1. Diabetic Athletes
Questions answered in this presentation
• How does Type 1 Diabetes affect athletes and athletic
performance?
• Does this condition affect pre competition and post
workout meals?
• What is Type 1 Diabetes and how does it affect
nutrient transportation?
• Are Type 1 Diabetic Athletes at a disadvantage?
3. What is Type I Diabetes?
• Also known as Juvenile Diabetes
• Autoimmune basis
• The beta cells of the pancreas can no longer
make the correct amount of insulin because
the body’s immune system has attacked and
destroyed them.
• Tis disease tends to occur before the age of 30
• Includes only about 5% of diabetics.
Bolus: regular or fast acting insulin injection
5. Treatment and Control
• Insulin injections
• Change in diet (nutrition)
• Physical activity
• Controlling blood pressure and cholesterol
6.
7. Overview:
• Non-diabetic when BG levels rise above normal (70-99 mg/dl
fasting), the hormone insulin is released to help lower
• Type 1 the pancreas has a reduced or in ability to release
insulin; ALWAYS insulin requiring
8. How Type I Diabetes affects Athletes
and performance
• Insulin levels on Exercise Glycemia
– Physical activity promotes the uptake of glucose
into active muscle cells
• This is why correct timing and dosage of insulin are key
to the effective glucose management during exercise.
• Maintaining energy levels throughout
exercise/performance becomes less
manageable needs to be planned
9. How Type I affects performance and
athletes
• Timing of Exercise
– Late evening can result in nocturnal hypoglycemia
– Early morning exercise can result in later-onset
hypoglycemia
– Higher chance for hypoglycemia when participating in
successive days of practicing/competing.
• Does not have to affect performance if levels are
steady pre-competition (with the exception of
endurance athletes)
10. Type 1 Diabetes & Athletic
Performancev
• Hypoglycemia abnormally low levels of glucose in the
blood (low blood sugar) negatively impacts diabetic
performance
• Dramatically lowers exercise performance
• Causes onset fatigue reducing exercise endurance
• Reduced ability to secrete beta-endorphins during
exercise increasing perceived effort
• Poor metabolic control causes decrease in maximal
aerobic capacity
• Reducing insulin & increasing carbohydrate/fluid intake
allows individuals to compete at optimal performance
Above are things that can happen if one is not meeting their body’s requirements.
11. What’s normal levels of Glucose?
Hypoglycemia
• 40-80 mg/dl
Hyperglycemia
• 120-400mg/dl
Normal
80-120 mg/dl
(some website say 70-
99)
12. Strategy Pros Cons
Reduce pre-workout bolus Reduced hypoglycemia
during exercise (reduce Carb
requirements)
Requires planning
Adjusting pre-exercise and
during exercise basal rate
Same as above Requires planning as basal
adjustments may need to be
made 60 minutes prior to
the beginning of exercise
Carbohydrate feeding during
exercise
Useful for unplanned
exercise (or long)
Counter productive if
exercise is for weight control
Pre-exercise or post exercise
sprint
Reduces post exercise
hypoglycemia
Effect limited to shorter and
less intense exercise
Reducing basal insulin post-
exercise
Reduces nocturnal
hypoglycemia
May caused raised fasting
blood glucose
Taking caffeine pre- exercise Reduced hypoglycemia
during and after exercise;
reduce Carb requirements
Impairments of fine motor
control
13. Risks & Benefits of Exercise
With Diabetes
Benefits Risks
Same as people without Type 1 Hyperglycemia
Increased whole body insulin
sensitivity
Hypoglycemia
Potentially lower A1C in children
and adolescents with type 1
Muscoskeletal Injury
Cardiovascular Accident
15. Pre-Competition Meals
• Consumed 3 – 4 hours before competition
• Critical to maintain BG levels in the near-normal
range (4 to 7 mmol/L)
• Beverage containing 1 to 2 g carb/kg body weight
should be consumed 1 h prior to competition to
maximize pre-exercise glycogen stores
• 6% carbohydrate electrolyte beverage containing
simple sugars like sucrose & fructose are ideal
16. Pre-Workout Meal
1. Check BG about one hour before
2. Options
– Coconut water with one ounce of raw nuts
– 2% organic milk or yogurt with a piece of fruit
– All natural whey protein with flax seeds and frozen
broccoli
– Pepper, carrots, and hummus wrapped in a slice of
turkey breast
3. Calculate amount of insulin you need from your
snack so you can be within 100-150 mg. (depends
on individual)
17. • Carbohydrate ingestion is essential for
maintaining BG concentrations
• Carbohydrate intake delays fatigue & provides
fuel for oxidation
• The amount consumed depends the exercise
intensity, gender, age, and the timing and dose of
the last insulin injection
• 1 to 1.5 g carb/ kg body weight should be
consumed during exercise
• Continue fluid intake (250 mL every 20–30 min)
Intake During Competition/Exercise
18. Nutrient Intake
Following Exercise
• Carbohydrate intake is needed to help
replenish liver and muscle glycogen stores.
• Carbohydrate intake should be within the first
hour following exercise
• Consume slow-acting carbohydrate to protect
against post-exercise late-onset hypoglycemia
19. Post Workout Meal
• Having carbs to protein in a ratio of 4:1
• This will help prevent low blood sugars later
21. Famous Type I Diabetic Athletes
Jay Cutler
"The more you put in your body the more you
have to regulate it with insulin. So later kickoffs
you're talking about breakfast, lunch and a
pregame meal, so that's more food you've got
to be aware of and what you put in your body.
A noon game, light breakfast, a little fruit and
some insulin and I'm good to go." (Jay Cutler
ESPN)
Ron Santos
"But I don't want this to go outside this room,"
I said. "I expect you to judge me by what I do
on the field. I just don't want to hide
anymore.” (Ron Santos)
23. Interview Summary
1. Diabetes DOES affect performance a great deal
2. Most often, the more intense the work out the less insulin
you will have to take.)
3. Also, I can't speak for others but for me, adrenaline affects
my sugar levels A LOT. Because I know this about myself,
whenever I am in a competition, I test a ton, monitor my
sugars, and do the best I can to keep them level.
4. DISADVANTAGE; no matter how much you try to control,
body does what it wants
Conclusion:” I am lucky and blessed to have medicine and
technology that enables me to live. If you have a good outlook
and proper guidance, there is not much a diabetic can't do. It
may take a lot more effort on our part, but it is a responsibility
you take on for love of your sport or fitness goals. It sucks, but
it is still manageable.”
DrewHow to lower the chances of hypoglycemia during Exercise…
Drew A1C: hemoglobin levels higher means higher chance for disease
RED BOX WILL COME IN ON CLICK (Diabetic suggestions)Andy
Andy
Andy
Drew
Scott
Ricky
Ricky 5:13
Ricky
Melissa
MELISSAWith Kelsey Vance, a personal trainer and recreation athlete; always played in high school; Athletic ability is compromised when sugar is too high or low. (fluctuates even more so when exercising) It can be time consuming and frustrating when you constantly have to drink a Gatorade, eat a snack, check your sugars etc during practice and/or competition but trying to keep your sugars level is much easier to deal with than trying to fix them once they are already really low or really high.(Every diabetic is different though and will have their own unique ratio of insulin to carbohydrate.) As a diabetic, it is important to understand how your own body responds to your physical activity and the food you eat so you can adjust accordingly. This ultimately effects your performance, practices, and recovery. That being said though, everyone has something. I do not believe that a diabetic has a more difficult time than another person with a disease, disorder or injury. The silver lining about diabetes is that even though it is a pain in the ass, difficult to handle and often really frustrating, a majority of the time everything is totally fine.
