Pete is a 16-year-old boy who was recently diagnosed with diabetes. He is a phenomenal diver and has competed in the World Youth Olympic Games this past summer. He dives at 1- and 3-meter boards and has been training on the platform diving at 7.5 and 10 meters.
You are the medical provider hired to provide medical services at the countywide meet, and you have minimal information on the athletes. Pete's coach brings you an extra glucometer and insulin prescribed for Pete and informs you that Pete's blood sugar was 130 an hour ago.
As the meet progresses, you notice Pete spending a lot of time by himself, but he seems fine from a distance. You witness him checking his blood sugar with his glucometer and then eating something. Ten minutes later, he repeats the measurement and injects insulin, prompting you to check on him.
Pete reports feeling dizzy on the high board, prompting him to take his first measurement, which read 60. He then consumed a candy bar. Scheduled for his next dive, he felt shaky, rechecked his blood sugar (10 minutes later), and found it was 375, so he injected insulin to lower it before diving.
You determine his blood sugar is not controlled and remove him from continuing dives at the higher levels, informing the coach that he cannot dive for at least 30 minutes. The coach is upset as this decision will remove Pete from the competition at the higher platform diving events, but you stand firm.
**Questions:**
1. What is your rationale for withholding Pete from diving?
2. What are the signs and symptoms of hyperglycemia and hypoglycemia?
3. Whom else, if anyone, do you need to notify of Pete's condition?
4. What educational strategies do you provide to both the coach and Pete about keeping his blood sugar levels consistent?
**Options:**
a) He needs immediate medical attention; Hyperglycemia: high blood sugar, thirst, frequent urination, confusion; Notify his parents and the event organizers; Monitor sugar levels closely and eat a balanced diet.
b) He needs immediate medical attention; Hypoglycemia: low blood sugar, dizziness, shakiness, confusion; Notify his parents and the event organizers; Carry fast-acting glucose and monitor levels.
c) He needs rest but can continue diving; Hyperglycemia: high blood sugar, increased energy, frequent thirst; Notify the coach and event organizers; Monitor sugar levels and adjust insulin as needed.
d) He needs rest but can continue diving; Hypoglycemia: low blood sugar, fatigue, confusion, irritability; Notify the coach and event organizers; Monitor sugar levels and adjust insulin as needed.
