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Type 1 Diabetes and Young Athletes

By Daniel Walock, submitted to Minnesota Hockey, 05/09/17, 10:30AM CDT

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Youth sports are woven into the fabric of society and are a large focus of many families. Regardless of the sport, the ability to play them is almost a foregone conclusion to many.

For some, it’s a daunting task. Like my family.

In August 2011, my wife and I learned our son, Keaton, was a Type 1 Diabetic. As people with little connection with Type 1, we embarked on a quick study. Type 1 diabetes is where the cells that produce insulin in the body are slowly destroyed by the immune system. As the number of active insulin producing cells falls, the ability to regulate blood glucose decreases and life threatening situations can occur. The Type 1 patient embarks on a life of injecting insulin into their bodies daily to survive.

Nothing a person did in terms of eating less nutritious food, lack of exercise, or being overweight caused it. This point was emphasized to my wife and I as when we were at the hospital with our son right after diagnosis, a family with an infant was in our educational classes. This young gal was also Type 1.

In a nutshell, lifestyle choices may impact persons with type 2 diabetes. They have no bearing on type 1 as it’s an autoimmune disease.

One thing that we weren’t prepared for is how Type 1 diabetes affects sports and how you need to manage it to be successful.

Keaton loves to play sports, although they all play second fiddle to his true love, hockey. Sadly, his career as a goalie hasn’t been without complications.

At times, he is forced to sit out until his numbers stabilize.  One time, at age 11, he wasn’t able to participate in hockey practice and he told his mom, “My diabetic care is more important than hockey”. For a child who stick handles endlessly in the cul-de-sac, it was an amazing admission that shows he has had to grow up before his time.

If his blood sugar levels go too high, he loses focus and concentration. If the levels run too low, he loses feeling in his legs. In his first year as a hockey goalie, he went low and collapsed in insulin shock and had to be carried off the ice by four coaches. Apparently his glucose levels fell and his body had to use a hormone called glucagon stored in his liver to supply sugar to help him rebound. He was incoherent until his glucose levels increased.

Often he has to eat or drink regardless if he’s hungry to simply get sugar into his system when he is low or on the lower side of his range of 80-140. Once, when a rink door was stuck, I was forced to hand him skittles one by one through the glass panels at a rink to help boost his numbers. Another parent, I think, thought I was crazy.

A big part of the challenge a type 1 diabetic faces is the unpredictable nature of the glucose levels. Keaton has went on the ice at 160, left it an hour later at 320 as adrenaline had kicked in and it spiked, then 30 minutes later he was at 50, a low number. Parents have to be careful to not react to the adrenaline spike and administer insulin to bring that near 300 number down as the body will bring it down as the adrenaline rush passes.  It’s an art that parents learn early on.

This unpredictability only gets more intense as the child moves into and through adolescence. My son’s endocrinologist has warned us that the hormonal changes make it very hard to manage in addition to stress, adrenaline, workout intensity, food, and many more triggers.

Right now, our family is going on year 6 of Keaton having Type 1 diabetes, and although there are challenges, there have been what I believe are great triumphs and examples of amazing human spirit.

One thing that has been key to our family is communicating constantly with our son’s coach and teammates so they understand the condition better. We have been extremely fortunate that my son has had the same person coaching him for over 5 years. This coach, Cale Politoski, has coached multiple players with diabetes in his career in youth sports and ad Shattuck St. Mary’s and has developed a keen ability to understand my son’s mannerisms and he will signal to us if he is concerned that Keaton’s numbers might be off. Usually, he is spot on.  He believes in developing a strong understanding between coach and player. According to Cale, “The biggest part for me always was to get the mindset of this is how they play when their numbers are on. Once you learn what works for that player, then you have the 'normal' in mind.  And when the normal is way off, well, then you start to ask the questions of what are your numbers at.”

After Keaton collapsed years ago, we developed a sign he can give if he every feels he is losing feelings in his legs so that we can stop a game and get him off the ice if need be. Cale and the assistant coaches know it, and we fortunately only had to use it once when he was a mite, but we are prepared for an emergency.  

Through it all, we have experienced the kindest people, and moments. When Keaton did leave the ice once as a Mite when his numbers were off, his teammates all went into the net for the period he was gone and he got an amazing eruption of applause when he returned to the ice.

His teammates have been amazing. They understand his condition, and they have supported him fully. In the last two annual JDRF One Walks for a cure in 2016 and 2017, a large majority of his teammates made the trip to the Mall of America to support him.   

As we have moved along this journey, we have seen improvement in sports issues, and much of that is due to careful testing of his blood sugar. As of today, he has tested himself over 16,000 times since August of 2011. Often 9 to 10 times in a given day and additional testing before, during, and after sports or vigorous activities. Depending on how he feels, he will test quickly in between periods.

We have to carefully count the carbs in everything he eats to ensure he has insulin to help his body convert the carbs to energy.  People with Type 1 diabetes also have celiac disease at a rate of close to 20% of the diabetic community, as oppose to 1-2 % of the general population. Keaton carefully avoids any foods with gluten, but any other food he is able to consume. For a Type 1 diabetic without celiac, no foods are off limits. They just need to administer insulin to offset the carbs in the food they eat.

There are some excellent examples of professional athletes that have Type 1 diabetes. They thrive showing diabetes doesn’t have to place limits on what a child achieves. Jay Cutler, Max Domi, Corey Conacher, Brandon Morrow are all examples that allow professional dreams to grow in the minds of our youth.

Keaton longs for a cure. He guest lectures every year at a nurses college, has built a JDRF night with the Wild, and fundraises endlessly.

He hopes his efforts would help kids like him no longer have to sit out in sports or perform less than their best due to the complications of Type 1. He has led a team of walkers in the Juvenile Diabetes Research Foundation One Walk at the MOA the last few years and this 2017 walk raised close to 2 million dollars. Minnesota’s walk is the largest one in the country and I’d like to ask you to consider supporting and joining Keaton’s Glucose Patrol at the MOA in the future. You can register to walk at jdrf.org and search for Keaton’s Glucose Patrol.    

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