Diabetes Management for Athletes

Allen Green, MD

5 years ago

People with diabetes who want to take part in sports may think that they have to give up their dream because of their lifelong medical condition. Even though these fears are not misplaced – exercise or physical activity may lead to low blood sugars (hypoglycemia) – with proper diet and careful control, you can easily take part in sports. Many professional athletes are enjoying successful sports careers while simultaneously fighting against their constant opponent ‘diabetes’.

While people with diabetes can play any sport, they have to make sure that their blood sugar levels are under control. The level of blood sugar has a direct impact on an athlete’s stamina, flexibility, strength, and speed. All of these components are essential for success in both sports and fitness. How would you know that you are suffering from hypoglycemia? When participating in physical activity, look out for the common signs of hypoglycemia, which include shaking, confusion, impaired vision, dizziness, irritability, weakness/fatigue, and hunger.

Tips and Strategies for Blood Sugar Management

Poor management of diabetes will not only have a direct impact on your performance, but it can also end up causing organ damage. This is why, regardless of the extent of your physical activity, you should follow some tried-and-tested tips and strategies that can help you with blood sugar management.

1. Monitor Closely

If you are participating in any sports or any physical activity, you must make sure that you monitor your blood glucose levels. Many experts recommend that glucose levels should be monitored every 30 minutes during any sort of physical activity. Before beginning a physical activity, you should check your blood sugar levels. Even though athletes with diabetes should undergo individualized tests, if an athlete’s blood glucose is 100, they should consume carbohydrate supplements. After a period of 30 to 45 minutes, the glucose levels should be rechecked. If the supplements fail to increase blood glucose levels even after two constant attacks of carbohydrate loading, the player should not participate in the sport. In the same manner, players’ urine can also be checked for ketones – in case their glucose level is >250mg/dl. Ketones are the chemicals made in the liver. Your body produces them when it doesn’t have enough insulin to convert glucose into energy. The liver uses up the fat in your body and turns them into ketone which is sent into your bloodstream. The buildup of ketones is poisonous and a warning sign that your diabetes is out of control. If ketones are present, they should not participate in sports. Even if there are no ketones present, the concerned athlete should only take part in light physical activity, such as walking. In case the glucose level is >350mg/dl, there should be no physical activity at all, regardless of the content of ketones.

2. Carry Snacks

Never start any exercise or a game on an empty stomach. It is also advisable that you carry some form of carbohydrates with you. Some carbohydrate-based, easy-to-grab snacks include fresh fruits, crackers, dried fruits, hard candy, and granola bars. If a workout or game’s duration is more than an hour, it is important for you to arrange for consuming snacks throughout. For daylong events, you must eat six small meals that contain both protein and carbohydrates. Make sure that you don’t eat food that is high in sugar and fat.

3. Let Your Coach Know

It is important to let your coach and other team members know that you are a diabetic patient. You should also teach them about the signs and symptoms of hypoglycemia so they can help you out in case your blood glucose levels drop.

4. Monitor Blood Sugar (Even after physical activity)

Make sure to keep your body fueled after any physical activity. Hypoglycemia can occur at least 48 hours after you have concluded your physical activity. This is why it is important to keep checking your sugar levels hours after the sporting event has concluded.

5. Stay Hydrated

When participating in any kind of physical activity, your body can end up being dehydrated. Therefore, it is important to be mindful of your water intake.Drink cool, plain water to keep yourself hydrated. Even though you may be tempted to drink fruit juice from the physical strain, avoid drinking that as it may upset your stomach and cause cramps, nausea, and bloating.

6. Insulin Treatment

Before you take part in sports or any kind of physical activity, you should consult with your doctor regarding the adjustment of your insulin dosage.

Managing Diabetes In Different Sports

Even though many people with diabetes believe that they shouldn’t take part in any physical activity, sports and exercise actually offer a lot of health benefits for people with diabetes. Since different sports bring different challenges with them, here is a short guide to how you can manage diabetes when participating in different sports.

Managing Diabetes When Playing Basketball

Basketball matches are short as they normally run for 48 minutes with four 12-minute quarters. However, with timeouts, halftime, and fouls, etc., the game time can extend up to two-and-a-half hours. Throughout the game, ensure that your blood glucose levels are somewhere between 7 and 9 mmol/l. With every timeout, you should get your sugar levels checked. In case your blood sugar levels decline a bit, you can have some carbohydrate snacks or take sips of sugary drinks.

After the game, make sure that your blood sugar levels are not lower than 7 mmol/l. You can also reduce the amount of your dose of insulin to prevent hypoglycemia. Even though it is generally recommended to reduce your insulin dosage, always consult your doctor when modifying the intake of medicines. Your doctor will modify your dose based on your level of activity.

Managing Diabetes When Swimming

Swimming is a popular sport that does wonders when it comes to improving cardiovascular fitness. The constant moving is an important part of the game, which leads to the smooth flow of blood and oxygen throughout the body. A good thing about this sport is that it doesn’t end up spraining your joints. People who are into swimming would know that this sport requires both upper and lower body muscles. This constant movement goes a long way in benefitting people who complain about diabetic neuropathy and suffer from numbness.

If you are diabetic and planning to include swimming somewhere in your weekly activity, you should start swimming once or twice a week. When swimming, it is essential that you keep your blood sugars above 12 mmol/l. Blood sugar levels lower than this can lead to hypoglycemia. In case your blood glucose level drops, you can take several sips of a glucose drink or consume glucose tablets to get the necessary sugar boost. Once your swimming session is over, don’t forget to consume sugar immediately. Later in the day, consume a big meal to prevent hypoglycemia. Even though short swimming sessions may not require excessive management, consistent swimming – an hour-long session, for example, can increase the risk of hypoglycemia both during and after the session.

Wherever you are swimming, don’t forget to wear any kind of medical identification. This will help people around you to provide immediate assistance in case you need help.

Managing Diabetes When Skiing

Skiing is another well-loved sport which is an integral part of the winter season. If you are diagnosed with diabetes, you don’t have to give up on your dreams of skiing on a snowy mountain. With proper management and some care, you can easily take part without any problem. When skiing, you have to make sure to get your blood sugar levels monitored. The first test should be done before you get on a chairlift. If you feel any symptoms of hypoglycemia, the best thing is to avoid getting on a chairlift as a hypoglycemic attack while you are on a chairlift can be scary. Before you enroll in swimming classes, you must manage your insulin dosage under the supervision of your doctor. Another thing that you have to make sure is to keep your body hydrated.

Managing Diabetes When Hiking and Trekking

Hiking and trekking are two different types of physical activities but require similar management. Unlike hiking, which occurs on pre-charted paths and is completed in a day or overnight, trekking takes days. The tracks of trekking are even more challenging and comprise rough terrain. Whether you are hiking or trekking in hot or cold weather, you have to take care of insulin storage. In hot weather, insulin may spoil quickly. When trekking on warm days, make sure that you store the insulin in the coolest place of your backpack. You can also carry cold portable boxes for storing insulin. Similarly, if you are trekking in an area that witnesses below freezing temperatures, you must keep the insulin at a warm place to prevent it from freezing. During your entire trip,eat plenty of carbohydrate-based meals and snacks – more than what you’d eat on a normal day. Eating whole-grain foods, such as pasta, breakfast cereals, and bread is a good source of long-lasting energy that will keep you energetic throughout the trip.

Managing Diabetes When Walking

Walking is a less stressful physical activity that has a lot of health benefits. People who are on insulin may find walking a healthy habit for getting their blood glucose levels close to the normal levels. After walking, do test your sugar levels to make sure that your blood sugar levels haven’t dropped. You can make a few changes to deliberately add walking into your routine:

Use stairs as much as you can.
Park your car further away from shops or shopping malls and walk up to the venue.
For short journeys, don’t take out the car at all.
Take short strolls in your nearby park every day.
Even when at home, move around as much as you can.
Instead of sitting in front of the TV, move around during commercials.

Managing Diabetes When Playing Squash

Squash is one of the most intense and tiring sports. When you are playing a game of squash, your blood glucose levels are bound to fluctuate significantly. The game of squash usually sees the dominance of upper limb movements. This means a low glucose use, resulting in higher blood sugar levels during the game. Since rising glucose levels is a big threat, you don’t really have to increase the intake of glucose drinks or carbohydrate before the game. This doesn’t mean that you shouldn’t carry these items with you. When you are playing the game of squash, it is important to wear some medical identification so that you can easily receive medical help during an emergency. Take breaks every 30 minutes to check your blood glucose levels. If your blood sugar drops below 5 mmol/l, you should munch on carbohydrate-based snacks.

Managing Diabetes When Playing Golf

On the face of it, golf is a very simple game that doesn’t require heavy physical exertion. If you are a person with diabetes, you should ensure wearing medical identification to let other people know that you may require medical attention. Before playing golf, it is important that you have eaten a healthy, nutritious meal. When leaving for the golf course, don’t forget to carry some snacks and glucose with you. Also, make sure to get your blood sugar levels checked throughout the game. Diabetic people who play golf can also reduce their insulin take, but they ought to consult with their doctor who will prescribe the right dose of insulin.

Managing Diabetes When Playing Rugby

Rugby is a rough game that requires a lot of physical energy and exertion. If you are going for a morning session of rugby training, you can inject the minimum amount with a large breakfast. If during lunchtime, your blood sugar is somewhere between 6 and 9 mmol/, you won’t need insulin at all and you can play the game after consuming your lunch or even a small portion of carbohydrate-based snacks. However, it is important to note that even though several studies have demonstrated that you can reduce your insulin intake before playing rugby, we strictly recommend you consult your doctor and diabetes healthcare team with regard to insulin intake before the game of rugby.

Managing Diabetes When Playing Tennis

One of the most intense sports, tennis is a game that is played for a longer duration. When exercising or practicing a game of tennis, make sure that your blood sugar levels are not lower than 5-7 mmol/l. Test your sugar levels every 50 minutes and top up your body with carbohydrates or glucose drinks to manage any decline in your blood glucose levels. Weather conditions should also be kept into account when playing a game of tennis. If you’re playing under the sun, reduce your insulin intake with a meal you had before the game.

Summary

For many people with diabetes, participating in any physical activity may seem like a daunting task. Although it is true that managing diabetes when participating in sports can be challenging, with adequate strategies and management skills, you can control your blood sugar levels. With proper management, both children and adults can participate in all types of physical activity.

Before you play any sport or game, make sure to consult a proper diabetes care team that can tell you what precautions you have to take when playing the game.

Learn more about blood sugar management techniques in our free ebook,. Hydrate to Regulate (Blood Sugar).