 2 is when the cells in the body fail to respond to insulin properly.

Physical exercise has proven beneficial role in helping to manage diabetes. It helps increase insulin sensitivity, which reduces the amount of insulin that is needed, and helps spread glucose across the cell membrane. In the context of competitive sport, managing diabetes requires more than one step. Proper precautions still need to be taken to ensure that the athlete is keeping their blood sugar at a proper level especially when pushing their bodies to the extreme. Professional athletes such as Max Domi, Jay Cutler, Bobby Clarke and Arthur Ashe have had successful professional careers while living with the disease. How does an athlete manage diabetes while playing their sport? Here are some tips:

• Athletes should consult with a medical professional before playing sports to ensure that there will be no adverse effects to their health by participating and to make athletes aware of any special precautions that should be followed while participating.
• Make sure to test  blood glucose levels frequently during exertion. Medical professionals recommend that tests should occur one hour before an event, then 30 minutes before an event, and multiple times during and after the event.
• Make sure to eat before, during, and after exercise. Eat a meal high in carbohydrates one to three hours before exercise, as it helps prevent hypoglycemia. Also, focus on foods that release glucose gradually, such as apples, bananas, pears, mangos, grapes, fruit muffins, multigrain bread, pasta, milk, low-fat yogurt, and baked beans.
• Try to consume food at the same time every day. This will help develop a routine for the body and make it easier to regulate blood glucose levels. Recommended foods include vegetables, meat, poultry, eggs, and dairy products. Foods with low glycemic index (GI) are best because they help assist blood glucose control.
• Create a diabetes care plan for practices and competitions. The plan should include blood glucose monitoring and insulin therapy guidelines, a list of other medications, guidelines for hypoglycemia recognition and treatment, and emergency contact information.
• Make sure team trainers and medical staff are aware and educated on the disease. The trainer can help identify when blood glucose levels are dropping, make sure that the athlete is properly hydrated, and help manage nutrition during exercise.

Parents of children with diabetes can help their young athletes have successful experiences in sport by expanding upon what they already know about managing the disease to incorporate the extra physical and mental demands inherent with sport. Here are some tips for parents to consider when supporting their athletic child:

• Know where the nearest source of food is at practice, competition and especially on road trips or pre-pack a food supply bag. Parents can make sure that their child can gain access to food or drink without delay, knowing that blood sugar levels can fluctuate throughout the day and depending on activity levels.
• As mentioned above, check blood glucose levels before, during and after sport. Adjustments in insulin dose or eating an extra snack will help prevent low blood glucose in your young athlete.
• Lack of sleep can lead to poor blood sugar control. Tips for getting more sleep include keeping regular bedtime and waking hours, establishing a relaxing bedtime routine, and eating and drinking long before bed.
• Know the signs of low blood sugar, also called hypoglycemia. Symptoms include sweating, lightheadedness, shakiness, weakness, anxiety, hunger, headache, problems concentrating, and confusion.
• Parents may not always be on-site with their athletes, especially as they grow older.  Making sure that coaches, managers, and/or other team personal are aware of your child’s medical history and actions to take in case of emergency is always a good precaution.

Athletes have proven over and over again how diabetes won’t stop them from competing in the sports that they love. Proper nutrition, good sleeping habits and attention to health cues can provide athletes with a game plan to allowing them to play hard and remain healthy! If you are an athlete, a family member, or work with athletes, keep these tips and tricks in mind and remember to get medical checks on a regular basis.

References:

Merrick, M. Managing Type-1 Diabetes in Athletes. Athletic Therapy Today. September 2001.

McQuaker, C. Diabetes and You. Hughston Health Alert. Volume 18, Number 3. Summer 2006

Jimenez, C, Concoran M, Crawley, J, Hornsby G, Peer K, Philbin R, Riddell M. National Athletic Trainers Association Position Statement: Management of the Athlete with Type 1 Diabetes Mellitus. Journal in Athletic Training. Volume 42, Number 4. December 2007

Andrew Caudwell