What coaches need to know

This page is for the adults on the sideline: coaches, physical education teachers, club volunteers and training partners. You don't need to manage anyone's diabetes. You do need to know enough to keep them playing safely, and to recognise the few moments when your reaction matters.

Start here

What you need to have

• A written plan from their diabetes team, shared with you. Ask whether you have actually been given one. Often the answer is no — and fixing that is the most useful thing you can do.
• Fast glucose at the side — glucose tablets, gel or a sports drink.
• A way to check glucose, and permission to pause for it. A pause to check is not a player being difficult.
• Their emergency contact.
• The knowledge that they may not feel a low coming.

Spot a low

Watch for someone who is shaky, pale, sweating oddly, confused, clumsy, suddenly irritable, or has just gone quiet.

In a child, these signs are harder to read and easy to mistake for effort or a bad mood.

Two moments where your reaction matters most

Most of what follows is common sense. Two situations, though, are where genuine emergencies tend to start — and in both, the pressure to act often comes from the sideline.

The pre-game high. Young athletes often run high before a match because of nerves and adrenaline. It usually settles once play starts. Pushing for an insulin correction on the sideline is what leads to a crash later.

The high after a hard session. Hard efforts push blood sugar up, but the hours afterwards bring increased insulin sensitivity. Stacking corrections on that high can lead to a severe low overnight. The guidance is to correct conservatively, or wait.

Eight things not to do

1. Don't bench someone because of their diagnosis.
2. Don't chase a pre-game high with insulin — it's adrenaline, and it settles.
3. Don't stack corrections after a hard session. This one can be life-threatening.
4. Don't trust a sensor number while glucose is dropping fast. Do a finger prick.
5. Don't restart the session after a real low.
6. Don't rely on a bedtime snack alone after afternoon sport.
7. Don't let anyone train alone anywhere risky after a recent low.
8. Don't forget to reconnect the pump.

If you remember only two lines from this page, make it numbers two and three.