Brother and Sister Team Manages Diabetes on the Field

How to manage your diabetes for peak performance

Leveling the Playing Field

Whether you’re riding in a long-distance bike race, kicking a soccer ball or shooting hoops, if you’re an athlete with diabetes, you need to pay special attention to your blood sugar. “Testing yourself regularly may help you avoid sugar highs and lows that could affect your performance,” says endocrinologist Matthew H. Corcoran, M.D., of Lehigh Valley Health Network.

“Low blood sugar, a common problem for athletes with diabetes, can make you feel tired and sluggish on the field,” says Corcoran. Too little blood sugar means you’re running out of glucose, your major fuel source for exercise, he says. “And if your blood sugar dips low enough, it can even affect your fine motor skills and your ability to think clearly.”

High blood sugar is also common among athletes. In fact, some athletes try to keep their blood sugar high to avoid low blood sugar, which Corcoran does not recommend (it’s not necessary with the advances in today’s insulin). “If sugar runs extremely high, you run the risk of ketosis, a condition that causes your body to use its own fat for energy,” he says. “Ketosis makes you breathe harder and faster, which can become a problem if you need to compete athletically or competitively.”

How do you know if your blood sugar is high? “High sugar can cause symptoms that mimic dehydration, such as fatigue and heaviness,” he says. “Exercises that require large bursts of energy over a short time - like sprinting and weightlifting - may drive blood sugar up.”

The good news? You can boost the odds in your favor. “We believe high and low blood sugar can negatively affect your performance,” Corcoran says. “But we also believe that keeping sugar under control can also positively affect it.”

Your Game Plan

To help boost your game-day performance, follow these important steps.

1. Check your blood sugar regularly and often. “Many people -- athletes included -- hesitate to keep close tabs on blood sugar because they don’t want to be criticized or judged for “bad” numbers,” Corcoran says. “Try not to think of your blood sugar results as a report card or a criticism. Instead, think of them as a road map to help you improve your performance and learn how to use those numbers to your advantage.”

Corcoran recommends checking your blood sugar twice before you exercise: once about 45 minutes before, and a second time right before you start your workout. “These two readings help determine whether your blood sugar is going up or coming down,” he says. “You should also check your sugar every 30 minutes during exercise.”

2. Learn about insulin. Although the rates of type 2 diabetes among young people are on the rise, most teens with diabetes still have type 1 and depend on insulin to survive. “Athletes using insulin need to know how it works and how to time doses (it’s different for each person),” says Corcoran. “You also need to understand how important it is to have insulin in your system when you exercise.”

“When you start checking your blood sugar regularly, your doctor can fine-tune your insulin dose and timing,” Corcoran says. “And when you learn what different insulins can do, you can use their benefits to help you feel and perform well throughout the game.”

Depending on whether your sugar is high or low, you should use insulin or carbs as needed during the activity (insulin for high sugars, carbs for low.)

3. Learn the basics of nutrition. “It’s important to know the difference between sports nutrition, nutrition for fueling your body, and nutritional supplements to help you maintain good blood sugar,” says Corcoran. Most people, he says, whether they have diabetes or not, don’t require carbs during performance unless they’ll be working out for more than 60 minutes. “Your body will have adequate fuel to get you through a 40- to 60-minute workout.”

But depending on your insulin levels, you may need carbs to sustain your blood-sugar levels to counteract the actions of the insulin. “That’s why we may recommend eating 15 to 20 grams of a more rapid-acting carbohydrate - like sports bars, granola bars or a sports drink like Gatorade - every 20 to 30 minutes during your workout. We can fine-tune the dose based on your experience,” Corcoran says.

4. Stay hydrated. The fact is, most people don’t drink enough fluids, whether they have diabetes or not. That’s why you should drink water all day long. “Once you’re thirsty, you’re already dehydrated,” Corcoran says. “However, it’s probably not necessary to drink a sports beverage like Gatorade unless you’ll be exercising for 50 minutes or longer. But that’s for hydration purposes only. You may still need the carbs in a sports drink if your blood-sugar is running low.”

5. Educate your coach and teammates. It’s important for your coach and other players to know you have diabetes, and to know the signs of low blood sugar (hypoglycemia) and how to treat it. (When you have hypoglycemia you may feel dizzy or hungry, and may seem shaky, nervous, irritable, sweaty or confused.)

Athletes in Action

This brother and sister talk about how they manage diabetes on the field

Having played soccer for five years, 14-year-old Fleetwood, Pa., resident, Jenna Dekovitch, knows what blood-sugar problems to watch for during games and practices. Her coach does, too.

Having played soccer for five years, 14-year-old Fleetwood, Pa., resident, Jenna Dekovitch, knows what blood-sugar problems to watch for during games and practices. Her coach does, too.

“I tell my coach right away if I’m not feeling well,” says Jenna, who was diagnosed with type 1 on her 8th birthday. “When my blood sugar is low, I feel dizzy and shaky. My coach tells me to take a break for as long as I need to.”

Sometimes her coach spots Jenna’s hypoglycemia even before she does. “If I seem ‘zoned out,’ like I’m not paying close attention to what’s happening on the field, he’ll ask me to check my blood sugar,” she says. “I do check it three or four times every day. On days I have a soccer game, I check my sugar at breakfast, lunch and 40 minutes before the game.”  

 Jenna’s 16-year-old brother, Jared, is also an avid athlete and was diagnosed with type 1 at age four. Jared prefers taking long bike rides (often for charity) and spending time on the golf course.

His golf coach knows about Jared’s diabetes and keeps an eye on him. “If I have a match after school, I’ll need to eat after nine holes,” Jared says. “My coach finds me on the course to make sure I’ve eaten.” Jared says his teammates know about his diabetes, too, and recognize the signs of trouble.

Jared checks his blood sugar four times daily and always before long bike rides.. “The longer the ride, the lower my blood sugar can go,” he says. “So I bring food or snacks with me.” “Extended-action” carbohydrate bars are designed to keep blood sugar levels steady for several hours. Granola bars help, too. And like his golf coach, Jared’s riding partner keeps tabs. “He always asks how I’m feeling and knows how to help if I have a problem.”

Diabetes hasn’t kept Jenna or Jared from participating in the sports they love: They keep up with their teammates on the field, on the golf course and on bike rides. In fact, Jared just completed the MS 150, during which he rode his bike 150 miles over two days!

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