Athletes with diabetes require intensive diabetes management to balance insulin, carbohydrate intake, and the effects of exercise. Effective care of active patients who have diabetes starts with a targeted preparticipation exam. Decreasing the insulin dosage may be necessary for heavier exercise programs if carbohydrate supplementation alone is insufficient. The documented risk for either hypoglycemia or ketoacidosis requires careful planning for training or competition. Analysis of 'high-risk' activities is essential to determine which may need to be modified, diminished, or restricted.
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