What’s the number one thing you tell athletes when they’re first diagnosed?
The biggest thing I want them to know is that the biggest risk of exercising with diabetes is becoming hypoglycemic and the reason is because they take insulin. Basically what insulin does is take sugar from your blood and pushes it into cells and into your muscles so you can use it.
| If you're going to exercise more, then you typically will take in more carbohydrates and then you can decrease your amount of insulin. |
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If you were to take a normal amount of insulin for a day you’re not really active and then decide later that you’re going to hop on the ice, you’re going to have too much insulin in your blood. You need to have some energy, or glucose in your blood and insulin doesn’t recognize your exercising like your pancreas would. So they would become hypoglycemic really quick if they have a normal dose of insulin and they’re exercising really hard.
Does exercise help with blood glucose control?
It will help in that it allows them to use their glucose more efficiently, which means they may not need to take as much insulin. Insulin certainly has a growth factor to it and can cause some to be overweight if it’s taken in high doses.
The diabetic athlete has that kind of benefit. By exercising, they can reduce the amount of insulin that they need.
How does a Type 1 diabetic balance the amount of insulin they take with their diet and amount of physical activity?
Insulin is basically a key to a cell that will open up doors to the cell and let glucose into the cell and into the muscle. The muscle needs the glucose to actually work but muscle also stores glucose.
So as far as eating goes, they need to monitor to see where their glucose levels are at. Insulin is going to drop their glucose so they’re going to figure out over time what dose of insulin they need and how much they’re eating. Then they have to calculate what kind of physical load they’re putting themselves. If you're going to exercise more, then you typically will take in more carbohydrates and then you can decrease your amount of insulin.
Do you think future advances in medicine will help athletes manage diabetes more efficiently?
I think so. As soon as we can get anything that is close to being a pancreas. Pancreatic transplants are not a commonplace. As soon as we get something that gives feedback like a normal pancreas. As soon as we get that automated, I think their life is going to be a whole lot easier because they’re not going to have to worry about it as much.
How can a diabetic athlete maintain the ability to compete at a high level?
Control is the key. I think they can thrive and really do whatever they want as long as their glucoses are controlled. The diabetic who loves their sport and understands their disease is just as competitive, maybe more competitive, because they understand themselves at a different level than most athletes do.
Dr. Barnes specializes in Sports Medicine, Adolescent Medicine, and Family Practice at the Mayo Clinic in Rochester, Minn.