Abstract
Diabetes prevalence has been rising rapidly worldwide, and the consequences of poorly managed diabetes can be costly. Managing diabetes as an athlete adds complexity to training and competing at a high level. Within the literature, there is a small amount of exploration of the athlete's experience managing diabetes and what resources they need or use to optimise their performance.
This project aimed to explore the principles of managing diabetes as an athlete and what resources could be better used to manage this effectively. An integrative review was carried out using the Whittemore and Knalf's (2005) methodology. A literature search was conducted across the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), EmCare, Medline Ovid, and Google Scholar. The key search words included diabetes, diabetes mellitus, type 1 diabetes, athlete, managing, self-management, and management. Eighteen highly relevant publications were identified, and following quality appraisal using Joanna Briggs Institute (JBI, 2015) validated tools, fifteen articles were eligible for data analysis. The following three categories emerged from the analysis: nutrition, self-management or reliance, and insulin strategy.
The findings highlighted key principles for athletes managing Type 1 diabetes mellitus. Nutrition which included carbohydrate intake and hydration, or fluid intake were noted as having a substantial impact on controlling blood glucose levels and aligned with best practice for athletes. Self-management or reliance was considered a key aspect of the individuality of diabetes and how past experiences, knowing the self, and trusting oneself was essential to manage the complexities of diabetes. Insulin strategy was considered important by athletes in maintaining subsequent energy to meet requirements alongside their nutritional intake and avoiding exercise-induced hypo or hyperglycaemia. These critical strategies highlighted by athletes and their management teams gave future recommendations. They directed athletes living with diabetes to manage blood glucose levels effectively to ensure performance goals were executed.