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

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

3. 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

4. Interactive Medical ID bracelet or Dog Tag

5. 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

6. Glucagon Emergency Kit

7. Pump Supplies

8. 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

9. Hypoglycemia

10. 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

13. 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

14. Travel Cool Packs for Diabetes Supplies

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

16. 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:
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:e