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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.