MADISON, Wis. – High school athletes with diabetes are actually playing two games at once – the visible one on the field and the invisible but vital one behind the scenes.
That’s the viewpoint of Dr. M. Tracy Bekx, assistant professor of medicine (endocrinology) at University of Wisconsin School of Medicine and Public Health.
“It’s certainly possible for diabetic kids to be great athletes,” says Bekx. “But they walk a tightrope – trying carefully not to lean too far one way or another in controlling their blood sugars—while at the same time trying to make a play, hit a ball or reach a finish line.”
Pro football quarterback Jay Cutler, pro basketball player Adam Morrison, and Hockey Hall of Fame member Bobby Clarke are all successful athletes with Type 1 diabetes who made it to the highest level of their sport.
Type 1 diabetes, which affects one in 300 children, is a chronic disease in which the pancreas doesn’t produce enough insulin. Type 1 diabetics require insulin via shots or a pump and close monitoring of blood-sugar levels. If those levels are too high, the patient is prone to serious long-term complications like nerve damage, heart and kidney problems. If they’re too low, people get dizzy, confused, and can lose consciousness.
Bekx, a pediatric endocrinologist at American Family Children’s Hospital, encourages younger Type 1 diabetics to stay physically active to improve overall health, but stresses the importance of keeping blood sugars under control before and after competition.
“We counsel patients on being proactive with diabetes and exercise and the possible adjustments in insulin,” she says. “During physical activity, muscles need and take energy, leading to increased risk of lower blood sugars that can impact athletic performance.”
Bekx says young people with Type 1 diabetes who keep an eye on their blood-sugar levels, stay hydrated and have a balanced diet should be able to perform on the playing field with minimal complications. But the risks may vary with the type of sport involved.
“Athletes who are long-distance runners or involved in strenuous aerobic activity such as swimming or soccer may have a different glucose response than a football player who is doing a lot of stopping or starting,” she says.
“Every patient is individualized, and a lot of it is trial and error.”
Bekx also says that during competition, blood-sugar levels may rise (due to increased adrenaline) and then drop hours later. That could lead to delayed hypoglycemia, which may cause dizziness, confusion, and fainting. Therefore, it’s important to monitor blood sugars several hours after competition, and adjust insulin or eat a snack if necessary.
Even though it is a challenge, Bekx believes young people with Type 1 diabetes can excel in sports if they take care of themselves.
“We do know athletes will perform better if they are metabolically in good control,” she says. “Their body is going to work better. Their muscles are going to work better. They will have the energy to perform better.”
“I tell patients who are newly diagnosed that they should aspire to be all things they want to be before they had Type 1 diabetes,” adds Bekx. “The diabetes will change how they reach their goals in life, but it shouldn’t prevent them from getting there. The patient with Type 1 diabetes most likely to succeed is one with the discipline of a trained athlete, committed to hard work and able to overcome daily challenges. If you have that personality and drive, you’ll be a winner both on and off the playing field.”
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