How to Best Support Young Athletes with Type 1 Diabetes, with Fran Damian, MS, RN

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A recent survey found that most people with type 1 diabetes felt their coaches, trainers, and teachers treated them differently after learning about their diagnosis. In this column, Fran Damian, MS, RN, provides 3 simple steps to better support athletes with diabetes.

The mental, emotional and physical toll of diabetes can drastically impact everyday life, especially for aspiring athletes. As a pediatric nurse living with type 1 diabetes (T1D) and an avid athlete myself, I’ve experienced this firsthand.

Following my diabetes diagnosis more than 27 years ago, I realized that my health and well-being depended on maintaining an active lifestyle. This led me to attend my first Diabetes Training Camp, where I was able to learn about diabetes and exercise, and train athletically with other people living with diabetes.

The experience opened my eyes to the benefits of having a network of people living with diabetes to support and learn from one another. It also showed me that the challenges and barriers we face are very similar – and for those who aspire to be physically active or compete at higher levels, diabetes can often prevent them from pursuing their dreams.

Unfortunately, these roadblocks appear as soon as a diagnosis is received. A recent survey found that nearly half of adults with T1D felt like quitting sports and physical activities because of their diagnosis2– and one in five adults said they stopped participating in sports or other physical activities altogether.3

This underscores the crucial role that athletic trainers and healthcare professionals (HCPs) as well as coaches and teammates can play in the success of athletes living with diabetes. While a diabetes diagnosis can be harrowing and lonesome, with proper education, resources, and game plan, we can have a positive and lasting impact on people’s lives.

Here are three crucial tips that will help you effectively support athletes living with diabetes.

1. Understand diabetes & exercise

Diabetes is a chronic health condition that affects the body’s ability to produce insulin or make good use of the insulin it does produce, which impacts glucose levels in the blood.4 Varying intensities and types of exercise can also affect blood glucose in individuals with diabetes by lowering or raising glucose levels. Understanding the physical signs and symptoms of when glucose is going higher or lower than target range is important to determine what actions may need to be taken to help the athlete.

For example, a falling glucose level can respond quickly to fast-acting carbohydrates, so the athlete may not need more than a short break from activity. In cases where a person’s glucose levels are higher than their preferred range, they may need to administer insulin to bring their levels back within range. It’s critical to partner with the athlete to determine when it’s safe to resume play. Sidelining for longer than is necessary can be discouraging and frustrating for athletes eager and motivated to train with their team.

2. Learn about your athlete

Everyone’s journey with diabetes is unique. Some athletes living with diabetes may be more comfortable than others speaking openly about their experience, while others may feel the need to hide their diagnosis, like almost half of adults with T1D surveyed.5 Depending on the age of the athlete and how recently they were diagnosed, they may lean on you for varying degrees of support, so it’s important to ask the athlete the right questions. This could include things like how involved they would like you to be in their diabetes management, how they check glucose levels, or what signs you should recognize when their glucose levels are too high or too low.

Remember that diabetes requires 24/7/365 management, and it takes time to find the best treatment plan for each person’s circumstances. By asking the right questions, you can help your player feel understood and encouraged, which in turn promotes good decision-making and motivation to persevere.

3. Consider technology

People with diabetes make countless additional decisions each day, which is especially cumbersome for athletes when they need to be in the zone and laser-focused on their performance. Modern technology can empower people with diabetes to pursue their goals by offering a reprieve from some of those minute-by-minute decisions. For me, diabetes technology meant I could run long distances for the first time completely aware of how my glucose was responding. If my glucose started to drop, I could consume carbs to return to target range without needing to take a break or completely end my run.

Continuous glucose monitors or CGM devices are small wearable sensors that track glucose levels continuously throughout the day and night. Glucose readings are then sent directly to a smart device or receiver, and some CGM systems like Dexcom G6, can connect to additional technologies such as Apple or Garmin smartwatches – giving athletes options to seamlessly manage their diabetes during even the most strenuous activities.

Remote monitoring capabilities that CGM systems also offer are also a game-changer for athletes with diabetes, with the ability to share their glucose levels in real time with their trainers and parents.

HCPs can have an enormous impact on athletes’ lives

Whether you’re an athletic trainer, HCP, or coach, you play a crucial role in ensuring that individuals with diabetes don’t give up on athletics. While living with diabetes can be challenging at times, it does not limit anyone’s ability to perform optimally. No matter what age or level of competition your athlete is, remember you can be a supporting partner to help them achieve or surpass their goals.

By being thoughtful in your approach, you can build trust with your athlete and help them reach their full potential. For more about diabetes, exercise, and how to support the athlete in your life, the website contains multiple valuable educational resources and more.

Fran Damian, MS, RN, is a pediatric nurse specializing in emergency care at Boston Children’s Hospital with more than 40 years of experience. For the past nine years, she has been part of the lead medical staff at Diabetes Training Camp and recently became the director of their teen boot camp, which works with teen athletes with diabetes as well as their parents.


  1. T1 Aspirations & Physical Activity research, dQ&A Market Research Inc., September 2022
  2. T1 Aspirations & Physical Activity research, dQ&A Market Research Inc., September 2022
  3. T1 Aspirations & Physical Activity research, dQ&A Market Research Inc., September 2022
  4. Centers for Disease Control and Prevention, What is Diabetes?
  5. T1 Aspirations & Physical Activity research, dQ&A Market Research Inc., September 2022