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Diabetes

Diabetes mellitus can be classified as either Type I or Type II. Type I is referred to as insulin dependent diabetes mellitus (IDDM) and Type II as non-insulin dependent diabetes mellitus (NIDDM). According to Podolsky (1980), “diabetes results from not only a derangement of glucose metabolism alone, but also involves metabolism of proteins, lipids, nucleic acids, and complex derivatives of these major groups” (p. 1). Treatment and control of diabetes includes, but is not limited to, insulin injections, oral hypoglycemic agents, dietary management, and exercise (Armstrong, 1985; Burr & Nagi, 1999; Kozak, 1982; Podolsky, 1980). A major risk associated with diabetes and participation in athletics is diabetic coma. “There are four classifications of diabetes-related comas. They are all true emergencies which require prompt, correct diagnosis. Listed in order of their probable frequency they are: (1) hypoglycemic coma, (2) diabetic ketoacidosis, (3) hyperglycemic hyperosmolar non-ketotic coma, and (4) lactic acidosis” (Kozak, 1982, p. 109).

Type I diabetes, or IDDM, usually occurs in childhood and is sometimes called juvenile onset diabetes. According to DeFronzo (1998), “the peak onset of type I diabetes i

If an athlete experienced any kind of diabetic emergency, whether it required hospitalization or not, they are not permitted to return to practice or competition until all symptoms have subsided. Glucose, insulin, glucagon, and any other regulated conditions must have returned to safe, manageable levels. It is important for the AT to know and understand the risks associated with athletics and diabetes in order to provide adequate and potentially life-saving care in the unfortunate event of a diabetic emergency.

presence of relative insulin deficiency in association with elevated levels of glucagon and

the principles of treatment of established ketoacidosis are a follows: (1) general assessment,

Hyperglycemic hyperosmolar non-ketotic coma (HHNC) is a diabetic-related coma characterized by extreme hypertonic dehydration due to severe hyperglycemia and lack of significant ketoacidosis (Kozak, 1982). Patients with HHNC frequently present in coma (30 percent), or with impaired consciousness (50 percent) (Kozak, 1982). According to DeFronzo (1998):

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