Jay Cutler has a cannon for an arm. A few weeks ago, when the 6-foot-3, 240-pound quarterback for the Denver Broncos and his team were backed up on their 1-yard line, he took the ball, faked a handoff and spun left to find himself face to face with a 300-pound lineman. Cutler passed, juking the opponent out of his socks.
You'd never guess the quarterback spends a good portion of every game on the sidelines keeping tabs on his type 1 diabetes, a condition that, if left unmonitored, can cause severe health problems.
Cutler, who was diagnosed last spring just before his 25th birthday, uses a fingerprick kit to check his blood sugar levels, sometimes half a dozen times during a game. If the reading is too low, he gulps down enough Gatorade to push it up. His medication is always on hand in case his blood sugar jets abnormally high.
Being an athlete with type 1 has its complexities, but research shows exercise improves the health of patients with diabetes, says Michael Jensen, professor of medicine and director of endocrine research at the Mayo Clinic.
Snacking, hydrating and protecting vulnerable body parts become lifelines for athletes with diabetes. But Cutler and experts say the condition doesn't have to stop a person from becoming a star athlete -- or even just enjoying a game of flag football now and again.
Type 1 diabetes accounts for about 5% to 10% of all diabetes cases, and about 1.4 million people in the USA have the disease, according to the American Diabetes Association. About 90% to 95% of diabetes patients have type 2, which is brought on by obesity and other lifestyle factors. Type 1, however, is an autoimmune disease that happens when the insulin-producing cells in the pancreas are destroyed by the body. Insulin is a hormone that helps the body use glucose for energy.
Effects of low blood sugar
It's common for someone with type 1 to experience low blood sugar, called hypoglycemia, during exercise, says Serge Jabbour, an endocrinologist at Jefferson Medical College in Philadelphia. The effects of untreated hypoglycemia include fatigue, a symptom Cutler experienced in the months before his doctors discovered his condition. Untreated, hypoglycemia can lead to coma and death.
On the other hand, high blood sugar, or hyperglycemia, can hit when a person with type 1 eats too much and doesn't take enough insulin. Chronic hyperglycemia can lead to kidney damage, vision problems and nerve complications, says Mayo's Jensen.
"When you and I exercise for any period of time, whether it's light or hard, our body needs less insulin, and the pancreas automatically does that for us," Jensen says. With type 1 diabetes, that doesn't happen naturally. Blood sugar can drop super-low during sports, and the only way to correct it is with food. If it jumps too high, Jensen says, insulin is needed.
Type 1 athletes should know their bodies and what's right for their sports routine, Jensen says. "It varies immensely depending on the sport you're in."
Improvement with insulin
Cutler remembers feeling lousy for about six months before he was diagnosed, during which he dropped 30 pounds. "I wasn't eating. I didn't have any energy," he says. The sluggishness followed him onto the field. "It absolutely impacted my game. I was tired before the game even started, and I was dead tired after."
Once he started taking insulin, Cutler's game and even his psychological outlook improved, says Steve Antonopulos, head trainer for the Broncos.
Offseason, Cutler uses an insulin pump attached to his body. When the football season started, he switched to manual injections.
Taking ownership of diabetes is the key for athletes, Antonopulos says. "Jay has tremendous knowledge about it, and he knows exactly how he should and shouldn't feel. He does everything he's supposed to do."
Exercise increases feelings of well-being and shows people that they are not limited by their disease, says David Nathan, director of the Diabetes Center at Massachusetts General Hospital. And "physically, it improves the sensitivity of muscle to insulin effects."
Since last spring, Cutler has gained back the lost weight, and he has been selected to play in the NFL Pro Bowl. "I feel very good where I'm at," he says.
Diabetes shouldn't hold athletes back, Cutler says. "If you've got a dream or something you want to accomplish, you can definitely still do it."
*For Cutler's pregame diet and more on type 1 diabetes, visit betterlife.usatoday.com.
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