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"Success at Sports"

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When it comes to participating in sports, 12-year-old Hilary Lemonick, an eastern Pennsylvania JDRF ambassador, says there’s really only one thing to worry about: having fun. As for playing lacrosse and soccer while trying to manage type 1? “Diabetes doesn’t help, but it doesn’t hurt, either,” she says. “It just is.” Hilary follows the five tips recommended here by experts Gary Scheiner, a type 1 athlete and certified diabetes educator who owns Integrated Diabetes Services, and Sheri Colberg, a type 1 athlete and associate professor of exercise science at Old Dominion University, Norfolk, Va., and author of The Diabetic Athlete: Prescriptions for Exercise and Sports.

Realize that you can be athletic with type 1—but it’s not going to be easy.

Whether you participate in sports or not, life with type 1 is a balancing act. Exercise, diet, rest, insulin, and testing all work together to keep your body humming in harmonious balance. Participating in athletics simply alters that balance—so you must adjust accordingly. Other than that, your life in athletics can be just as successful as anyone else’s! Plenty of pro and Olympic athletes have proven just that. From gold-medal Olympic swimmer Gary Hall Jr., to marathoner Missy Foy, to Jay Cutler, NFL quarterback, to the entire Team Type 1 champion cross-country cycling team, elite athletes with
type 1 are proving this every day. “Blood sugar control affects just about everything in a kid’s life, and when it comes to sports and athletics, it has direct bearing,” says Scheiner. “Performance is dependent on good control. Don’t accept poor blood sugar control as just something that happens when you’re active. It doesn’t have to be that way.”

Search for support from professionals.

Your physician isn’t your only resource when it comes to exercise with diabetes. Certainly, your doctor must be involved in your care. If you want to try continuous glucose monitoring, insulin pumps, or other changes in your care regimen, you must do so under the supervision of your doctor. But you can seek out specialized consultants who can also advise you regarding your athletic needs. Look for exercise physiologists who specialize in type 1 diabetes, or certified diabetes educators who specialize in the needs of type 1 athletes. Muscle physiology, blood glucose reactions to various exercise conditions (such as cold, heat, duration), and day-to-day variations in blood sugar due to physical activity are all examples of specific knowledge that would help. Where do you find such a specialist? Ask your area JDRF chapter, ask your physician, and search online. Don’t feel limited by the location you’re in—you can get help from a distance. Companies like Scheiner’s consult with individuals worldwide.

Join a community of type 1 athletes.

You may live in a town where few people have type 1, or you may be the only one in your school! Fortunately, with the internet, you never have to feel alone. Contact your nearest JDRF chapter to find active athletes in your area, and look up online communities and bulletin boards. Chances are, you will find someone who’s been where you are. “Sometimes it’s best to just know how someone else did it,” says Sheri Colberg. “That gives you a starting place.” JDRF’s web site features a new area called “Juvenation,” a social-networking site for teens that includes forums for athletes. Other groups dedicated to athletes with type 1 include the Diabetes Exercise and Sports Association and the Diabetes Sports and Wellness Foundation. Also check out insulindependence.org.

Learn about your own body.

Believe it or not, your own body contains the most important information available! No doctor or professional can match the knowledge that you can gain about your own needs. When it comes to sports and exercise, this knowledge is vital. Scheiner recommends keeping a daily journal about your body and its responses to your daily physical activities. Information from professionals, or a book such as Colberg’s, forms a great starting point, but then you must fine-tune your regimen, based on your own body’s results. Also, Colberg points out, your body’s reactions to physical activity will vary by sport. “It will be fairly predictable once you figure it out,” she says. She recommends that you track and record your numbers during and between games and practices.
Don’t forget the importance of rest! Your body needs rest between activities to be effective. Colberg says 24 to 48 hours after strenuous activity is required to restore the glycogen in your muscles (glycogen is a short-term energy source). If you have diabetes, your muscles’ needs may affect your blood sugar. Colberg recommends keeping your glucose levels as close to normal as possible
on the off-days from heavy activity, so your body can most effectively restore its glycogen stores. If you are continuing strenuous activity, count on having low blood sugar bouts, or for your body to be less responsive to lows.

Make self-care your number-one priority but use your diabetes as an excuse.

This is a fine line that kids and athletes must walk. On one hand, you must make your health your number-one priority. On the other hand, you have to prove that you are a dedicated team member who doesn’t require special treatment. Inform your coaches about your diabetes. Provide them with educational materials from JDRF and DESA. Talk to them about how to recognize your signs of low blood sugar. Explain your needs, such as having food and drink nearby and needing to test during practices and games. Hilary says she has a signal for her coaches when she’s feeling low in a game—she comes to the sideline, and they know to sub someone in while she takes care of herself.
If necessary, involve your parents in this discussion, and your school principal or other important adults who need to support you. The Americans with Disabilities Act protects you from discrimination in school activities—you shouldn’t be benched simply because you have type 1. And don’t forget to have fun! Hilary’s advice? “Keep track of your blood sugar—but have a good time!”

TO CGM, OR NOT TO CGM?

When cross-country bicyclists Team Type 1 raced across America this summer, they were equipped with the latest technology: continuous glucose monitors. The riders’ up-to-the-minute data helped them avoid what they call the “bonk,” a drop in energy levels that many endurance athletes encounter even if they don’t have diabetes. But for the average student athlete, are CGMs recommended? These new monitors can be very helpful, Colberg says, in tracking and learning
about your own body’s reactions to physical activities. Their ability to show you trends—which direction your blood sugar is heading, and how fast—is a positive. But she cautions that the CGMs can take longer than finger sticks to detect rapid changes in blood glucose levels. CGMs measure glucose from interstitial fluid, which is slower to indicate glucose changes than blood samples are.
Scheiner, as the Team Type 1 cyclists, likes the CGMs ability to forecast what direction your glucose levels are heading, thanks to their minute-to-minute readings. This information provides athletes with the ability to adjust glucose intake or insulin based on the trend. Is CGM right for you? If you are interested in learning more, talk to your doctor.