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 is during childhood and adolescence, with the majority of patients (approximately 75 percent) presenting before age 30" (p. 2). IDDM is associated with deficient insulin secretion. The American Academy of Orthopaedic Surgeons (1991) states: .
             Insulin, a hormone secreted by the beta cells of the pancreas, is essential in the metabolism of .
             glucose. It promotes storage of glucose in the muscles and liver in the form of glycogen. .
             Insulin is also needed for the efficient transfer of glucose from the bloodstream into skeletal .
             and cardiac muscles. (p.874).
             Common symptoms observed in athletes or patients with IDDM are swings in blood sugar from hyperglycemia (high blood sugar) to hypoglycemia (low blood sugar).