{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T04:16:21Z","timestamp":1749701781840,"version":"3.41.0"},"reference-count":38,"publisher":"National Athletic Trainers' Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3]]},"abstract":"\n Context<\/jats:title>\n People with diabetes mellitus (DM) are at increased risk for adverse health events and complications throughout their lifetime. Whether DM significantly affects collegiate athletes\u2019 concussion baseline testing performance remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To (1) describe the prevalence of DM and associated comorbidities and (2) compare concussion baseline testing performance between student-athletes with DM and student-athletes without DM (NoDM).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective, cross-sectional study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n University.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n Using the Concussion, Assessment, Research and Education (CARE) Consortium research database, we matched athletes with self-reported DM (N = 229) by institution, sex, age, sport, position, testing year, and concussion history to athletes with NoDM (N = 229; total sample mean age = 19.6 \u00b1 1.4 years, women = 42%).<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n Descriptive statistics and \u03c72<\/jats:sup> tests of independence with subsequent odds ratios were calculated. Independent-samples t<\/jats:italic> tests compared baseline symptoms, neurocognitive testing, and balance performance between athletes with DM and athletes with NoDM. Effect sizes were determined for significant group differences.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n At baseline, athletes with DM had higher rates of self-reported pre-existing balance disorders, sleep disorders, seizure disorders, motion sickness, learning disorders, vision and hearing problems, psychiatric disorders, depression, bipolar disorder, nonmigraine headaches, and meningitis than athletes with NoDM (P<\/jats:italic> values < .05). We found balance differences between groups (P<\/jats:italic> = .032, Cohen d<\/jats:italic> = 0.17) such that, on average, athletes with DM had 1 additional error on the Balance Error Scoring System (DM = 13.4 \u00b1 6.5; NoDM = 12.1 \u00b1 5.9). No other comparisons yielded significant results.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although athletes with DM had high rates of self-reported balance disorders, sleep disorders, seizures, and meningitis, their baseline neurocognitive testing results were largely identical to those of athletes with NoDM. Our findings suggested that nonclinically meaningful differences were present in concussion baseline balance testing but no significant differences were noted in cognitive testing; however, the effect of DM on concussion recovery remains unknown.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0202.23","type":"journal-article","created":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T12:07:57Z","timestamp":1693570077000},"page":"297-303","source":"Crossref","is-referenced-by-count":0,"title":["Collegiate Athletes With Diabetes: Baseline Medical Comorbidities and Preseason Concussion Testing Performance"],"prefix":"10.4085","volume":"59","author":[{"given":"Melissa N.","family":"Anderson","sequence":"first","affiliation":[{"name":"Applied Health Sciences and Wellness, Ohio University, Athens"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin A.","family":"Gallo","sequence":"additional","affiliation":[{"name":"Kinesiology and Applied Physiology, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott W.","family":"Passalugo","sequence":"additional","affiliation":[{"name":"Kinesiology and Applied Physiology, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jake M.","family":"Nimeh","sequence":"additional","affiliation":[{"name":"Department of Biological Sciences, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Edgar","sequence":"additional","affiliation":[{"name":"Anderson Orthopedic Clinic, Arlington, VA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron M.","family":"Yengo-Kahn","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen","family":"Neitz","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas P.","family":"Terry","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center, Nashville, TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven P.","family":"Broglio","sequence":"additional","affiliation":[{"name":"University of Michigan Concussion Center, Ann Arbor"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McCrea","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"McAllister","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences, Bethesda, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Buckley","sequence":"additional","affiliation":[{"name":"Kinesiology and Applied Physiology, University of Delaware, Newark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2557","reference":[{"issue":"1","key":"i1062-6050-59-3-297-b01","series-title":"Clin J Sport Med","first-page":"8","article-title":"American Medical Society for Sports Medicine position statement on the care of the athlete and athletic person with diabetes","volume":"32","author":"Trojian","year":"2022","unstructured":"Trojian\n T,\n \n \n Colberg\n S,\n \n \n Harris\n G,\n \n et al.\n \n American Medical Society for Sports Medicine position statement on the care of the athlete and athletic person with diabetes. Clin J Sport Med. 2022;32(1):8\u201320. doi:10.1097\/JSM.0000000000000906"},{"key":"i1062-6050-59-3-297-b02","article-title":"Centers for Disease Control and Prevention","author":"CDC newsroom.","year":"2016","unstructured":"CDC newsroom.\n \n Centers for Disease Control and Prevention. Published January 1, 2016. Accessed January 3, 2024. https:\/\/www.cdc.gov\/diabetes\/data\/statistics-report\/index.html"},{"issue":"1","key":"i1062-6050-59-3-297-b03","series-title":"Curr Sports Med Rep","first-page":"38","article-title":"Update on management of type 1 diabetes and type 2 diabetes in athletes","volume":"16","author":"Yardley","year":"2017","unstructured":"Yardley\n JE,\n \n \n Colberg\n SR.\n \n \n Update on management of type 1 diabetes and type 2 diabetes in athletes. Curr Sports Med Rep. 2017;16(1):38\u201344. doi:10.1249\/JSR.0000000000000327"},{"key":"i1062-6050-59-3-297-b04","series-title":"Diabetes Res Clin Pract","first-page":"1","article-title":"Subjective sleep disturbances and glycemic control in adults with long-standing type 1 diabetes: the Pittsburgh\u2019s Epidemiology of Diabetes Complications Study","volume":"119","author":"Deni\u0107-Roberts","year":"2016","unstructured":"Deni\u0107-Roberts\n H,\n \n \n Costacou\n T,\n \n \n Orchard\n TJ.\n \n \n Subjective sleep disturbances and glycemic control in adults with long-standing type 1 diabetes: the Pittsburgh\u2019s Epidemiology of Diabetes Complications Study. Diabetes Res Clin Pract. 2016;119:1\u201312. doi:10.1016\/j.diabres.2016.06.013"},{"issue":"1","key":"i1062-6050-59-3-297-b05","series-title":"BMC Med","first-page":"145","article-title":"The comorbidity burden of type 2 diabetes mellitus: patterns, clusters and predictions from a large English primary care cohort","volume":"17","author":"Nowakowska","year":"2019","unstructured":"Nowakowska\n M,\n \n \n Zghebi\n SS,\n \n \n Ashcroft\n DM,\n \n et al.\n \n The comorbidity burden of type 2 diabetes mellitus: patterns, clusters and predictions from a large English primary care cohort. BMC Med. 2019;17(1):145. doi:10.1186\/s12916-019-1373-y"},{"issue":"2","key":"i1062-6050-59-3-297-b06","series-title":"Chest","first-page":"285","article-title":"Coexistent chronic conditions and asthma quality of life: a population-based study","volume":"129","author":"Adams","year":"2006","unstructured":"Adams\n RJ,\n \n \n Wilson\n DH,\n \n \n Taylor\n AW,\n \n et al.\n \n Coexistent chronic conditions and asthma quality of life: a population-based study. Chest. 2006;129(2):285\u2013291. doi:10.1378\/chest.129.2.285"},{"issue":"4","key":"i1062-6050-59-3-297-b07","series-title":"J Athl Train","first-page":"536","article-title":"National Athletic Trainers\u2019 Association position statement: management of the athlete with type 1 diabetes mellitus","volume":"42","author":"Jimenez","year":"2007","unstructured":"Jimenez\n CC,\n \n \n Corcoran\n MH,\n \n \n Crawley\n JT,\n \n et al.\n \n National Athletic Trainers\u2019 Association position statement: management of the athlete with type 1 diabetes mellitus. J Athl Train. 2007;42(4):536\u2013545."},{"issue":"7","key":"i1062-6050-59-3-297-b08","series-title":"JAMA","first-page":"691","article-title":"The mental health comorbidities of diabetes","volume":"312","author":"Ducat","year":"2014","unstructured":"Ducat\n L,\n \n \n Philipson\n LH,\n \n \n Anderson\n BJ.\n \n \n The mental health comorbidities of diabetes. JAMA. 2014;312(7):691\u2013692. doi:10.1001\/jama.2014.8040"},{"issue":"Suppl 1","key":"i1062-6050-59-3-297-b09","series-title":"Can J Diabetes","first-page":"S130","article-title":"Diabetes and mental health","volume":"42","author":"Robinson","year":"2018","unstructured":"Robinson\n DJ,\n \n \n Coons\n M,\n \n \n Haensel\n H,\n \n \n Vallis\n M,\n \n \n Yale\n JF;\n \n Diabetes Canada Clinical Practice Guidelines Expert Committee.\n \n Diabetes and mental health. Can J Diabetes. 2018;42Suppl 1:S130\u2013S141. doi:10.1016\/j.jcjd.2017.10.031"},{"issue":"2","key":"i1062-6050-59-3-297-b10","series-title":"Diabetes Care","first-page":"333","article-title":"A review of the Mental Health Issues of Diabetes Conference","volume":"38","author":"Ducat","year":"2015","unstructured":"Ducat\n L,\n \n \n Rubenstein\n A,\n \n \n Philipson\n LH,\n \n \n Anderson\n BJ.\n \n \n A review of the Mental Health Issues of Diabetes Conference. Diabetes Care. 2015;38(2):333\u2013338. doi:10.2337\/dc14-1383"},{"issue":"8","key":"i1062-6050-59-3-297-b11","series-title":"J Am Coll Health","first-page":"790","article-title":"Unhealthy behavior clustering and mental health status in United States college students","volume":"67","author":"Jao","year":"2019","unstructured":"Jao\n NC,\n \n \n Robinson\n LD,\n \n \n Kelly\n PJ,\n \n \n Ciecierski\n CC,\n \n \n Hitsman\n B.\n \n \n Unhealthy behavior clustering and mental health status in United States college students. J Am Coll Health. 2019;67(8):790\u2013800. doi:10.1080\/07448481.2018.1515744"},{"key":"i1062-6050-59-3-297-b12","series-title":"Handb Clin Neurol","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/B978-0-444-53480-4.00015-1","article-title":"General aspects of diabetes mellitus","volume":"126","author":"Alam","year":"2014","unstructured":"Alam\n U,\n \n \n Asghar\n O,\n \n \n Azmi\n S,\n \n \n Malik\n RA.\n \n \n General aspects of diabetes mellitus. Handb Clin Neurol. 2014;126:211\u2013222. doi:10.1016\/B978-0-444-53480-4.00015-1"},{"key":"i1062-6050-59-3-297-b13","series-title":"Ann N Y Acad Sci","first-page":"60","article-title":"Impact of diabetes on cognitive function and brain structure","volume":"1353","author":"Moheet","year":"2015","unstructured":"Moheet\n A,\n \n \n Mangia\n S,\n \n \n Seaquist\n ER.\n \n \n Impact of diabetes on cognitive function and brain structure. Ann N Y Acad Sci. 2015;1353:60\u201371. doi:10.1111\/nyas.12807"},{"issue":"3","key":"i1062-6050-59-3-297-b14","series-title":"Diabetes Care","first-page":"726","article-title":"The effects of type 1 diabetes on cognitive performance: a meta-analysis","volume":"28","author":"Brands","year":"2005","unstructured":"Brands\n AMA,\n \n \n Biessels\n GJ,\n \n \n de Haan\n EHF,\n \n \n Kappelle\n LJ,\n \n \n Kessels\n RPC.\n \n \n The effects of type 1 diabetes on cognitive performance: a meta-analysis. Diabetes Care. 2005;28(3):726\u2013735. doi:10.2337\/diacare.28.3.726"},{"issue":"5","key":"i1062-6050-59-3-297-b15","series-title":"Clin J Sport Med","first-page":"343","article-title":"The effects of sleep quality and sleep quantity on concussion baseline assessment","volume":"23","author":"Mihalik","year":"2013","unstructured":"Mihalik\n JP,\n \n \n Lengas\n E,\n \n \n Register-Mihalik\n JK,\n \n \n Oyama\n S,\n \n \n Begalle\n RL,\n \n \n Guskiewicz\n KM.\n \n \n The effects of sleep quality and sleep quantity on concussion baseline assessment. Clin J Sport Med. 2013;23(5):343\u2013348. doi:10.1097\/JSM.0b013e318295a834"},{"key":"i1062-6050-59-3-297-b16","series-title":"Gait Posture","first-page":"291","article-title":"Self-reported sleep duration affects tandem gait, but not steady-state gait outcomes among healthy collegiate athletes","volume":"62","author":"Howell","year":"2018","unstructured":"Howell\n DR,\n \n \n Berkstresser\n B,\n \n \n Wang\n F,\n \n et al.\n \n Self-reported sleep duration affects tandem gait, but not steady-state gait outcomes among healthy collegiate athletes. Gait Posture. 2018;62:291\u2013296. doi:10.1016\/j.gaitpost.2018.03.038"},{"issue":"2","key":"i1062-6050-59-3-297-b17","series-title":"Sleep","article-title":"Differences in sleep between concussed and nonconcussed college students: a matched case\u2013control study","volume":"42","author":"Hoffman","year":"2019","unstructured":"Hoffman\n NL,\n \n \n O\u2019Connor\n PJ,\n \n \n Schmidt\n MD,\n \n \n Lynall\n RC,\n \n \n Schmidt\n JD.\n \n \n Differences in sleep between concussed and nonconcussed college students: a matched case\u2013control study. Sleep. 2019;42(2). doi:10.1093\/sleep\/zsy222"},{"issue":"5","key":"i1062-6050-59-3-297-b18","series-title":"Phys Sportsmed","first-page":"427","article-title":"National Collegiate Athletic Association athletic trainers\u2019 response to the Arrington settlement: management, compliance, and practice patterns","volume":"51","author":"Buckley","year":"2023","unstructured":"Buckley\n TA,\n \n \n Bryk\n KN,\n \n \n Hunzinger\n KJ,\n \n \n Costantini\n K.\n \n \n National Collegiate Athletic Association athletic trainers\u2019 response to the Arrington settlement: management, compliance, and practice patterns. 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Br J Sports Med. 2017;51(11):838\u2013847. doi:10.1136\/bjsports-2017-097699"},{"issue":"7","key":"i1062-6050-59-3-297-b20","series-title":"Sports Med","first-page":"1437","article-title":"A national study on the effects of concussion in collegiate athletes and US military service academy members: the NCAA\u2013DoD Concussion Assessment, Research and Education (CARE) Consortium structure and methods","volume":"47","author":"Broglio","year":"2017","unstructured":"Broglio\n SP,\n \n \n McCrea\n M,\n \n \n McAllister\n T,\n \n et al.\n \n A national study on the effects of concussion in collegiate athletes and US military service academy members: the NCAA\u2013DoD Concussion Assessment, Research and Education (CARE) Consortium structure and methods. Sports Med. 2017;47(7):1437\u20131451. doi:10.1007\/s40279-017-0707-1"},{"issue":"9","key":"i1062-6050-59-3-297-b21","series-title":"Med Sci Sports Exerc","first-page":"1621","article-title":"Identifying impairments after concussion: normative data versus individualized baselines","volume":"44","author":"Schmidt","year":"2012","unstructured":"Schmidt\n JD,\n \n \n Register-Mihalik\n JK,\n \n \n Mihalik\n JP,\n \n \n Kerr\n ZY,\n \n \n Guskiewicz\n KM.\n \n \n Identifying impairments after concussion: normative data versus individualized baselines. 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Athl Train Sports Health Care. 2019;12(2):67\u201373. doi:10.3928\/19425864-20190401-02"},{"issue":"2","key":"i1062-6050-59-3-297-b25","series-title":"Clin J Sport Med","first-page":"174","article-title":"Sensitivity and specificity of the Modified Balance Error Scoring System in concussed collegiate student athletes","volume":"28","author":"Buckley","year":"2018","unstructured":"Buckley\n TA,\n \n \n Munkasy\n BA,\n \n \n Clouse\n BP.\n \n \n Sensitivity and specificity of the Modified Balance Error Scoring System in concussed collegiate student athletes. 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Br J Sports Med. 2023;57(11):695\u2013711. doi:10.1136\/bjsports-2023-106898"},{"issue":"1","key":"i1062-6050-59-3-297-b28","series-title":"Sci Rep","first-page":"36996","article-title":"Bacterial meningitis in diabetes patients: a population-based prospective study","volume":"6","author":"van Veen","year":"2016","unstructured":"van Veen\n KEB,\n \n \n Brouwer\n MC,\n \n \n van der Ende\n A,\n \n \n van de Beek\n D.\n \n \n Bacterial meningitis in diabetes patients: a population-based prospective study. Sci Rep. 2016;6(1):36996. doi:10.1038\/srep36996"},{"issue":"4","key":"i1062-6050-59-3-297-b29","series-title":"Curr Diabetes Rev","first-page":"350","article-title":"Association between seizures and diabetes mellitus: a comprehensive review of literature","volume":"9","author":"Yun","year":"2013","unstructured":"Yun\n C,\n \n \n Xuefeng\n W.\n \n \n Association between seizures and diabetes mellitus: a comprehensive review of literature. 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Br J Sports Med. 2016;50(3):167\u2013171. doi:10.1136\/bjsports-2015-095756"},{"issue":"1","key":"i1062-6050-59-3-297-b31","series-title":"Afr J Prim Health Care Fam Med","first-page":"1405","article-title":"Social support and coping in adults with type 2 diabetes","volume":"9","author":"Ramkisson","year":"2017","unstructured":"Ramkisson\n S,\n \n \n Pillay\n BJ,\n \n \n Sibanda\n W.\n \n \n Social support and coping in adults with type 2 diabetes. Afr J Prim Health Care Fam Med. 2017;9(1):1405. doi:10.4102\/phcfm.v9i1.1405"},{"issue":"1","key":"i1062-6050-59-3-297-b32","series-title":"J Diabetes Metab Disord","first-page":"14","article-title":"Role of self-care in management of diabetes mellitus","volume":"12","author":"Shrivastava","year":"2013","unstructured":"Shrivastava\n SR,\n \n \n Shrivastava\n PS,\n \n \n Ramasamy\n J.\n \n \n Role of self-care in management of diabetes mellitus. 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Am J Psychiatry. 2021;178(10):914\u2013920. doi:10.1176\/appi.ajp.2021.20101479"},{"issue":"8","key":"i1062-6050-59-3-297-b35","series-title":"Sports Med","first-page":"1971","article-title":"Baseline performance of NCAA athletes on a concussion assessment battery: a report from the CARE Consortium","volume":"48","author":"Katz","year":"2018","unstructured":"Katz\n BP,\n \n \n Kudela\n M,\n \n \n Harezlak\n J,\n \n \n McCrea\n M,\n \n \n McAllister\n T,\n \n \n Broglio\n SP;\n \n CARE Consortium Investigators\n . Baseline performance of NCAA athletes on a concussion assessment battery: a report from the CARE Consortium. Sports Med. 2018;48(8):1971\u20131985. doi:10.1007\/s40279-018-0875-7"},{"issue":"18","key":"i1062-6050-59-3-297-b36","series-title":"N Engl J Med","first-page":"1842","article-title":"Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications Study Research Group. 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Diabetologia. 2007;50(8):1763\u20131769. doi:10.1007\/s00125-007-0714-0"},{"issue":"4","key":"i1062-6050-59-3-297-b38","series-title":"Diabetologia","first-page":"329","article-title":"Cognitive dysfunction in adults with type 1 (insulin-dependent) diabetes mellitus of long duration: effects of recurrent hypoglycaemia and other chronic complications","volume":"36","author":"Ryan","year":"1993","unstructured":"Ryan\n CM,\n \n \n Williams\n TM,\n \n \n Finegold\n DN,\n \n \n Orchard\n TJ.\n \n \n Cognitive dysfunction in adults with type 1 (insulin-dependent) diabetes mellitus of long duration: effects of recurrent hypoglycaemia and other chronic complications. 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