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Diabetes…Dealing With A Game Changer

By Mark Winters

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Watching the pros makes it seem that tennis is easy to play. They flow across the court and hit shot after shot while their bodies are often stretched to the limit. Exchanges appear to be crafted by skilled sculptors using tennis racquets, instead of tools to work on marble.They ply their talents, around the world, on hard, clay and grass court surfaces. The settings, whether indoor facilities or outdoor arenas, are elegant and in some instances, are regarded with reverence.

The game is deceptive and always demanding no matter how good a performer is supposed to be. As the truism brings out – There is only one winner in a match, only one winner of a tournament. The formula is ridiculously simple but achieving a winning result can be challenging and in some cases, tremendously complex.

The route to realizing success differs from player to player. For some, mitigating health factors is in the forefront of what they have accomplished. Serbian Novak Djokovic has become the poster boy for a plant-based, gluten-dairy free diet.

Since 2009, Venus Williams of the US has suffered from Sjogren’s Syndrome. In order to continue playing she follows a “Chegan” (raw and vegan) diet, as she calls it.

Djokovic and Williams happen to be two of the best known performers contending with significant health concerns but there are a number of other competitors who quietly go about juggling a variety of factors so that their play isn’t adversely affected.

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Bill Talbert was inducted into the International Tennis Hall of Fame in 1967. He was a stellar singles competitor and teaming with countryman Gardnar Mulloy, an even better doubles player. He was a rarity being a successful Davis Cup performer before becoming the team captain and winning the revered trophy in 1954.

Bill Talbert’s Grand Slam results. Image: International Tennis Hall of Fame

Once his playing days were over, he moved into tennis administration serving as the US Open Tournament Director from 1971-’75 and again from 1978 until 1987. With all the accolades he received his most extraordinary accomplishment is not overly praised – He led an active life handling Type I Diabetes after being diagnosed at 10 in 1928.

Hamilton (Ham) Richardson won the NCAA singles title in 1954 and ’55 while attending Tulane University. He went on to become a Rhodes Scholar and earned a master’s degree at Oxford University.

During the mid-1950s, he was a Men’s Singles semifinals at Roland Garros, The Championships and the US Nationals. The Baton Rouge, Louisiana native topped the US Men’s Singles rankings in 1956 and again in ’58.

The same year he was a member of the winning US Davis Cup team and teamed with Alex Olmedo, with whom he played doubles in the triumph over Australia, to capture the US National Men’s Doubles trophy. In addition, he was on 1954 US Davis Cup winning side (playing for Talbert)…and he achieved all of this after learning in 1948, at 15, that he was a Type I Diabetic.

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Without doing a medical dissertation, the pancreas produces insulin which enables sugar, technically, glucose, to reach cells and produce energy.

A Type I Diabetic is insulin-dependent because the pancreas fails to manufacture the peptide hormone necessary to live an active life. To do so an individual must either inject insulin or use an insulin pump to keep his blood sugar level “balanced” so that damage to organs such as the eyes, kidneys, etc. doesn’t occur.

Generally individuals with diabetes don’t use a “Public Address System” to announce the fact, primarily, because of the “Social Torment” that can accompany being “different…” The situation is regularly confounded by the public’s inability to grasp the complexity of handling the chronic disease on a daily basis. Classically if someone happens to “cop to…” being a diabetic…the almost standard response is – “Really, I have an aunt who is in her 60s and is a Type II diabetic…she is really overweight…”

Simply put…Type I and Type II Diabetics are not one and the same…What’s more…and this can’t be stressed enough…In 1859 Charles Darwin coined the phrase “Individual Differences” which is the most appropriate way to think of those with diabetics…

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Heredity can play a role in the likelihood of an individual becoming a Type I or Type II Diabetic… But this isn’t always the case. A viral infection, which damages the insulin generating capability of the pancreas, can be the culprit.

JC Aragone playing the US Open in 2019. Photo: USTA

This is what happened to JC (Juan Cruz) Aragone. Born in Buenos Aires, Argentina, he grew up in Yorba Linda, California. Aragone was 16 and training at the USTA facility in Florida when he had an adverse reaction to a medication in 2012. His immune system collapsed and began cannibalizing his internal organs. The resulting stress to his liver, kidneys, spleen, etc. almost killed him… Critically ill, he survived…but his pancreas didn’t. It was no longer able to provide insulin which resulted in Aragone becoming a Type I Diabetic.

Undeterred, he became one of the country’s top juniors which led the University of Virginia to recruit him. He went on to play a significant role in the men’s team winning a trifecta of NCAA Championships in 2015, ’16 and ’17 (the same year he graduated with a degree in Government.)

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No matter the level of competition, routines are essential for tennis players. Adding diabetes to the equation increases the intricacies of life and makes managing matching playing more complicated. Stating the obvious, it is critical for all players to control variables such as training, diet, emotions, hydration, sleep etc. to realize success. In the case of a diabetic, there are more boxes to check in order to be fully prepared to compete.

Awareness is essential… For example, after a long rally is the resulting weariness the outcome of exertion or is there more…such as a drop in blood sugar which can lead to “Teetering…” (hypoglycemia) that muddles thinking; affects coordination and brings about erratic shot making. In addition, emotional control can become shaky leading to tirades, ball abuse or racquet mashing…or all three…

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Since leaving the Charlottesville, Virginia campus, the 27 year old Aragone has contested ITF World Tour events, (along with ATP Qualifyings when possible), while using an insulin pump to deal with his diabetes.

JC Aragone revealing the 5G mobile device he uses to track glucose levels and send real-time alerts to his smart device. Photo: Paula Aragone

In our exchanges, he admitted, “It’s a little harder when you are used to living life one way and then get thrown a massive curveball, changing every aspect of your life. Tennis is a difficult sport as it is and being diagnosed with Type I Diabetes added an extra level of difficulty. I have to think not only about my strategy, my play, and my opponent, but I also have to add in extra challenges such as with my blood sugar fluctuations.

“Whenever my blood sugar begins to drop I get blurry vision. I start sweating profusely, become extremely hungry, and, yes, I can get extremely temperamental and flustered (so my wife tells me). Obviously, these symptoms make it more difficult to maintain the focus I need for high level tennis and that is why it is important for me to keep me blood sugar in a stable range during play.

“In addition to having a tennis and a fitness coach, I also work with a diabetes coach, Cliff Scherb. Cliff helps oversee everything from my nutrition to timing my insulin doses and makes sure I account for the level of stress before matches so my blood sugar is under control and I can compete at the highest level.”

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November is “American Diabetes Month” when a concerted effort is made to inform and offer direction about Type I and Type II Diabetes.

In 1922, Sir Frederick Banting and Charles Best discovered insulin. The International Diabetes Federation (IDF) and the World Health Organization (WHO) teamed up, in 1991, to honor Banting by designating November 14th, his birthday, “World Diabetes Day”. It became an official United Nations Day in 2006 and is now a mammoth annual increase diabetes awareness activity involving more the one billion people and over 160 countries.

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Aragone has been forthright, taking every opportunity available to provide insight about being a diabetic and playing tennis on an elite level. He revealed,  “A lot of players tend to ask about my pump. I imagine it’s because they have never seen one. But they always tend to ask the same questions, ‘How do you play with that’ or ‘Does that bother you when you play?’ A few people have mentioned how they have someone in their family with diabetes, ­but again it’s generally Type II…”

He added, “I have many Type I friends whom I have met from giving motivational speeches at diabetes events. I am continually inspired by other people’s stories and it lifts me up. It really is an amazingly close group. I always joke about it, but I seriously would love to have a Diabuddy on tour.

(Diabuddies is a mobile app that enables diabetics to connect with those living with the disease and foster mutual mental health support.)

JC Aragone showing his blood sugar device and insulin needle.
Source: World Tennis Magazine

Looking ahead Aragone revealed, “Part of my path as a person with Type I Diabetes is to educate others about the disease and my health challenges. This always includes educating people about the challenges of both Type I and Type II Diabetes. I have gotten a call from a player who had a family member diagnosed with Type 1, and I was honored that he called me seeking my advice and help.

“Overall, I find that diabetes does not control my life and feel I have adapted well, but it is a constant presence that I can’t underestimate. My diabetes diagnosis has shown me that life is uncertain and you never know when you will be challenged by something unexpected. This realization has made me worry less and live my life more in the moment. This is beneficial for tennis and everyday life.”

(On August 6th, Alexander Zverev announced the creation of the Alexander Zverev Foundation…Dedicated to helping youngsters with Type I Diabetes and also encourage an active lifestyle in an effort to prevent Type II Diabetes…In the statement, Zverev admitted that he was a Type I Diabetic.)

Postscript

Four months before my eighth birthday, I became a Type I Diabetic (and like JC Aragone it was the result of medication). I hid the condition because, in those days, being “different” resulted in becoming an “outcast”. This perception led me to do everything possible to prove I was just as capable as “normal kids”… so I became a standout academically and competed in all sports. In high school I finally decided that if I wanted to “excel”, tennis would be the way I could do it.

I went on to play on the intercollegiate level and enjoyed “a fun but undistinguished…” period as a professional. I segued into teaching the game, spent time as a US National Boys’ Team coach before settling into a career as an international tennis journalist. During most if not all of these escapades I rarely, if ever, mentioned I was a diabetic.

Looking back, I now realize how foolish this was…Had people known, perhaps they would have understood me better…And with the understanding, appreciated what it is like to live a day walking in my shoes…

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