Understanding Athletes with Diabetes

Ms. Chelsea Butler

Purpose• To understand the key concepts associated

with diabetes mellitus including etiology, types, and prevalence

• To understand how diabetes mellitus is diagnosed, treated, and managed

• To become aware of special considerations during physical activity and athletics

• To understand very basic nutritional concepts associated with diabetics who are physically active

What is Diabetes Mellitus?• Health complication:– Result of excessive glucose in the bloodstream– Caused by a lack of or intolerance to insulin production

• Glucose:– The body’s primary fuel source – Needed in order to function from day to day

• Insulin:– Hormone secreted by the pancreas– Produced to move glucose from the bloodstream to

the body’s tissues • Normal blood glucose levels: 70-110 mg/dL

What is Diabetes Mellitus?

• Three different types:– Type 1 Diabetes– Type 2 Diabetes– Gestational Diabetes

What is Diabetes Mellitus?

• Type 1 Diabetes “Juvenile Diabetes”– Characterized by very little or no insulin production – Leads to synthetic insulin dependency

• May be diagnosed at an early age

• Type 2 Diabetes– Characterized by the body’s intolerance to insulin– Pancreas is making insulin; body will not absorb it

• Most common form in our society; associated with obesity

• Gestational– May develop at some point during pregnancy – Women do not have to be diabetic previous to diagnosis

Recent Trends in the U.S.

Diagnosis and Management• Diagnosed only in individuals with consistently

high blood glucose (BG) levels • Fasting blood glucose test: – Performed after waking up,

before eating the first meal of the day

– May be done at home with the use of a glucometer

– Fasting BG of 126+ mg/dL or a random BG taken at any time of 200+ mg/dL is considered diabetic

Diagnosis and Management

• Most commonly used test for diabetes:– Glycated hemoglobin (A1c) test– Measures the amount of

glucose attached to the hemoglobin in the body

– Finds average BGlevels over a two to three month time period

– The higher the BG levels, the more hemoglobin with attached glucose

Diagnosis and Management• Education• Medication • SELF MONITORING

• Type 2 Diabetes Management:– Increasing physical activity levels– Improving diet– Maintaining a healthy body weight– Making lifestyle changes

Can Diabetics Be Athletes?

Of Course!

Physical Activity & Sports

• Most beneficial to Type 2 Diabetics:– Decreases sedentary lifestyle– Aids in weight loss– Assists with normalization of BG levels• Uses glucose more adequately • Increases insulin sensitivity

• Physical activity suggested for Type 1 Diabetics in order to maintain or gain overall health benefits

Physical Activity & Sports

• Special Considerations:– Hypoglycemia (Low BG)• May result in weakness, nausea, sweating, confusion,

shaking• Severe cases may lead to unconsciousness, seizure,

potential brain damage, and possibly death• Prevention: eating a meal or snack +/- 1 hour before

activity, adjusting insulin levels appropriately (especially for Type 1 Diabetics)– Consult physician for individual guidelines

Physical Activity & Sports• Special Considerations:– Hydrate adequately– Appropriate footwear

• Cushioning, shock absorption, etc.– Appropriate clothing

• May have impaired circulationand sensation; dress for the weather/situation

– Monitor BG levels• Before, during, and after

depending on intensity/duration– WEAR AN ALERT BRACELET

Basic Nutrition• Carbohydrate consumption– Great source of glucose– Pre-exercise snacks:

high in carbs, low in fat– Fluctuations depend on

overall physical activityand exercise levels

• Replenish lost energy– Post-exercise: eat a snack with appropriate

carbohydrate and protein levels to ensure glucose restoration and tissue repair

Basic Nutrition

• Glucose sensitivity may vary– Can depend on intensity and duration of activity,

environmental conditions, and emotions• Nutritional guidelines may need

individualized– Consult physician

and/or dietician

Support and Information

• American Diabetes Association• Diabetes Exercise and Sports Association

• Centers for Disease Controland Prevention

• Medline Plus• Mayo Clinic

Questions?

References

Eckman, A. (2010). Diabetes. Medline plus medical encyclopedia. Retrieved September 25, 2010, from http://www.nlm.nih.gov/medlineplus/ency/article/001214.htm.

Hornsby, W., & Chetlin, R. (2005). Management of competitive athletes with diabetes. DiabetesSpectrum, 18(2).

Jimenez, C., Corcoran, M., Crawley, J., Hornsby, W., Peer, K., Philbin, R., & Riddell, M.(2007). National athletic trainer’s position statement: management of the athlete with type 1 diabetes mellitus. Journal of Athletic Training, 42(4), 536-545.

MacKnight, J., Mistry, D., Pastors, J., Holmes, V., & Rynders, C. (2009). The daily management of athletes with diabetes. Clinics in Sports Medicine, 28(3), 479-495.

Mayo Clinic Staff. (2010). Diabetes. MayoClinic. Retrieved on September 26, 2010, fromhttp://www.mayoclinic.com/health/diabetes/DS01121.