Denver Health Examiner

Type 1 Diabetes Not A Barrier to Competitive Athletes

It’s probably small comfort to Jay Cutler, but Type 1 diabetes is more manageable and the diet is less restricted than 40-50 years ago.  Now, blood glucose can be measured on the spot, and insulin adjusted accordingly. Then, you had to go to a doctor’s office for a blood draw, and then wait hours for results, while insulin and blood sugar remained at potentially dangerous levels. Now, insulin pumps can deliver customized doses on demand. Then, daily injections of set doses required careful 24/7 dietary monitoring, and avoidance of sugars. But despite these welcome advances, medical science still hasn’t identified clear causes or devised a cure for Type 1 diabetes.

The far more prevalent Type 2 diabetes, which is diagnosed more frequently in older adults, is linked to lifestyle issues such as excess weight and lack of exercise. Type 1 diabetes is linked to immune dysfunction. Insulin-secreting cells in the pancreas are destroyed by the body’s own immune system. Without insulin, blood glucose can’t move from the blood into cells, where it is burned for energy or stored. Blood glucose can rise to dangerous levels, while the person feels extreme fatigue. With all that sugar floating around, the kidneys are signaled to flush the sugar out. Extreme thirst results, as the body tries to rid itself of the excess blood glucose. In fact, unexplained weight loss, thirst and fatigue are classic symptoms of Type 1 diabetes. Mr. Cutler reportedly experienced all of these symptoms.

Forty years ago, dietary restrictions for diabetics were rigid. Patients had to follow a strict food plan everyday, to match their prescribed insulin doses. 21st century management of Type 1 diabetes depends on appropriate doses of insulin matched throughout the day to blood sugar, diet and carbohydrate intake. Mary Englick, MS, RD, a Certified Diabetes Educator who practices in metro Denver, describes the difference as The Art of Diet (then) vs. The Science of Diet (now).

One of the most welcome recent management options is the insulin pump, which eliminates the need for daily injections.  Susan B, whose husband has diabetes, likens the pump to a programmable sprinkler system. The pump maintains a base level of insulin, and can maintain different base levels, depending on activity level. Before a meal, the patient enters information about blood glucose (from a finger stick test) and grams of carbohydrate in the meal, and the pump calculates an appropriate insulin dose. The patient can even override the dose recommendation if necessary. Patients still need to be conscious about food intake, particularly carbohydrate, which is digested and absorbed as blood glucose.

Athletes must learn how to balance energy needs for their activity level with energy intake and insulin dose. This will be Cutler’s challenge. Many other professional athletes have Type 1 diabetes. Thanks to modern management techniques, the disease is not seen as a barrier to competing. Recently the National Athletic Trainers Association issued guidelines for managing diabetic athletes. The Colorado-based Barbara Davis Center for Childhood Diabetes is an excellent information resource for parents and young adults dealing with Type 1 diabetes. Additional resources are available from the American Dietetic Association, American Diabetes Association and Juvenile Diabetes Research Foundation. Best of luck to Mr. Cutler as he learns to manage this condition, and Go Broncos!

Topics: diabetes , Jay Cutler , Type 1 diabetes , athletics

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