At a camp three years ago when he was 12, wrestler Zach McCauley’s blood sugar level dropped. He says he hadn’t passed out yet, but was dozing in a corner. The coaches hadn’t shared the information McCauley had diabetes, and one saw him “sleeping.”
“One of the coaches started throwing Post-it notes at me, saying, ‘This isn’t nap time!’ But my brother was there, and he said, ‘He’s a diabetic, he’s not napping.’” They ran to get the athletic trainer, who gave him juice immediately. He felt better quickly, spared from going unconscious.
That incident is the only troubling one varsity wrestler McCauley, 15, recalls, as he manages life with diabetes, a disease that affects how the body uses blood sugar (glucose) and can cause serious health problems. As an athlete, “everything just takes an extra step,” he says. Pricking his finger several times a day, he monitors his blood glucose. He enters on a monitor what food he’s eating, such as carbohydrates, and takes needed insulin from a pump attached to his body. He disconnects the pump during matches.
Larry Cooper, a licensed athletic trainer for Penn Trafford High School (Harrison City, Pa.), and chair of the secondary school committee of the National Athletic Trainers’ Association, said he’s seen more high school athletes with diabetes compared to the past.
“We’ve seen an increase in the number of athletes who are insulin-dependent,” he said. Penn Trafford now has five athletes with diabetes.
Parents and kids with diabetes are unafraid of competitive sports, as they may have been 20 years ago, he adds. “People have realized diabetes isn’t a debilitating thing, you can still remain very active.”
The statistics back up what Cooper has seen. According to the Juvenile Diabetes Research Foundation (JDRF), the number of U.S. youth with type 1 diabetes (T1D) — juvenile diabetes or insulin-dependent diabetes — has increased 21% from 2001 to ’09. Of the 29.1 million Americans living with diabetes, 1.25 million have juvenile diabetes.
“Data suggests type 1 is increasing worldwide,” says Dr. Joseph Wolfsdorf, an endocrinologist and director of the diabetes program at Boston Children’s Hospital.
Wolfsdorf advises his patients to “learn how to take care of their diabetes, so they can resume their sports and athletic activity.”
But he shares the message that it requires “extra effort, tasks that have to be done for diabetic youth athletes to be safe and able to control blood sugar properly. It’s not an easy undertaking. It takes learning, understanding, knowing your body, food, monitoring, but I truly believe it’s possible. I’d never say to a young person, ‘Now that you have diabetes, you’re an invalid. You can’t participate in sports.’”
He agrees exercise is good, yet requires a “high degree of understanding of how rigorous activity affects an individual’s blood glucose [BG] levels. The student athlete has to know how to adjust insulin doses appropriately to avoid extreme high or low levels.”
Cooper, of Penn Trafford, adds communication among athletes, parents, school nurse, athletic trainer and coaches is vital.
McCauley, a freshman at Grayslake North High School (IL), who in eighth grade took third at the USA Wrestling Cliff Keen nationals and was named a USA Wrestling Youth All American, checks his levels an hour — and also 15 minutes — before his match. Then, he checks afterwards. He keeps seven bottles of apple juice in his bag.
“My teammates are thinking, ‘What do I have to do to beat this person, and I have to also think, ‘what is my blood sugar at?’”
Last year at a regional tournament vying for first place, he lost. He came off the mat dizzy, stumbling. He checked and was low, at 52. “Is that the reason I lost? No, I don’t want to make excuses. But I beat that same kid at sectionals the next week.”
“Grayslake North is wonderful with how they help Zach do his sport with diabetes. The trainers are all tuned in and available during each practice if there’s any issue,” says his father, Tom McCauley.
Zach McCauley was diagnosed at 7, after losing 17 pounds within a few months. They took him to the hospital, thinking frequent urination meant a bladder infection. Diagnosed with T1D instead, the family quickly learned about diabetes, giving him 6 shots a day. After a year, he got an insulin pump and “it helped a lot.” He doesn’t let insulin dependence hinder him: He wakeboards too.
“There’s an advantage when diagnosed young — it becomes normal,” says Christopher Rucas, a spokesman for JDRF.
Track standout Kate Hall, 18, of Casco, Maine, was diagnosed at age 10. She felt sick, “emotional,” and was excessively hungry and thirsty.
“I remember staying at my grandparents one day, and I would just eat all day, and my grandmother was like, ‘What’s wrong with her?’ I was really skinny, like 50 pounds at 10.” Her parents researched, then took her to the hospital, where they confirmed T1D diabetes. She gave herself her first shot, learning about needing insulin to stay alive.
Hall tried injections, then tried an insulin pump she disconnected for sports.
“It had the tubing, and it would always fall off if I was running, or if playing soccer or basketball. It wasn’t so bad if it was a soccer game, it was only an hour, but at track meets? It got really difficult because of all my events … you don’t want to have it off for a long time, because then you’re not getting [insulin]. You could go really high [blood sugar] really quickly, so that’s when we decided to switch.”
At 15, she tried a tubeless pump; now she credits this pump, the OmniPod, for being easy for her. Usually taped to her hip, she wears it 24/7, including at meets, so it delivers insulin continually. She has a wireless meter, for entering foods and calculating insulin. She changes the pump every three days. According to a spokesman for the brand, it is safe for contact sports.
“I have a 16-year-old swimmer who uses that,” says Wolfsdorf, who notes the tubeless pump is waterproof. He warns that because pumps can cost $6,000 to $7,000, “you can’t have a pump [with tubing] on your body if you are in a contact sport — considerable risk of damage in a collision.”
Athletes who use traditional pumps often disconnect the tubes during sports. Since they’re not receiving insulin for those minutes, the time the sport takes is critical. This can be managed successfully, like in McCauley’s case.
Athletes also must be cognizant how their particular sport affects blood sugar. Ice hockey, for example, has bursts of exertion which may cause blood glucose to rise with adrenaline surges.
Hall and McCauley say constantly considering foods, blood glucose and insulin made them more disciplined, which translated well to athletics.
What would they suggest to other young athletes with diabetes?
Hall, who will study kinesiology at Iowa State, wants to inspire others. “I know kids that are almost embarrassed about having diabetes — they’re afraid of what others think of them, afraid of being judged …. but if you let people know, ‘Hey it’s cool,’ they’ll ask you a bunch of questions … it’s cool for people to know who you are.”
McCauley, an accelerated science student, says aspiring youth athletes should not let diabetes stop them from playing competitive sports.
“In sports, there’s nothing you can’t do … I’m guessing people told (diabetic) Ron Santo he couldn’t play pro baseball. I’m guessing people told Jay Cutler he couldn’t play football. As long as they can manage it, they can do whatever.”