Anup Janak Shah, MD is a pediatrician, population health expert, and a medical device digital health leader who currently resides in Portland, Oregon. In the following article, Dr. Shah discusses the importance of regularly monitoring glucose levels for diabetic athletes and the effects on sports performance.
Almost 18,000 youth are diagnosed with type 1 diabetes every year, and some of these are young athletes who want to remain active despite their diagnoses. Although popular perceptions may indicate otherwise, exercise for these patients should never be discouraged. They just need to learn how to manage their condition and safely perform optimally in the long run.
While it can be discouraging for teen athletes who receive the diagnosis, their time playing their favorite sport is far from over. With the right education and physicians that allow them to take an active role in their treatment, sports performance remains largely unaffected.
In fact, those at Nemours Teens Health states that
diabetes shouldn't hold them back; they can play sports just like anyone else.
Dr. Anup Janak Shah on the Relationship of Exercise and Diabetes
Athletes' bodies use carbohydrates and lipids as their main fuel source. At the beginning, muscle contraction utilizes glycogen and ATP in the muscle, before shifting to free fatty acids and blood glucose as the duration increases.
Anup Janak Shah, MD says that if the individual continues exercising beyond this point, their primary fuel source becomes blood glucose, which originates from liver glycogen breakdowns and previously eaten carbohydrates. This need for carbs increases in line with the intensity of the exercise.
Youth athletes with type 1 diabetes have an impaired ability to oxidize consumed carbohydrates. Therefore, they lean harder on muscle glycogen and free fatty acids, making them prone to ketosis during vigorous activity.
In athletes without diabetes, insulin secretion regulates blood glucose levels. And even though these hormone processes also happen in those with diabetes, the response is diminished and less effective. In other words, they cannot change insulin levels before exercise, causing a hyperinsulin state if not properly dosed throughout activity.
The Key to Correct Management in Adolescent Athletes
Through extensive research Michael Yurkewicz, DO et al. discovered that taking
a team approach to management for teen athletes works best. Everyone around the athlete should be involved — physicians, parents, coaches, trainers, other school staff, and the individual themselves.
Anup Janak Shah, MD explains that diabetic athletes should have easily accessible testing supplies, prevention/treatment plans, emergency contact information, and blood sugar goals at all games and practices.
Before competitions, the National Collegiate Athletic Association and the Pennsylvania Interscholastic Athletic Association requires preparticipation physicals. While generally used to identify individuals with risks of exercising, like cardiac problems, it can also be utilized to screen poorly controlled diabetic patients.
Experts consider this physical a good time to provide education on the appropriate testing times and reaffirming the athlete knows how to handle their glucose monitoring during the game.
Blood Glucose Monitoring Throughout Exercise
Anup Janak Shah, MD notes that specialists recommend monitoring blood glucose every half an hour during exercise, with at least two measurements taken in the hour before activity begins.
Although, this may not be feasible in some sports. Therefore, the use of continuous glucose monitoring devices is often preferred. Such monitors constantly read blood glucose levels, allowing adolescent athletes to check their levels in a matter of seconds both on and off the pitch/field/court.
Dr. Shah says that thanks to the advancements in technology, these devices are more affordable than in previous history, enabling more teenage athletes to take control of their condition and perform at their best without adverse long-term effects.
Impacted Sports Performance Proves Concerning for Many Young Athletes
Many young athletes with type one diabetes let their sugars run higher than ideal because they fear that hypoglycemia will negatively impact their performance. But these affects are only present when insulin intake and carbohydrates aren't properly controlled.
Anup Janak Shah, MD explains that those with diabetes can reach exceptionally high levels of athletic performance, rivalling those without the condition. However, the fear that causes them to allow their glucose levels to run high is, sadly, the very thing that stops them reaching their potential.
The fix? Education. Teenage athletes must be aware of the dangers associated with ultra-high and low blood glucose levels. Plus, emphasizing the fact that impaired sports performance typically occurs when levels aren't optimally controlled will often spur them into taking appropriate action.
Overall, continuous monitoring and thorough education brings unaffected sports performance for adolescent athletes with type one diabetes, allowing them to keep playing the sport they love for years to come.
