In order to decrease the risk of heat illness, coaches should consider rescheduling practices, competitions, and workouts to cooler times of the day such as morning or early evening. If moving the practice time is not practical, an abbreviated or less intense practice could also help reduce risk. Water breaks should be frequent and unrestricted. When players are taking breaks for water or new plays are being taught, get them out of the sun and let them remove their gear. Athletes should be weighed before and after practice to keep track of fluid and weight loss. Fluid should be replaced at a general rate of 24 oz. (3 cups) of sport drink with water per pound of weight lost. Athletes should also be encouraged to take in salty foods during meals and snacks.

Heat illness is a preventable condition. Athletes should be educated in proper hydration, nutrition and rest strategies. Coaches should be encouraged to monitor changes in athlete´s bodyweights and mental statuses. Following these simple prevention strategies will not only help to decrease the risk of heat related conditions, but will also help athletes to achieve their performance potential.

References:
¹⁾ Anderson MK, Hall SJ and Martin M, Sports Injury Management: Second Edition, Lippincott Williams and Wilkins, 2000.

The Type I Diabetic Athlete
Gary Hall swims. Jason Johnson pitches. Kelli Kuehne and Michelle McGann play golf. Michael Sinclair plays football. Chris Dudley plays basketball. Steve Redgrave rows. What do they have in common? They are all world- class athletes with Type I diabetes. The Type I diabetic athlete presents unique challenges in youth and high school sports. Any coach that has a Type I diabetic athlete under their supervision must be aware of safety guidelines specific to blood glucose (BG) monitoring and control.

Glucose is the final by-product of carbohydrate metabolism and is the preferred fuel source of the body´s muscles and organs. Type I diabetes is a congenital, autoimmune disease where beta cells of the pancreas are attacked and its ability to secrete insulin, the hormone needed to transfer BG into the body´s cells for energy production, is permanently damaged. By the time symptoms occur, 80% of the beta cells have been destroyed. Thus, insulin injections by the athlete on a regimented basis balanced with nutrition and training are essential to BG regulation and producing peak athletic performance.

The two major concerns with Type I diabetic athletes are hypoglycemia (low blood glucose) and hyperglycemia (high blood glucose). Hypoglycemia is the most common problem experienced by the Type I diabetic athlete and is defined as BG of 70 mg/dL or lower, with accompanying rapid onset of symptoms which include hunger, excessive sweating, headache, heart palpitations, trembling, impaired vision, confusion, irritability, dizziness, and fainting. Because exercise/training uses BG for muscular energy and immediately lowers BG during the actual time of performance, therefore, it has an insulin-like effect. The American College of Sports Medicine (ACSM) guideline states that BG should be 100mg/dL or above prior to exercise/training and 20-30 grams of carbohydrate should be given for training, they also recommend that BG levels should be monitored every 15-30 min. and 10-15 grams of carbohydrate should be given for every 30-60min. of sustained training or competition. Insulin levels may be decreased and carbohydrate intake increased on training/competition days to avoid hypoglycemia. A carbohydrate snack may be required post training/competition to re-regulate BG after intense physical activity. The athlete´s doctor should prescribe an insulin/carbohydrate regimen specific to energy requirements for training and competition days.

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