Kenny is a 14-year-old soccer player who happens to have type 1 diabetes. Kenny, diagnosed just shy of his thirteenth birthday, loves sports. His favorite sport is soccer and he never thought about giving it up due to his diabetes. He plays defensive stopper. He says playing sports has its challenges but he has not looked back. In fact, as a defensive stopper his coach encourages him to not look back and to keep the ball in front of him.
Prior to soccer matches or practices Kenny tries to keep is blood sugar around 120 mg/dl. Because of the intensity of his sport, he sometimes goes high during matches. He often checks his blood sugar about a half hour prior to matches to see if he needs to give a little insulin, so he does not go too high. He says he likes to know at least a half hour before so he has time to adjust. If he checked just before the match this would not give him enough time to adjust for high or low blood sugars.
For athletes who have problems with low or high blood sugars prior to their activity a suggestion may be to check twice, an hour and a half hour prior to game time. Now you can compare two numbers to see what direction your blood sugar is going. As Kenny mentioned, there is a buffer time of thirty minutes to eat some food if blood sugars are too low or give insulin if blood sugars are too high.
Kenny has been on an insulin pump for about six months. One of the most difficult parts of dealing with his pump and diabetes is with his infusion set. He uses an angle set which is inserted approximately 30-45 degrees in his abdomen. He sometimes has trouble with the tape coming off when he sweats or having it dislodge during a soccer match.
Preparing the skin prior to inserting the infusion set can go a long way to preventing problems that may occur in a day or two. Ideally, the skin should be washed with an antibacterial soap rather than with a soap that may leave a film on the skin. For example, using Dove soap can sometimes make it more difficult for the tape to stay in certain individuals. Since the skin temperature and perspiration will increase during activity, using a skin prep (i.e., Mastisol) should help with adhering the tape to the skin.
It is important to check the site during a timeout or halftime to make sure it was not pulled out during the game. To reduce the risk, make sure the tape is secure and use extra tape (i.e., IV 3000) if the tape from the set starts to peel. It is also important to have an extra set available in case it was dislodged.
Kenny at times has his blood sugar go high after a match but later on that night it will go low. He knows he wants his blood sugars normal but is a little unsure on how to handle this type of situation.
Athletes who play in intense or competitive sports often struggle with high blood sugars during or shortly after a game. This can be due to the body recognizing the activity as a stress and releasing hormones (i.e., epinephrine or adrenaline) that signal the liver to release glucose causing a spike in blood sugars. Because Kenny knows he may go low later on that night he is not sure if he should give insulin to bring down his blood sugar immediately after the match. This would be a good question for one of his health care team members. If the decision is going to be to give a correction bolus, it is important to check your blood sugar shortly after giving insulin (i.e., 30 mins) to see what direction the blood sugar is going. Is it going from 325 mg/dl to 150 mg/dl or 325 mg/dl to 70 mg/dl? Drinking water is very important when blood sugars are high regardless. This will help clear ketones if they are present. A snack is probably in order once blood sugars are near a normal range to help prevent a low blood sugar later on and to help restore the glucose stores (i.e., glycogen) lost during the activity. Many insulin pump users reduce their basal rate several hours or even overnight to help prevent a low blood sugar that may be caused by activity earlier in the day.
Kenny has a great support team including his parents and health care team who encourage him to continue with soccer and any other sports. He has made many friends through CWD at the conferences he has attended. He says his parents seem a little less stressed about his diabetes too since attending conferences and chats on CWD.
Rick Philbin, MBA, M.Ed., ATC
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Last Updated: Friday September 07, 2012 11:16:52
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