Management of the Athlete With Type 1 Diabetes Mellitus

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Presentation transcript:

Management of the Athlete With Type 1 Diabetes Mellitus J. Atilio Canas MD

NATA Guidelines Diabetes Care Plan Supplies for Training Kits Hypoglycemia Ketoacidosis Travel Recommendations Athletic Injury National Athletic Trainers’ Association www.journalofathletictraining.org

Diabetes Care Plan Blood glucose monitoring a must! Pre-exercise exclusion values Insulin therapy guidelines Medication list Emergency contacts Consent for medical treatment Medic-Alert Tag

Interactive Medical ID bracelet or Dog Tag

Supplies for Athletic Training Kits Copy of Diabetes Care Plan Glucometer and supplies with expiration dates Hypoglycemia supplies Glucose gel or tablets Juice or sugary liquids Glucagon emergency kit Hyperglycemia supplies Urine ketone testing strips Non sugary liquids Sharps container Spare parts Batteries; infusion sets and reservoirs for insulin pumps

Glucagon Emergency Kit

Pump Supplies

Hypoglycemia Know signs and symptoms Know treatment guidelines for Mild Hypoglycemia (Concious and able to follow commnads and swallow) Severe hypoglycemia( Unconcious or unable to follow commands or swallow) How to administer a glucagon injection Provide appropriate training

Hypoglycemia

Hyperglycemia ADA guidelines for avoiding exercise during periods of hyperglycemia Exercise induced hyperglycemia (over 70% VO2 max or >85% max heart rate) Drink non-carbohydrate fluids when BG > 180 mg/dl) which will lead to increased urination Ketone testing BG > 250 mg/dl test for ketones and if present omit exercise if > 300 with negative ketones exercise caution

www.MyHydrate.com

Travel Recommendations TSA in conjunction with ADA guidelines for airline passengers within the USA will require letter Carry supplies with them and replacement Rx Storage requirements include cool packs Carry on prepackaged meals and snacks Coordinate insulin therapy based on time zones and duration of action

Travel Cool Packs for Diabetes Supplies

Athletic Injury and Glycemic Control Avoid hyperglycemia Frequent monitoring should be allowed Develop contingency protocols during Injury recovery

References 1. Jimenez CC, Corcoran MH, Crawley JT, Guyton Hornsby W, Peer KS, Philbin RD, Riddell MC 2007 National athletic trainers' association position statement: management of the athlete with type 1 diabetes mellitus. J Athl Train 42:536-545 2. Younk LM, Mikeladze M, Tate D, Davis SN 2011 Exercise-related hypoglycemia in diabetes mellitus. Expert review of endocrinology & metabolism 6:93-108 3. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B, American College of Sports M, American Diabetes A 2010 Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 33:e147-167