Athletes with diabetes

Athletes with diabetes should consult with their physician prior to beginning any exercise and nutrition program. Blood glucose levels should documented by the physician to establish a normal range for the individual. Certain exercises of a strenuous nature may be contraindicated for athletes with diabetes. Blood glucose levels should be tracked and documented by the athlete thirty minutes before exercise, and then again one hour after exercise. This self-monitored tracking of blood glucose levels helps to assist the athlete in managing nutrition and insulin requirements. Exercise is an important component in managing diabetes. A well planned exercise program can help to maintain desired body composition levels, decrease insulin requirements, increase insulin sensitivity, lower the risk of diabetic nephropathy, and reduce the risk of hypertensive and cardiovascular diseases (Anderson & Parr, 2013). 

 

Diabetic athletes are more challenging to manage than non-athletes. The demands of sport and performance enhancement training can have more pronounced effects on blood glucose levels. Frequent monitoring of an athlete’s blood glucose levels before, during, and after exercise is recommended. Athletes should have routine medical examinations and physicians clearance to exercise. A physician should supervise the diabetic athlete’s exercise and nutrition program. Diabetic identification bracelets or necklaces should be worn by diabetic athletes during all exercise and sporting activities. Athletes with diabetes should remain hydrated during the conduct of physical events. Carbohydrate intake and insulin dosage should be managed, to allow peak performance during exercise and sporting activities. Athletes should always have readily available sources of fast acting carbohydrates during all physical events. Avoiding exercise in the evenings, and at peak insulin action times is recommended, to avoid hypoglycemia (Hornsby & Chetlin, 2005).

Athletes normally have to perform a variety of aerobic and anaerobic exercises to meet the demands of their sport. Diabetic athletes have to be aware of the threats from hyperglycemia, hypoglycemia, and ketoacidosis. Aerobic exercise is primarily recommended for those with diabetes. Walking, swimming, bicycling, and rowing are the recommended aerobic training methods. Diabetic athletes who have lost their protective neural sensation should avoid walking on a treadmill, step exercises, jogging, and walking for long period of time. Thirty minutes of aerobic exercise is recommended for adults on most days. Teens, and youth athletes with diabetes, should strive for thirty to sixty minutes of aerobic exercise on most days. Resistance based, strength training is allowed for athletes who do not show signs of retinopathy and nephropathy (Colburg, 2008).

Aerobic exercise is primarily recommended for athletes with diabetes. Aerobic exercise, done at moderate intensity, for longer duration, lowers blood glucose levels. It is easier to plan for the required insulin dosage, during and after exercise, as needed. Carbohydrate intake prior to aerobic exercise is frequently required. Anaerobic exercise is required for most athletes for performance enhancement. Explosive, short duration, high intensity, bouts of power and strength during exercises such as sprints, powerlifting, Olympic weight lifting, and related weight bearing activities, do not drop blood glucose levels in the same manner as aerobic exercise. Due to the increase in adrenaline and noradrenalin, which is more common with anaerobic exercise, hyperglycemia may occur during and immediately after the training. Hypoglycemia may follow hours after an intense exercise session. Carbohydrate intake may not be required prior to anaerobic training. Both aerobic and anaerobic training have numerous benefits for the diabetic athlete. Proper management of blood glucose and insulin levels will allow the diabetic athlete to perform both types of training (Stinogel, 2010).

Olympic and professional athletes compete at much higher intensity levels than high school and college athletes. The physical requirements of the sports and training are very demanding with professional and Olympic athletes. These professional and Olympic athletes, who have diabetes, face challenges that are similar to, but greater than the challenges faced by high school and college athletes. The advances in medical treatment options, for athletes with diabetes, have come a long way. Many professional and Olympic athletes, with diabetes, have been able to manage their condition and successfully compete at the highest levels. Proper management techniques for diabetes have been successfully implemented into these athlete’s training and nutrition programs. Diabetes is no longer a show stopper for high level athletes, as it was in the past. While the demands and challenges are greater for professional and Olympic athletes, more efficient treatment methods and management techniques have emerged. These high level athletes usually have a much more robust support network than younger athletes (Evans, 2015).

Team physicians, nutritionists, athletic trainers, coaches, and other support staff ensure that elite level athletes receive the proper care that they require. Larger team operating budgets, and high levels of individual income, help provide the funding for advanced diabetic management. Professional and Olympic athletes have also demonstrated the self-discipline and commitment, which allows them to overcome obstacles presented by diabetes. These athletes have trained for many years and are more in tune with their body’s needs. Nutrition and hydration methods, in concert with any required medications, have been honed into a coordinated program, which supports the training and competition demands. Elite level athletes, with diabetes, also usually have a very positive and strong mental outlook. This allows them to view their condition as something very manageable, as opposed to a roadblock that prevents success (Evans, 2015).

References:

Evans, Z. (2015). Great athletes with type 1 diabetes. Diabetes Daily. Retrieved from https://www.diabetesdaily.com/blog/2015/10/great-athletes-with-type-1-diabetes/

Anderson, M.K., & Parr, G.P. (2013). Foundations of athletic training: prevention, assessment, and management (5th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins.

Colburg, S. (2008). Working with diabetic athletes part 1. Diabetes in Control. Retrieved from http://www.diabetesincontrol.com/working-with-diabetic-athletes-part-1/

Hornsby, W., & Chetlin, R. (2005). Management of competitive athletes with diabetes. Diabetes Spectrum. Retrieved from http://spectrum.diabetesjournals.org/content/18/2/102

Stinogel, B. (2010). Nutrition for athletes exercising and competing with type 1 diabetes. University of Minnesota Duluth. Retrieved from https://cehsp.d.umn.edu/sites/cehsp.d.umn.edu/files/nutritionforathletesexercisingandcompetingwithtype1diabetes

Eric Dempsey

MS, ISSA Master Trainer

Dempseys Resolution Fitness