SI Vault
Arnold Schechter
April 22, 1985
Former Chicago Cub Ron Santo will remember one at bat long after the other 8,142 have been forgotten.
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April 22, 1985

The Diabetic Athlete: His Toughest Opponent Is His Own Metabolism

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Former Chicago Cub Ron Santo will remember one at bat long after the other 8,142 have been forgotten.

"September 1968. It was the bottom of the ninth. The Dodgers led 1-0, and the bases were loaded for me.

"But I had broken into a cold sweat, and my tongue was numb and tingly. I stumbled to the plate, seeing triple. I lunged weakly at the first decent pitch, and—God knows how—I connected for a grand-slam home run to win the game. I staggered around the bases, and my roommate, Glenn Beckert, rescued me with candy bars and a Coke."

Santo had experienced the nemesis of diabetic athletes: a plunge in his blood-sugar level that crippled his ability to think and act.

Santo and such athletes as Bill Gullickson of the Montreal Expos, Calvin Muhammad of the Washington Redskins and golfer Mark Lye have the most severe form of diabetes. Their bodies produce no insulin, the hormone that enables body cells to produce energy by metabolizing sugar from the blood. They were stricken suddenly in their youth with extreme thirst and hunger, frequent urination and rapid weight loss. From then on they had to take an injection of insulin daily to live.

The more easily treatable and common form of diabetes, in which the body produces a little insulin, rarely strikes active athletes. It usually develops after age 40 and is often triggered by obesity. It is widespread among just one group of active athletes: Japanese sumo wrestlers, who are so grossly overweight that many become diabetic before middle age.

All 11 million diabetics in the U.S. have to control their blood sugar, but for athletes, male and female alike, this is extraordinarily complicated. Inevitably, competition makes unpredictable demands on the body. And, despite decades of diabetes research, normalizing blood-sugar levels remains less a science than an art. As ex- Philadelphia Flyer Bobby Clarke, a diabetic, says, "Everyone's metabolism is different, and each diabetic has to learn how to cope with his own."

Any athlete who has been keeping his blood sugar in the normal range must deal with a fundamental problem: Exercise lowers the sugar level. A single sprint or jump may make no difference, but prolonged or vigorous activity will force the muscles to burn sugar. If he exercises hard at least 30 minutes daily, the effect of his insulin will be enhanced and he must reduce his dosage by as much as half.

The diabetic athlete can choose from over a dozen types of insulin, ranging from Regular, which peaks in two to four hours and whose effects last perhaps twice that long, to Ultralente, which peaks in 18 to 24 hours and is effective for more than 36 hours. He can also experiment with mixing two insulins for two peaking effects.

He must schedule his shots and decide where to inject them. A runner, for obvious reasons, should not inject insulin into a leg; his leg muscles work the hardest, and the increased blood flow there will use up his insulin too quickly.

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