The Diabetic Athlete
By Matthew Solan
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In 1998, two-time Olympic gold medal swimmer Gary Hall Jr. was preparing for
the Goodwill Games when his hands suddenly began to shake in the middle of practice.
He shrugged it off; after all, he was training up to eight hours a day, burning
calories out of the pool as well as through running, weightlifting and boxing.
He downed some PowerBars and Gatorade to boost his blood sugar and went back
to work.
But then he began sucking liquids like a diesel truck, sometimes drinking four
gallons of orange juice in one sitting. Soon he couldn’t make out the letters
on a Pepsi can held at arm’s length. He had all the telltale signs of diabetes:
extreme thirst, blurry vision and fatigue. When he was diagnosed, he was told
that his swimming career was over.
“The doctors said exercise was good in moderation, but not at the level
I was at,” says Hall. Yet he continued to dive into his sport, revamping
his diet and closely monitoring his condition for warning signs. And when he
climbed out of the pool in Sydney last year, four more Olympic medals hung around
his neck, two of them gold.
Hall may be an exceptional case, but he shows that men can pursue active lifestyles,
and even exceed their expectations, while managing diabetes.
What’s Your Type?
About 16 million Americans have diabetes, and about 2,200 new cases are diagnosed
each day. There are two primary kinds of diabetes: Type 2, in which the body
lacks sufficient insulin or the ability to use it properly, accounts for more
than 85 percent of cases and is generally diagnosed in obese adults over 40.
Type 1, in which the pancreas becomes unable to manufacture insulin, usually
strikes those under 30 and is the more common condition among active males.
Insulin is a protein hormone that enables the body to use sugar and other carbohydrates;
it also helps tissues to store nutrients. Because those with type 1 diabetes,
such as Hall, cannot produce insulin, they require daily insulin injections,
often two or more a day. (Pills are not effective because stomach acids destroy
insulin before it can do its work.)
Unfortunately, there are times when the body doesn’t use insulin like
it should. Insulin resistance, which fluctuates even within a single day, may
be triggered by any type of physical stress, such as the flu or taking cortisone
to treat inflammation. There are two ways to fight it: exercise and diet. Moderate
to intense aerobic exercise for 20 minutes to an hour can break the resistance
within 24 hours, while strength training works within 48 hours.
Studies published in Public Health Nutrition and other journals have shown
that diets high in fat and refined sugar tend to boost insulin resistance, while
monounsaturated and polyunsaturated fats do not; also, omega-3 fatty acids found
in cold-water fish may offset resistance to a degree. “If you change your
diet to include higher fiber, complex carbs, whole fruits, and vegetables, then
the symptoms will often go away within a few days,” says Sheri Colberg-Ochs,
Ph.D., assistant professor of exercise science at Old Dominion University in
Norfolk, Va., and author of The Diabetic Athlete.
Bad Sports
Exercise has always been encouraged for diabetics because it can help to transport
glucose into cells, reducing blood-sugar buildup. However, there are certain
activities in which blood-glucose imbalances could lead to inattention and result
in serious injury. “These sports include scuba diving, rock climbing, mountaineering—anything
where you are really out on the edge and don’t have a lot of backup,”
says Martin B. Draznin, M.D., director of the Pediatric Endocrine Specialty
Clinics at Michigan State University Kalamazoo Center for Medical Studies.
Hypoglycemia, marked by an abrupt decline in blood-sugar levels, is the No.
1 concern for type 1 diabetic athletes. Red flags include moodiness, shakiness,
confusion, and numbness in the arms and hands. If you experience any of these
symptoms, try consuming some rapidly absorbing carbohydrates, such as fruit
juice, hard candy, soda, bagels, or glucose tablets and gels. For extended activities—long
runs, cycling—diabetics have to balance insulin intake with carbohydrates.
Some diabetics can become “hypoglycemia unaware” and must learn the
subtler signals that their bodies give out, says Colberg-Ochs. “One guy
told me when he’s out running, his warning sign is when he begins kicking
the back of his left shoe with his right foot.”
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