Managing Diabetes Care as a High-Intensity Athlete

Diabetes Care|Jan.26, 2019


Professional athletes have a single-minded focus when it comes to the game and their career, so to have to divert attention from that focus to manage a condition like diabetes has a huge impact on players not just in soccer but other sports, too. However, diabetes management is essential, and diabetic athletes (such as Spanish footballer Nacho and Pakistani cricketer Wasim Akram, for example) need to heed to their health regime in order to succeed.

Athletes with diabetes such as football players walk a tightrope as they strive to manage both their health condition and their careers.

Care involves juggling every facet of lifestyle while maintaining healthy blood glucose levels, and for a high-intensity athlete, this means devoting extra attention to diet and exercise.

Being proactive is an integral part of diabetes care. During intense physical activity, the muscles draw energy, resulting in a higher risk of low blood sugar, which in turn can affect athletic performance.

On the field, blood sugar levels rise due to increased adrenaline, and they drop hours later. This can sometimes cause hypoglycaemia, indicated by dizziness, confusion and fainting. Players must constantly monitor blood sugar even hours after they are off the field and adjust their insulin and other medication.

Regular exercise is beneficial for diabetes as it helps reverse most of the complications caused by the condition while helping with weight management.

When an ordinary person exercises, the contracting muscles absorb glucose rapidly from the blood and the body naturally regulates the production of insulin to compensate, thus preventing hypoglycaemia. However, in those with diabetes and on insulin, the pre-exercise insulin dose and carbohydrate intake must be adjusted before, during and after exercise to avoid hypoglycaemia.

Factors Impacting a Diabetic Body

As a competitive sport, football involves active play where there is moderate to high-intensity cardio workout across a long session. For professional players with diabetes, it's imperative to have a solid plan in place to monitor and keep blood sugar at target levels during and after play.

Diabetes management also depends on the time of day a player is scheduled to play, as blood sugar responds to extreme hot and cold temperatures, so appropriate adjustments must be made. When a player's activity comprises a series of short sprints with intervals of low levels of activity, at the end of a half of football, blood glucose levels are likely to be higher than at the beginning of play. This is because short sprints trigger glucagon release, raising blood glucose levels. However, this can vary depending on the person.

While getting ready for intense training, it is crucial to check blood sugar. Exercise for diabetes should ideally begin when blood sugar is at least 4 mmol/L supplemented by a snack.

Are Some Positions in Football More Strenuous for Someone with Diabetes?

Another factor to consider for football players with diabetes is their position on the pitch. For example, playing in goal involves less active play, while midfielders cover more ground moving throughout the game and experience gradual lowering of blood sugar.

What are Some Strategies to Minimise the Risks of Hypoglycaemia?

Sport is linked to an increased risk of hypoglycaemia for people with diabetes. Soccer players minimise this risk by learning to recognise the symptoms and keeping a source of short-acting carbohydrates on hand for emergencies. Since the effect of exercise on diabetes includes an increase in heart rate and adrenaline, they must test before the match, during halftime and after the match.

It is important to ensure that sugar levels are on target to sustain them through the half of play. On the day of the match, they minimise the risk of hypoglycaemia by reducing their prior basal dose before the match.

It takes some experimentation and a close monitoring of blood glucose to reach the right balance. In his interview with, Hibernian Scott Allan mentioned that he used to take chocolate bars before games but stopped when it caused him to cramp from spikes in blood sugar. Later, he learned to keep his blood sugar between 4–6 mmol/L before playing and took insulin without sugar to compensate for the adrenaline rush.

Effective diabetes care takes into account the energy demands of intense competition and training. For athletes with diabetes, managing diabetes on and off the pitch is a continuous process because of the added complexity the condition brings to the playing arena.


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