Management of the Athlete WithType 1 Diabetes Mellitus

J. Atilio Canas MD

NATA Guidelines

Diabetes Care Plan

Supplies for Training Kits

Hypoglycemia

Ketoacidosis

Travel Recommendations

Athletic Injury

www.journalofathletictraining.org

Diabetes Care Plan

Blood glucose monitoring a must!

Pre-exercise exclusion values

Insulin therapy guidelines

Medication list

Emergency contacts

Consent for medical treatment

Medic-Alert Tag

Interactive Medical ID bracelet or Dog Tag

Supplies for Athletic Training Kits

Copy of Diabetes Care Plan

Glucometer and supplies with expiration dates

Hypoglycemia supplies– Glucose gel or tablets– Juice or sugary liquids– Glucagon emergency kit

Hyperglycemia supplies– Urine ketone testing strips– Non sugary liquids

Sharps container

Spare parts– Batteries; infusion sets and reservoirs for insulin pumps

Glucagon Emergency Kit

Pump Supplies

Hypoglycemia

Know signs and symptoms

Know treatment guidelines for– Mild Hypoglycemia (Concious and able to follow

commnads and swallow)– Severe hypoglycemia( Unconcious or unable to follow

commands or swallow)

How to administer a glucagon injection – Provide appropriate training

Hypoglycemia

Hyperglycemia

ADA guidelines for avoiding exercise during periods of hyperglycemia

Exercise induced hyperglycemia (over 70% VO2

max or >85% max heart rate)

Drink non-carbohydrate fluids when BG > 180 mg/dl) which will lead to increased urination

Ketone testing– BG > 250 mg/dl test for ketones and if present omit

exercise– if > 300 with negative ketones exercise caution

www.MyHydrate.com

Travel Recommendations

TSA in conjunction with ADA guidelines for airline passengers within the USA will require letter

Carry supplies with them and replacement Rx

Storage requirements include cool packs

Carry on prepackaged meals and snacks

Coordinate insulin therapy based on time zones and duration of action

Travel Cool Packs for Diabetes Supplies

Athletic Injury and Glycemic Control

Avoid hyperglycemia

Frequent monitoring should be allowed

Develop contingency protocols during Injury recovery

References

1. Jimenez CC, Corcoran MH, Crawley JT, Guyton Hornsby W, Peer KS, Philbin RD, Riddell MC 2007 National athletic trainers' association position statement: management of the athlete with type 1 diabetes mellitus. J Athl Train 42:536-545

2. Younk LM, Mikeladze M, Tate D, Davis SN 2011 Exercise-related hypoglycemia in diabetes mellitus. Expert review of endocrinology & metabolism 6:93-108

3. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B, American College of Sports M, American Diabetes A 2010 Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 33:e147-167