Common Medical Conditions: Asthma & Diabetes

Medical Conditions in Sport

Many sports performers live with long-term medical conditions. Asthma and diabetes are two of the most common conditions encountered in sport. Understanding their causes, symptoms and management is essential for coaches, teachers and performers so that participation can continue safely and emergencies can be handled correctly.

Asthma: Causes and Triggers

Asthma is a chronic respiratory condition in which the airways become inflamed, narrow and produce excess mucus, making breathing difficult. The exact cause of asthma is not fully understood, but two key triggers are especially relevant in sport. Environmental triggers include cold air, air pollution, pollen, dust, pet dander and cigarette smoke — all of which can inflame the airways. Exercise is a particularly important trigger: during vigorous physical activity, increased ventilation draws cold, dry air deep into the airways, which can provoke an asthma attack — sometimes called exercise-induced bronchoconstriction.

Asthma: Symptoms and Treatment

The four key symptoms of asthma are: coughing (often worse at night or after exercise), wheezing (a whistling or rattling sound on breathing out), shortness of breath (difficulty getting enough air, particularly during exertion) and tightness in the chest (a squeezing feeling that can feel like pressure). During an asthma attack all four symptoms may occur together and can escalate rapidly.

Treatment in a sporting context has two elements: reassurance — remaining calm, helping the performer sit upright in a position that opens the chest, and reassuring them reduces anxiety, which otherwise worsens the attack; and inhalers or nebulisers — a reliever inhaler (usually blue) delivers bronchodilator medication (typically salbutamol) that relaxes the airway muscles and opens the airways within minutes. A nebuliser delivers the same medication as a fine mist for more severe cases. If a performer's reliever inhaler does not work after 10 puffs, or if they become very distressed or their lips turn blue, call 999 immediately.

Diabetes: Type 1 and Type 2

Diabetes is a condition in which the body cannot regulate insulin correctly, leading to abnormal blood sugar levels. There are two main types. Type 1 diabetes is an autoimmune condition typically diagnosed in childhood or young adulthood — the body's immune system destroys the insulin-producing cells in the pancreas, so the body produces no insulin at all and the person is entirely dependent on insulin injections or a pump. Type 2 diabetes is much more common and is strongly linked to lifestyle factors such as a poor diet and physical inactivity; the body either does not produce enough insulin or the cells become resistant to it. Type 2 is more commonly diagnosed in adults, though increasing numbers of young people are affected.

Diabetes: Symptoms and Treatment

Common symptoms of both Type 1 and Type 2 diabetes include: increased thirst (the body tries to dilute excess blood sugar by drawing water from cells), urinating more often (kidneys filter excess glucose through urine), extreme tiredness (cells cannot access glucose for energy), unexplained weight loss and cuts or wounds that take a long time to heal (high blood sugar impairs immune function and circulation). These symptoms are shared across both types, though Type 1 tends to develop more rapidly.

Treatment differs by type: Type 1 requires daily insulin injections or an insulin pump, as well as careful diet management. Type 2 is often managed initially through lifestyle changes — including increased physical activity and a healthier diet — with medication or insulin added if lifestyle changes are insufficient. Both types require regular blood sugar monitoring, especially around exercise, as physical activity significantly affects blood glucose levels.

Blood Sugar Levels: Hypos and Hyperglycaemia

Blood sugar levels in a diabetic performer can fall dangerously low or rise dangerously high, both of which are medical emergencies. Hypoglycaemia (a 'hypo') occurs when blood sugar falls too low — often triggered by exercise, missed meals or too much insulin. Symptoms include shakiness, sweating, dizziness, confusion, pallor and weakness. Treatment is rapid ingestion of fast-acting glucose (e.g. glucose tablets, a sugary drink or orange juice). Exercise significantly increases the risk of a hypo in Type 1 diabetics, so blood sugar should be checked before, during and after activity. Hyperglycaemia (high blood sugar) develops more slowly — caused by too little insulin, too many carbohydrates or illness — and symptoms include increased thirst, frequent urination and fatigue. Severe hyperglycaemia requires medical attention.