Anyone have experience with college athletics and T1D?

My son is 17 and wants to play baseball in college. I am wondering if anyone has experience with this? I feel like college will be difficult enough with him managing his T1D and then adding the issue of trying to manage during games and the after effects on his own. It all seems overwhelming at this point.

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Does he play baseball now? If so, does he manage his diabetes during and after games reasonably well? If so, then he will be doing the same thing, just in a different place. If he is not managing the activity well, then there’s still time for him to learn.

Decades ago, I was told I could not or should not do all sorts of things because I was a T1. Sometimes I did those things anyway, and so in high school and college I was involved in various sports people had told me I shouldn’t do. Diabetes management was much more primitive then, but even so, the basics of managing activity weren’t too hard to figure out: eat before and during and, depending on intensity, after. It’s more of a science these days, and there is tons of advice on this forum.

If your son has a passion, there’s no reason why he can’t pursue it because of his diabetes. If it doesn’t work out for him, that will be obvious to him soon enough, and he will change his mind because he wants to, not because other people told him he had to.

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I played soccer in college for the school. Lots of practice time, and lots of travel time on the bus. It was actually very easy. Meals were arranged after practice, and having to follow a tight schedule meant that there was more consistency than just eating pizza or junk at random times at night

There is no reason why diabetes should be a factor in the decision. If he wants to play and has the skills, he should do it.

Baseball is probably one of the easier sports to manage from a diabetes perspective. In the inning half when your team is at bat is a chance to check BG and correct. Plenty of chances to pop a sugar packet when in the field too.

Really should not let D influence the decision one little bit.

Is he on a pump or MDI? What has he done so far for managing BG?

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My (glucose-normal) son was a freshman in an Ivy-equivalent college last year—he is a sophomore now. In high school, he was his soccer team’s captain, and was also US national champion in a shooting sport in his senior year (much better than his old man). He considered playing soccer in college, but decided against it. He found out that he was quite overwhelmed by his classes in his freshman year. It is only now, 1.5 years into college, that he has found some balance.

So I would say that it depends upon the maturity of your son and the competitiveness of the classes and college. A good friend of my son, with exactly the same curriculum (a year younger, soccer team goalie, silver medal shooting when my son was champion and gold medal last year), went to a local college this year, doing both soccer and shooting sports. He could not maintain his academics and withdrew before the end of the first semester. He is going back right now but we don’t know how well he will do. Regardless of D, I think sports are a real challenge in college if academics are important.

If I had the skill level and the interest to compete in baseball at the college level, diabetes would not be a factor or a consideration…

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@Beacher Yes he plays on his high school team and also a club team. He handles the diabetes well in practices, and I am at most of his games and I keep an eye on his bg with the share app on his cgm. He definitely needs some improvement in this area though.

Baseball is his passion and it has been his goal to play in college since he was young. I agree with you that he should be able to do anything, and I am hopeful that this forum can provide help for us in order for him to achieve those goals as safely as possible while preserving his health.

@Eric Eric, that is great to hear that you had a good experience!
I agree that in baseball, you do have the opportunity between innings to eat something and check bg. My bigger concern for him is after the games. He tends to crash overnight after games. He uses the Omnipod, so we lower the basal rate, but he still has some pretty serious lows post game. Any suggestions?

Also let me ask you, when do you think it is a good time to tell a coach that he has T1D? In the past, we have had him go through tryouts and wait until he is offered a roster spot before telling the coach. Most coaches have been good about it and usually have had previous kids with T1D on their teams, but this is a whole different level and the competition for roster spots is huge.

@Michel I agree. College can be very challenging. My oldest just graduated from college in May and my 2nd is currently a sophomore. Neither played a sport. Playing a sport in college is like having a job. I have known kids that have done it and we have discussed how difficult it is.
For my son, this is his only love. He works at it every day and is super committed. I have tried to convince him to play club ball in college, but he doesn’t want to do that. He just went to a prospect camp at a local university and talked with coaches and some of the players about how they handle the academics as well as the team commitments. I am definitely worried about the work load, but to him this really all he wants. He feels most happy and at ease on the baseball field.

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@Sam Diabetes is a factor only because physical activity affects blood sugar, and blood sugar affects performance. We need to find ways to best handle the challenges, so he is safe and can perform well :smiley:

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He should make sure he is getting sufficient carbs in his daily diet, and also after games to replace muscle glycogen. The first 45 minutes after exercise is very important (see what-should-i-consume-after-exercise), but in general, he should make sure he has sufficient fuel available for exercise from his entire diet (not just before and after). That will help reduce the crashes.

What is his diet like? He needs to taking his diet very seriously to compete at his best.

Not sure how he is doing it, but I would suggest not eating like a diabetic, but rather eating like an athlete, and making the diabetes work around it. It is possible to do that. Personally I never let diabetes influence my meal, my first consideration is eating what I need to help me run my best.

I would wait until after he has made the team. It is not something that should influence the coach’s decision, but it is possible it would. So I think he should wait until after he is on the team.

And I wouldn’t make it like it’s any big deal or something for the coach to worry about, just a BTW mention. “By-the-way, I am a diabetic, but it’s well-controlled, it won’t get in the way. You will never know it, I’m here to play ball.”

Then he needs to make sure it doesn’t get in the way. And don’t bother the coach with a litany of items of what to do if I am high, what to do if I am low, etc. The team’s athletic trainer should be able to help him with any specific diabetes things he needs.

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@Eric . His diet is terrible unfortunately. He has never been a healthy eater, no matter what I tried with him. Right now he is eating to gain weight. He is 5’10, 170lbs. Trying to gain muscle mass to help increase fastball velocity. He eats a ton of carbs and protein.
Those crashes can come several hours after a game.

That’s what we thinking about telling coaches. It really shouldn’t influence them, but if he has 2 prospects that are roughly the same and one has diabetes, he might just pick the other if he thinks it will be a problem at all.

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Or it could be the opposite that he gets to fill some sort of quota for having a person with a problem on the team. Either way, he deserves to make the team on his own merit.

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What do you mean by that, like he eats junky stuff?

It’s a serious thing to consider. He needs to know how important it is. Eating poorly is like skipping practice. You just aren’t preparing well if you don’t eat properly.

Those post-game crashes sounds like he needs to get more carbs right after games.

Right away after every game - carbs, protein, fluids, and insulin.

Carbs to restore muscle glycogen and protein to repair and rebuild the muscle fibers.

Insufficient carbs will cause a crash several hours later. He should have both fast-acting carbs, and slower carbs after games. If his BG is high immediately after games, he won’t be able to use the carbs after games, so he also needs sufficient insulin immediately after to be able to process the carbs.

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@Eric Yes he just eats junk. No fruit or vegetables. I couldn’t agree more about the importance of diet, but you can lead a horse to water… He is the most stubborn person I have ever known. When he was 6 months old and just starting solids, he would vomit at every meal. The pediatrician would just say that he has a strong gag reflex and he is fine because he is gaining weight. Finally I insisted that he see an ear, nose and throat doctor and we found out his tonsils and adenoids were huge and were causing this problem, but by then the psychological damage was done. He refused to eat any fruits and vegetables because of the texture. I have brought him to several nutritionists and even a psychologist to no avail. He won’t even do it for his coach who he really looks up to and is a former MLB pitcher.

He is usually high after games because of the adrenaline and/or because we have given him too many carbs during the game. We went to an Exercise Physiologist at the Joslin Diabetes Center in Boston. She said when he is high after games don’t correct because it will cause him to be low later.

Ugh…
:face_with_raised_eyebrow:

That is not really “complete” advice.

Like I mention in the link I gave above, the crucial time to restore muscle glycogen is within 45 minutes after your workout. If he has high BG after a game, no carbs are able to be used. High BG = wasted carbs. They can’t be processed.

So this advice is the kind of stuff they give the general diabetic population for safety. But it overlooks the key elements of what you want to do for performance, which is replace the carbs you used so your body has them for the next day.

As an example, today when I finished running I was 64. I took 6 units as soon as I finished and took about 80 grams of fast-acting carbs right away - within 10 minutes of being finished. And then I fed the rest of the insulin as I needed to for a few hours until dinner.

That’s a lot of insulin to take right after 11 miles, especially when your BG is 64. But doing so enabled me to take a lot of carbs right away. I won’t need to worry about dropping low tonight because that big carb load right when I finished.

If he doesn’t reload after a game, that is something that can cause him to drop at night. And if he is high afterwards from the game hormones - epinephrine, norepinephrine, cortisol - or from the game carbs, then he is not able to restore.

Two things are needed to replace carbs in your body after a workout - carbs and insulin. You can’t restore when you are high.

So the advice you got is not complete advice. It’s just “safety” advice. Better advice is to correct and eat.

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I totally agree with @Eric (from whom we learned all we know about sports and diabetes btw). My son has intense swimming practices. The key to dealing with post-exercise lows for us (we cant get away from them altogether, but as best we can), is to tightly control BG immediately post exercise so that we can eat lots of carbs as soon as possible afterwards.

For long swimming practices, we try to take 25-35 carbs right after practice (chocolate milk, then an 80-100 carb meal 45 minutes later if possible). It all depends upon good BG after practice. If we have to deal with a big high, it is much harder to refuel efficiently, and we typically get much worse post-exercise lows later evening.

That said, we don’t play baseball, and swimming is our most intense sport by far compared to what we know, i.e. soccer, volleyball, biking and track. I am guessing that baseball should be easier to deal with

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I’m a huge baseball fan! I wouldn’t let diabetes be a factor personally.

Peer pressure can help with quality of food and refilling reserves after xc/swim practice in high school. We’d all go to dining hall (I went to boarding school) and grab fruit/yogurt/granola/milk… if you have motivation to be good, you have motivation to take care of yourself. That includes both diabetes-related and not. And the not is a bigger factor (for me). I wan’t diabetic then, but I’ve never let it stop me from doing anything. Unlimited, that’s why we are here…

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Wow @Eric! So glad I found this forum. I am going to have him try this today after his workout. I’ll let you know how it goes.

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Seems to me eating carbs after exertion is natural and intuitive. After a long run in my youth, I’d sit down and scarf cookies and milk. Not because I knew anything about replenishing muscle glycogen (“Muscle what?”) but simply because I was hungry. I’d burned off all that energy, of course I was going to eat. The tricky part is the insulin, because it’s sort of counter-intuitive to take insulin right after exertion (and I never did in my youth): you know you should take some because you’re consuming carbs, but you’re afraid to take any because you don’t want to crash low. It’s the same brain-dilemma I have when taking insulin after over-treating a low. I’m low and bolusing?! What the?! But it makes perfect sense.

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As a parent of two glucose normal young adult daughters and a T1 myself, I truly want my children to pursue their dreams (assuming it’s legal). I’ve had to step back and let them “do their thing” with only a few “do you think that’s the right choice for you now” questions required. :smirk:

I hope college is a wonderful experience for him (and the whole family).

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