Diabetic Collegiate Athletes: Do their Baseline Medical Comorbidities and Preseason Concussion Testing Performance Differ from Non-Diabetics?

Abstract

Context: People with diabetes mellitus (DM) are at increased risk for adverse health events and complications throughout their lifetime. It remains unclear if DM significantly impacts collegiate athletes' concussion baseline testing performance. Objective: We sought to 1) describe the prevalence of DM and associated comorbidities and 2) compare concussion baseline testing performance between DM and non-diabetic (ND) student-athletes. Design: Retrospective, cross-sectional. Setting: College athletes using the Concussion, Assessment, Research, and Education (CARE) Consortium research database. Participants: Athletes with self-reported DM (N=229) were matched by institution, sex, age, sport, position, testing year, and concussion history to ND athletes (N=229) (total sample mean age=19.6±1.4, female=42%). Main Outcome Measures: Descriptive statistics and chi-square tests of independence with subsequent odds ratios were performed. Independent samples t-tests compared baseline symptoms, neurocognitive testing, and balance performance between DM and ND athletes. Effect sizes were calculated for significant group differences. Results: At baseline, athletes with DM had significantly higher rates of self-reported pre-existing balance disorders, sleep disorders, seizure disorders, psychiatric disorders, depression, bipolar disorder, non-migraine headaches, and meningitis than ND (p<0.05) We found significant balance differences between groups (p=0.032, Cohens d=0.17) such that, on average, DM had one additional error on the Balance Error Scoring System (DA=13.4±6.5; ND=12.1±5.9). No other comparisons yielded significant results. Conclusions: Though diabetic athletes had high rates of self-reported balance disorders, sleep disorders, meningitis, and seizures, baseline neurocognitive testing was largely identical to ND athletes. Our findings suggest there are non-clinically meaningful differences in concussion baseline balance testing but no significant differences in cognitive testing; however, the effect of DM on concussion recovery remains unknown.