Playing Competitive Sports
Being active is important for people with diabetes. But for those who are driven to be athletic and want to make it to the competitive level, we have some suggestions about how you can do this in a healthy and safe way.
Participating in competitive sports can have long-lasting benefits. Besides setting the foundation for a lifetime of physical activity, playing sports during high school and/or college also offers emotional and social rewards.
Athletes with type 1 diabetes can compete safely, as long as they maintain good control of their blood sugar and plan for, monitor, and react to changes in blood sugar levels that can happen because of different levels of exercise intensity and duration.
Look below for tips on setting up a sports care plan for practices and games. You'll also find advice on what to include and how to compete safely on the same turf as teammates and competitors who do not have diabetes.
Discuss any competitive sports you may want to join with your diabetes care team, especially if you are experiencing diabetes-related health problems. While most sports are safe, some may be risky for people with type 1 diabetes who have eye, nerve, or kidney issues.
Develop a diabetes sports care plan
According to the National Athletic Trainers’ Association (NATA), every competitive athlete with type 1 diabetes should have a diabetes care plan for team practices and scheduled games. The NATA recommends that you and your health care team consider including the following in your diabetes sports care plan:
- Blood sugar guidelines, including how frequently blood sugar should be checked and what pre-exercise levels would prevent you from playing
- Insulin guidelines, including the type of insulin you are using, dosages, and adjustment strategies for planned activities, and insulin correction dosages for high blood sugar levels
- A list of all other medicines, supplies, and instructions, including those used to help with blood sugar control and those that are used to treat other diabetes-related conditions
- Guidelines for recognizing and treating low blood sugar (hypoglycemia). Make sure fast-acting carbs, such as juice, crackers, and glucose tablets are available
- Guidelines for recognizing and treating high blood sugar (hyperglycemia). Make sure supplies for measuring the level of ketones (a measure of very high blood sugar) in the urine or blood are available
- Emergency contact information, including the name and phone numbers of family members and health care providers
- A medical identification bracelet
You should share your sports care plan with your coach and make sure he or she understands what to do in an emergency. Let the coach know that assistance from team members may be needed in the case of severe low blood sugar.
To avoid blood sugar highs and lows during and after sports competitions:
- Match insulin to activity intensity. Blood sugar levels can also go too high if physical activity is too intense and/or insulin levels are too low. Sometimes during vigorous exercise, the nerves signal the liver to release stored sugar, which can cause a rapid rise in blood sugar levels. High-intensity activities, which burn more than 7 calories a minute, include running, playing singles tennis, bicycling at more than 10 mph, swimming laps, and circuit training
- Don’t start out too high! A high blood sugar level can go even higher because of exercise
- Check for ketones. If blood sugar is too high, the body might produce ketones (acidic waste products that can occur when fat is broken down for energy) and a dangerous condition called ketoacidosis can result
- Don’t go too low!
—Be mindful of length of time: Blood sugar levels can go too low if you engage in physical activity for long periods of time
—Eat something first: Engaging in physical activity on an empty stomach can cause low blood sugar
—Plan ahead for insulin and food needs: This may take some trial and error, as well as the help of the diabetes care team. Adjusting insulin dosage and food intake to the planned level of physical activity can help keep blood sugar in a safe range
—Stop if there are any warning signs: Just going “5 minutes more” can be dangerous. Take a moment to eat or drink something with a high level of carbohydrates
—Keep “emergency carbs” close at hand: Always keep some form of high-sugar food handy, just in case it is needed. This can be a soft drink (nondiet), fruit juice, glucose tablets, raisins, or hard candy
—Monitor later, too: Blood sugar levels can drop even 16 to 24 hours after physical activity because the body uses blood sugar to replace sugar that has been used by the muscles
When traveling with the team, always remember to take all diabetes medicines along. If traveling takes place over several days, also take your updated prescription(s) in case medicine or supplies need to be replaced. Be prepared for unusually long bus rides or travel delays by having prepackaged meals and snacks (especially fast-acting carbs) close at hand.
Expect the unexpected
It’s important to prepare for the unpredictable, such as when, for example, the game lasts longer than expected, the weather suddenly changes, or it is unusually hot or cold on game day. The very thing that makes sports exciting—you never know what’s going to happen next—is the thing that can make it challenging to manage your type 1 diabetes during competition. However, by planning ahead for (and responding to) factors that affect blood sugar levels, it is possible to stay safe during games.