1. Understanding Athletes with Diabetes Ms. Chelsea Butler

2. 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

3. 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

4. What is Diabetes Mellitus? Three different types: – Type 1 Diabetes – Type 2 Diabetes – Gestational Diabetes

5. 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

6. Recent Trends in the U.S.

7. 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

8. 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 BG levels over a two to three month time period – The higher the BG levels, the more hemoglobin with attached glucose

9. 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

10. Can Diabetics Be Athletes?

11. Of Course!

12. 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

13. 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

14. Physical Activity & Sports Special Considerations: – Hydrate adequately – Appropriate footwear Cushioning, shock absorption, etc. – Appropriate clothing May have impaired circulation and sensation; dress for the weather/situation – Monitor BG levels Before, during, and after depending on intensity/duration – WEAR AN ALERT BRACELET

15. Basic Nutrition Carbohydrate consumption – Great source of glucose – Pre-exercise snacks: high in carbs, low in fat – Fluctuations depend on overall physical activity and exercise levels Replenish lost energy – Post-exercise: eat a snack with appropriate carbohydrate and protein levels to ensure glucose restoration and tissue repair

16. 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

17. Support and Information American Diabetes Association Diabetes Exercise and Sports Association Centers for Disease Control and Prevention Medline Plus Mayo Clinic

18. Questions?

19. 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. Diabetes Spectrum, 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, from http://www.mayoclinic.com/health/diabetes/DS01121.