High level competion and Diabetes
Competing in high-level sports presents unique challenges for individuals managing type 1 diabetes (T1D). Whether it's gearing up for a fitness championship, training for a marathon, or participating in competitive team sports like hockey or soccer, maintaining blood sugar levels during physical activity is no easy feat for those with T1D or their parents.
Research indicates that the fear of hypoglycemia, a condition characterized by low blood sugar levels, is the primary obstacle preventing people with T1D from engaging in physical activity. Normally, insulin production decreases during exercise, but this response is disrupted in individuals using insulin therapy, putting them at risk of hypoglycemia.
On the other hand, high-level athletes also face the challenge of hyperglycemia, or high blood sugar levels, which can significantly impact performance, especially in competitive events. Some athletes may deliberately raise their blood sugar levels before competitions to avoid hypoglycemia, but this poses safety risks and hampers performance.
Physical activity, particularly high-intensity sports, can trigger stress hormones that release stored glucose from the liver, leading to hyperglycemia. Symptoms of hyperglycemia include thirst, frequent urination, blurred vision, nausea, fatigue, and shortness of breath.
A study following a professional cycling team with T1D revealed that competition days were associated with significantly higher levels of hyperglycemia compared to training days, partly due to stress hormone secretion and pre-competition blood sugar management strategies. Additionally, post-exercise recovery periods often saw elevated blood sugar levels due to increased carbohydrate intake and reduced insulin levels.
Hyperglycemia-related anxiety is a reality for some athletes, affecting both performance and mental preparation. Young athletes with T1D may experience physical and cognitive symptoms above a certain blood sugar threshold, impairing their ability to perform optimally. Despite attempts to manage hyperglycemia through insulin adjustments and dietary modifications, athletes may still face challenges such as post-exercise hypoglycemia.
Improving support for athletes with T1D is crucial to address the complexities of blood sugar management during physical activity. Customized protocols are needed to minimize the risk of hyperglycemia and hypoglycemia during training, competitions, recovery periods, and nighttime. Healthcare professionals must also address hyperglycemia-related anxiety and integrate it into treatment plans to prevent unintended consequences such as severe hypoglycemia.