There are approximately 21 million people living with diabetes in the United States, and among that population are many athletes. A new position statement from the National Athletic Trainers Association outlines several guidelines that can help athletes and their parents, coaches and health care professionals effectively manage diabetes. NATAs position statement published this month in the Journal of Athletic Training, the associations scientific publication, provides relevant information on type 1 diabetes mellitus and offers specific recommendations for athletic trainers who work with diabetic athletes. To read the entire statement in the Journal, please click here.


    The primary goal of diabetes management is to maintain blood glucose levels consistently in a normal or near-normal range. Strategies to recognize, treat and prevent hypoglycemia (low blood glucose) typically include blood glucose monitoring, carbohydrate supplementation and insulin adjustments.


    Although the literature supports the benefits of physical activity for people with diabetes, exercise training and competition can cause major disturbances when it comes to blood glucose management, said certified athletic trainer Carolyn C. Jimenez, PhD, ATC, lead author of NATAs position statement. Special considerations for blood glucose control, medication, travel and recovery from injury are required for all athletes with type 1 diabetes. Also critical to diabetes management is weight control and attention to nutrition.


    According to the statement, athletes with type 1 diabetes can benefit from a well-organized plan that allows them to compete on equal ground with their teammates and competitors. This plan should include the following seven elements:


    1.       Blood glucose monitoring guidelines: These shouldaddress the frequency of monitoring as well as pre-exercise blood glucose levels where beginning exercise could be unsafe.

    2.       Insulin therapy guidelines: Theseshould include the type of insulin used, dosages and adjustment strategies for planned activities types, as well as insulin correction dosages for high blood glucose levels.

    3.       List of other medications: Make sure to include medicines used to assist with blood glucose control and/or to treat other diabetes-related conditions.

    4.       Guidelines for low blood glucose (hypoglycemia) recognition and treatment: These guidelines include prevention, signs, symptoms and treatment of hypoglycemia, including instructions on the use of the hormone glucagon to metabolize carbohydrates.

    5.       Guidelines for high blood glucose (hyperglycemia) recognition and treatment: These guidelines include prevention, signs, symptoms and treatment of hyperglycemia and diabetic ketoacidosis, a condition where insufficient levels of insulin lead to hyperglycemia and the buildup of ketones (by-products of fat metabolism, which can reach toxic levels) in the blood. Diabetic ketoacidosis can be life-threatening.

    6.       Emergency contact information: Include parents and/or other family members telephone numbers, physicians telephone number and consent for medical treatment (for minors).

    7.       Medic alert: Athletes with diabetes should have a medic alert tag with them at all times.


    Since travel is also often a part of life for those on sports teams, athletes with diabetes are also advised to carry pre-packaged meals and snacks in case food availability is interrupted. If travel occurs over several time zones, insulin therapy may need to be adjusted to coordinate with changes in eating and activity patterns.


    Athletic trainers play a critical role in the prevention, recognition and immediate care of athlete with diabetes, said Jimenez. We are there to provide perspectives on proper exercise and nutrition, counsel them on proper hydration and help them keep track of the intensity of exercise sessions so they can adjust glucose and insulin levels accordingly.


    Athletic trainers are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. The National Athletic Trainers' Association represents and supports 30,000 members of the athletic training profession through education and research. Only 42% of high schools have access to athletic trainers. NATA advocates for equal access to athletic trainers for athletes and patients of all ages and supports HR 1846. For more information, please visit