For Atheletes

Jay's endocrinologist, Dr. Patricia Wolff, coined the word "diabet-ologist" to describe the level of knowledge and understanding he acquired to ensure that diabetes would not interfere with his participation in athletics or endanger his well-being.

Dr. Wolff's "diabet-ologist" offers these Word of Wisdom for anyone managing diabetes and playing sports, whether competitively or recreationally.

1. Educate
Educate yourself to the signs and symptoms of insulin reactions. Know the first signs and each progressive sign as they change your body and thoughts. Educate yourself to know how long you have before you get into the danger zone of non-compliant behavior or confusion.

2. Anticipate
Know the activity you are engaged in, and know when the problems may arise before they occur. If you are planning a two-hour run, know that the last 30 minutes are the time when lows could become a problem and be prepared to deal with them. If a certain time of day is difficult for you, plan your insulin accordingly. On game days I would cut my insulin demands in half!

3. Hydrate
Dehydration can not only lead to physical problems but also result in false blood glucose readers of higher numbers. When diabetics have high blood sugars the body flushes the extra sugar out of your body through the kidneys, and that uses fluids from your body and dehydrates you. Dehydration can often be misunderstood as high blood sugars (the symptoms of dehydration and extreme high blood sugars are very similar), aches and an overall malaise.

4. Use Restraint
Don't overreact. A blood sugar of 200 is just fine. It is much safer to have slightly elevated sugars than to constantly fight lows throughout the activity. As long as your blood sugars do not stay elevated for extended periods of time, you are not in danger of causing serious long-term problems. It is much more threatening to have extreme lows while exercising than moderate highs.

Check with your physician before you administer insulin during competition. And remember that insulin is used much more efficiently during exercise, so it will not take as much insulin to lower your high readings. My insulin needs changed from a non-exercise dose of 1 unit lowering my blood sugars 20 points, to a dose of 1 unit taken during exercise lowering my sugars 50 points! That's a huge difference, so KNOW YOUR BODY!

5. Communicate
Tell someone else what is gong on. Tell a coach, a trainer or a teammate that you need to treat your sugar low. If you ever get in a situation when you drop into a dangerous low blood sugar situation, those precious seconds can make the difference between a scare and a trip to the hospital. Don't keep it a secret! There were plenty of times during a game when I would make a mistake and teammates would joke, "Do you need to eat?" Sometimes I did, and the reminder helped me out.

6. Don't Hesitate
Always have some kind of high-energy food available, and take time out to eat to treat your low blood sugar. When I played sports I was able to tell the signs of a low blood sugar coming on so I did not have to miss plays but instead could wait until a timeout to treat my low. Having said that, it was paramount that the food I had would get into my blood stream fast. I would either have a regular soda or fruit juice on the sidelines or nearby. I even kept Lifesavers in all my teachers' desk drawers. In my regular life outside of football I use Skittles because they don't freeze in the winter and they don't melt in the summer. It does not matter the brand of the food, just that it is a simple sugar that can be digested very quickly so it enters your blood stream fast. During exercise it is important to err on the side of being high rather than low. If in doubt eat first and check later.

For Coaches and Teachers

The most frequent comment parents make is, "Tell the coach (or teacher) not to hold my child back just because he/she has diabetes. Let them participate."

Diabetes doesn't have to limit a child's activities or sports participation. It doesn't have to limit their ability to perform as well as any other child in class or on the field or court. The key, as much for every teacher or coach as for every child, is knowledge.

These tips, from one of those diabetic kids - one who grew up to become a college football All-American, a National Football League star, and eventually a third grade teacher — should help:

1. Know who your diabetics are.
Don't wait until the diabetic student in your classroom, or diabetic athlete on your team, is having a low blood sugar to find out they are diabetic. It's okay to ask students at the beginning of the school year, or at the start of a season's practices, if anyone has a medical condition that you should be aware of. Let them know you want to know so you can help them make sure it is never a problem for them.

2. Have a plan for lows.
In the classroom, decide on a plan before your student has a low. Decide if it is okay to eat in the classroom. If not, where can they eat? Don't have the diabetic student go alone when they are low. Send a friend with them if they will be out of sight. Make them check their sugar levels, particularly if they have difficulty identifying a low. On the field or court, know what food you will have available, where it will be kept, and how it will be dispensed.

3. Don't eat the food!
Emergency food is Off Limits to everyone, including diabetic students or athletes - unless they are low. Teachers, coaches, fellow students and teammates are notorious for eating the emergency food that has been set aside for lows. Treat the food as medicine. Don't let the student/athlete eat at will. Monitor them to make sure they are low.

4. Check and replenish supplies.
You will be amazed how quickly the food disappears. Be sure to restock before you run out completely.

5. Know the signs of hypoglycemia.
They change and are different for each diabetic and for each athlete. Just because you may have taught or coached a diabetic in the past, don't think they are all the same.

6. Have a plan for treating high sugars.
Know or find out if your diabetic student or athlete gives their own shots. Do they bolus? Remember, you are not the doctor. But at times children need extra insulin. If a diabetic is high, the No. 1 thing is to drink water! Dehydration is the first problem. Drinking water helps fight ketones and helps the kidneys. Remind your diabetic, if they normally bolus for highs, use about one-half.

7. Make the student/athlete part of the process.
It is not up to the teacher or coach to manage their student's or athlete's diabetes. It is the diabetic's responsibility to identify lows. The teacher or coach is the diabetic's support. Watch for signs. If you notice patterns, help them see them. Are they always low during tests? Help them plan for that. Before they go to phys ed, ask them if they have checked their sugar.

8. Don't try to be the doctor.
As a teacher or coach, you don't know all there is to know about diabetes, and you are not expected to know everything. It is okay to say, "ask your doctor. I don't know." It is better to seek information than to give bad dicrection. Children know if you try to pull the wool over their eyes. Don't lose that trust. It isn't worth it.

9. Communication is key.
Talk about what you see. Communicate with parents and diabetics about patterns and concerns, what they do well and what they need help with.

10. Teach/coach them on their diabetes.
The lesson is simple and straightforward, in both school and in life: If you want good grades, take care of your diabetes. If you want to play better, take care of your diabetes. If you want to enjoy life and participate fully, take care of your diabetes.

For Parents

In chapter 14 of Yes I Can! Yes You Can! Ingher Leeuwenburg, Jay's wife, sums up the anxiety and fears that many parents feel as they try to help their diabetic children learn to live successfully with their disease.

"There are a lot of parents of children with diabetes who are looking for that miracle," she says. "Jay's message is not professing a miracle. It is out there communicating how to deal with challenges in your life. It is not giving false hopoe. It is not sayingthere is an easy way out.

"It is saying, 'If you put the effort in, if you're committed, if you're educated, if you take the necessary steps, you will succeed."

If you're the parent of a child with diabetes, see if these tips from Jay help you respond more confidently to the challenges you and your child encounter in your daily lives:

1. Create a diabetic family.
Encourage everyone in your family to accept diabetes as a part of everyday life. For example, avoid having two menus in your home, one for the diabetic child and another for everyone else. Instead, have your family eat the same meals. No one will go hungry, and you may all start to eat a healthier diet. Don't have different rules for your diabetic child than you have for your other children. If your diabetic child wants to have a sleepover, support it - just as you would if your non-diabetic child had come to you. You need to set guidelines you are comfortable with, but don't instantly say, No! Use the activity as an opportunity for your child to learn how to manage diabetes and enjoy life. It's a good idea to make sure the supervising adult is aware that your child needs to take insulin and test blood sugar levels, but put responsibility for self-sufficiency with your child.

2. Have a schedule!
You don't have to have everything at the same time every day, but meals especially help if they are at a consistent time. This is not to say you can't go out or do something different. But a different meal time every day makes it much more challenging to manage insulin levels.

3. Always have emergency food handy.
As an adult, never forget to have some fast-acting food ready for your child in case he or she is having a low blood sugar. You don't have to make every low a learning experience or a lesson in responsibility. Have your diabetic try to be responsible for their own health, but you are the adult; make it part of your planning.

4. Don't overreact, especially to high sugars.
Use blood tests as a tool, not to "catch" your diabetic child sneaking extra food. If your child has a high sugar for three days in a row at the same time of day, think about changing insulin needs. Be sure to coordinate with your doctor or dietician before you make a change.

5. Slowly give your child more responsibility.
Depending on your child's age and their maturity level, start making them aware and responsible for their own care. It may be giving their own shots. Figure out how much to blous for a meal. Count carbs. Pack their own meals. Remember that, at some point, they will leave home and be on their own. Your goal is to help prepare them to be safe and in control of their diabetes. Some of the best words of advice my parents and I received was, "No matter how much your parents want to have this disease for you, they can't. You, as a diabetic, ultimately are the only one who can control and effect your own health."

6. Let your child make mistakes, and help them learn from them.
Talk to your diabetic child about the choices they make and how those choices affect their body. If they have to have that triple-decker ice cream sundae with hot fudge, then don't ignore the extra insulin needed when they come home and their blood sugar is 400 and they throw up. Discuss how having that pizza at Suzie's house with regular Coke wasn't the best idea, and how water would have helped so much more. Or at least tell them to take extra insulin and take it when they go to the bathroom, which they surely had to do anyway!

7. Don't treat your diabetic child differently.
If your diabetic child is out of line, call them on it. If they do a good job, praise them. But don't give extra praise just because the child has diabetes. Never say, "Wow, Johnny got a hit; isn't that great because he has diabetes!" It's great because it was his first hit - diabetes had nothing to do with it. Don't let diabetes be an excuse, either. Never say, "Oh, it's okay to steal because she has diabetes." Wrong is never okay.

8. Puberty is hard for diabetics, too.
Hormones affect blood sugars. Know that your teenage diabetic child will rebel and be angry. Have the foundation in place to talk with your child about diabetes and anything else that comes up. High school was the most difficult time for me and for many other diabetics.

9. When traveling, always keep medication in your carry-on.
Have a supply of insulin and syringes or pump site kits in your unchecked luggage. It might sound obvious, but you wouldn't believe how many people pack these vital things, only to lose their luggage or have a flight change and be separated from their bags -and their medicine! The last thing you want to do on vacation is to have to get a prescription and find a drug store to buy insulin and syringes. I have never had anyone in airport security deny me or stop me because of my supplies. But you should have a prescription from your doctor handy to explain the need, just in case.

10. Teach your child to become educated about diabetes and the human body.
So much research and knowledge is being generated everyday about diabetes that it is hard to keep up. But every diabetic needs to try. Diabetes management is constantly changing and improving. Your child's needs will change; their body will change; and so will their daily regimen. Encourage them to be flexible as they grow, and do what works. There is no one right way, or one right answer. We all hope for a cure, but until one is discovered, there is no reason why your child can't use what is available to be healthy and productive.

Name: Jay Leeuwenburg

College: University of Colorado
Degree: B.A., English
College Football Distinctions: Unanimous All-American, 1991
Three-year starter at center
Appeared in four bowl games
Starred on 1989 National Champion Team

NFL Career: 9 seasons (1992-2000)
NFL Teams: Chicago, Indianapolis, Cincinnati, Washington
Position: Offensive line
Pro Football Distinctions: Pro Bowl alternate; played in 4 playoff games

Profession After Football: Third Grade Teacher

Jay was diagnosed with Type 1 diabetes at the age of 12 but went on to become an all-state football player and state tournament wrestler at Kirkwood High School in suburban St. Louis.

He was recruited by many major college football programs, and accepted a scholarship to the University of Colorado. He earned his degree in English, completing his undergraduate course work by the end of his junior year. During his senior season he was enrolled in the Graduate School of Business, and took some education courses.

During Jay's college football career, CU played for the national championship in back-to-back Orange Bowl games, both against Notre Dame. Jay started at center in both games, two of four bowl games in which he played.

The Buffaloes were unbeaten going into the first one, in 1989, but lost. They rallied from a slow start the next season to capture the national title.

In his senior season at CU, Jay was a unanimous All-American, the first-team center on every All-American team named in 1991. He allowed only one quarterback sack his entire senior season.

Jay played nine seasons in the National Football League, including four with the Chicago Bears (1992-95) three with the Indianapolis Colts (1996-98) and one each with the Cincinnati Bengals (1999) and Washington Redskins (2000). He started 129 regular-season games, was a Pro Bowl alternate, and played in four NFL playoff games. He is one of only a few NFL offensive linemen to start games at all five offensive line positions.

Jay never missed a down of football because of any diabetes-related complication.