Type 1 Diabetes and Youth Athletes: What Every Parent Should Know
This article was written by University of Washington dietetic intern, Melissa Crane, and was reviewed/edited by Stephanie Magill, MS, RDN, CD, FAND.
Have you ever heard of Jordan Morris (Seattle Sounders), Nacho Fernández (Al-Qadsiah), Jesper Karlström (Udinese Calcio), or Andrea Pereira (Pumas Femenil)? Besides all being elite soccer players and World Cup participants, each of these athletes is always fighting another battle on and off the field: Type 1 Diabetes.
But their diagnoses, some in childhood, didn’t stop them or other professional and Olympic athletes from chasing their dreams. And it shouldn’t stop your child either.
If your child was recently diagnosed with Type 1 Diabetes (T1D), playing sports may suddenly feel overwhelming. The good news–with the right planning and support, kids with T1D can safely participate in the sports they love.
A quick reminder: Every athlete responds differently to exercise, carbohydrates, and insulin. The suggestions below are general guidelines and should always be individualized with your child’s endocrinologist or diabetes care team. Never make changes to insulin dosing without consulting your healthcare provider.
What is Type 1 Diabetes?
You probably have heard of diabetes, but may not know the difference between T1D and Type 2 Diabetes (T2D). Both T1D and T2D affect the way the body regulates blood sugar, but they do so for different reasons. Insulin, an important hormone released by the pancreas, helps regulate blood sugar (glucose) levels.
Type 2 Diabetes (T2D) occurs when the body’s cells stop responding to insulin over time. T1D is an autoimmune disorder where the immune system attacks and destroys the cells in the pancreas that produce insulin, mistaking them for foreign invaders.
Blood sugar naturally rises and falls during physical activity, creating challenges for managing diabetes in young athletes regardless of type. In this post, we will focus on T1D.
While it can develop at any age, it is most commonly diagnosed in children and adolescents under 20. This makes it more likely to cause challenges for kids participating in sports.
How insulin works
When you eat a high carb pre-workout meal, the carbohydrates break down into smaller parts of sugar during digestion and enter the bloodstream. Insulin works by sending a message to cells that blood glucose (sugar) is available to be used as energy.
The pancreas senses the increase in blood sugar and releases insulin to signal cells that there’s energy available. The glucose is then used right away, in the brain or muscles, for example, or stored for later in the liver as glycogen.
However, in T1D, cells can no longer produce enough insulin to manage blood sugar levels, leading to high blood sugar. This can lead to long-term high glucose levels. These high levels can impact many bodily functions and eventually lead to diabetes-related complications if not treated.
To manage T1D, individuals must receive regular insulin doses, usually by injection, and carefully timed with meals and carbohydrate intake.
Why does T1D matter during exercise?
Have you ever tried to exercise on an empty stomach and felt fatigue, shortness of breath, and brain fog? Does it ever seem like your body just does not want to move anymore?
Now imagine trying to play an entire soccer game while feeling that way.
When athletes aren’t properly fueled or their insulin isn’t dosed or timed appropriately, exercise can feel much more difficult.
When you exercise, your body relies on blood glucose and glucose stored in your muscles as glycogen to provide energy to keep moving. That’s why we see shifts in blood glucose during movement; your muscles – including your heart, lungs, and brain – all use blood sugar to keep going.
These changes become even more important when your athlete is also managing T1D. Exercise affects how much insulin the body needs, making it more difficult to keep glucose in a safe range.
If insulin levels are too high or too low for the activity, glucose levels can also shift, affecting both performance and safety.
When engaging in moderate physical activity, we often see decreases in blood sugar, since what’s available in the bloodstream is enough to fuel cells in the body. However, as exercise intensity increases, the liver releases glucose from stored glycogen to provide additional energy.
High-intensity exercise can sometimes cause blood sugar to rise. This means athletes with T1D may need to adjust their insulin or fueling strategy to keep their blood sugar in a safe range.
How parents and coaches can help
It’s important to note that every athlete responds differently to carbohydrate intake, insulin dosing, and exercise. Therefore testing different fueling and insulin regimens is extremely important.
Of course, changing the timing or dosing of insulin must come from the recommendation of your child’s doctor. But coaches and parents, can help monitor your athlete’s response to different regimens.
It is also crucial that your athlete learns how to manage their own insulin and carbohydrate intake over time. Help them identify what it feels like to have blood sugar highs and lows during practices. Then how to safely respond to these changes to set them up for success on game day.
Key Takeways
The most important thing to remember is that every youth athlete will respond differently to carbohydrate intake and insulin dosing. Their needs depend on several factors, including age, gender, sport, exercise intensity, activity duration, blood glucose trends, and insulin regimen.
Remember to take advantage of low-stakes practice environments to figure out a routine that works for your child. Work with coaches, athletic trainers, and your child’s diabetes care team to make sure they are safely fueled on game day.
And most importantly, remember that a T1D diagnosis should not prevent your child from playing sports, being active, and chasing their dreams.
Ready to put these concepts into practice? Read our post on Fueling Athletes with T1D, we’ll cover what to eat before, during, and after practices and games, plus snack ideas to help keep young athletes fueled and ready to play.
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Stephanie Magill, MS, RD, CD, FAND has over 22 years of experience in public health and nutrition. As a performance registered dietitian nutritionist, Stephanie specializes in sports nutrition and provides simple and actionable information so that athletes can be well fueled for high performance on and off the field. Stephanie has a Master’s Degree in Nutrition and is a Fellow of the Academy of Nutrition and Dietetics.