Tips for Athletes with Diabetes: No Limits!
Tips for athletes with diabetes
(Always consult your health care team before beginning an exercise program and to learn the best and safest way to include physical activity in your diabetes care routine.)
Exercise is part of the universal prescription for people with diabetes—both Type 1 and Type 2. It helps keep your blood sugar under control and is vital to your general health in more ways than you could count. Ask your doctor if you should begin a regular program of moderate exercise and the answer will be a resounding “yes!” in almost every case.
But what if you want to do more than “moderate” exercise? What if you are a competitive athlete and really want to challenge yourself?
In this case, you may find you’re largely on your own. The truth is many doctors don’t know a lot about diabetes and competitive athletes. Many doctors have never had a serious athlete with diabetes in their care, and there is very little in the medical literature for them to research. When champion cross-country skier Kris Freeman, who is sponsored by LifeScan through 2006, was diagnosed, the best his doctors could say was that he could “probably” continue to ski. He not only continued, he has improved his already world-class performance and competed in the 2006 Olympic Winter Games. Champion swimmer Gary Hall Jr. was diagnosed with diabetes in 1999 and was told it meant the end of his competitive career. The doctors were wrong—he is still the best in the world at the 50-meter freestyle.
Learning as you go
Over the years, I’ve written about dozens of successful competitive athletes in “Diabetes Positive!” magazine. I’ve profiled competitors with diabetes in sports including golf, fencing, triathlon, marathon, mountain climbing, rock climbing, aerobatics, bicycling, swimming, baseball, soccer, cross-country skiing, bodybuilding and more. Very few of these athletes reported getting useful advice from their physicians on how to manage their diabetes while competing at the highest levels in their sport.
So how do they manage it? For the most part, by trial and error. Most of them look on their diabetes as just one more challenge, and they control their blood sugar with the same strict discipline they apply to their training. They test and observe. They try different approaches and go with what works best.
They also seek out advice from fellow athletes with diabetes. The Diabetes Exercise and Sports Association (DESA) is an outstanding resource for athletes with diabetes. Founded in 1980 by a marathon runner with Type 1 named Paula Harper, DESA has become a clearinghouse for information about sports and diabetes worldwide.
Whether you’re a competitive athlete who has just been diagnosed or someone with diabetes who wants to take up a competitive sport, go for it! It can be done. And I wish you the best of success!
General principles
Although you will need to find out for yourself the best ways to control your diabetes while training and competing, these are some general principles that may help guide you.
- As a rule, the more exercise you do, the less insulin you need. Serious athletes—especially those in endurance sports—usually find they need much less insulin on heavy training days than they do on light training days, and much less insulin than people who don’t exercise at all. However there are exceptions to every rule. Some athletes find that on game days, their blood sugar levels actually go up due to the release of adrenaline in the heat of battle. The only way to know for sure how your body reacts to different levels of exercise and competitive situations is to test.
- Muscle is responsive to insulin and burns sugar very efficiently, while fat is naturally resistant to insulin. As a result, you may find that as your muscle mass increases and your body fat decreases, you will need less insulin even on light training days or rest days. Bodybuilders with diabetes, who have very little body fat, usually require only very small doses of insulin to keep their blood sugar under control.
- The harder you exercise, the great risk of hypoglycemia (low blood sugar) and the greater the need to carry some kind of fast-acting carbohydrate with you at all times. Even athletes who do not have diabetes can experience hypoglycemia if they exercise hard enough without eating. Bicyclists call it “bonking.”
