Mid-Day Opinion: Zverev’s battle beyond the baseline

Alexander Zverev during his US Open-winning campaign in New York recently. Pic/AFP

Whenever Alexander Zverev, 29, plays competitive tennis, he has two opponents to tackle. The first, obviously, is the man on the other side of the net. The second is the medical condition he was diagnosed with at the age of four - Type 1 diabetes.

Type 1 diabetes is a condition in which the pancreas produces little or no insulin, the hormone required to regulate blood sugar levels. Unlike Type 2 diabetes, it is not caused by lifestyle and currently has no cure. Patients have to rely on externally administered insulin, constantly monitor their glucose levels and carefully manage their diet and physical activity throughout their lives. Now imagine having to serve, volley and sprint across a tennis court for several hours while managing all of that in an intensely competitive environment.

Zverev does it for a living - and is pretty good at it too. He won his second Grand Slam title at the US Open a few days ago, beating Ben Shelton 6-3, 7-6, 5-7, 6-2 last Sunday. Moments after the victory, Zverev had a few teary-eyes in the audience at the jam-packed Arthur Ashe Stadium as he spoke: "When your four-year-old son is diagnosed with diabetes and doctors in the office tell you that life and sports will be very limited for that child, it takes a very strong mother to say ‘my son will be whatever he wants to be. If he wants to be a tennis player, he'll be a tennis player. If he wants to do something else, he'll do something else, but this illness will not define us'. I'm happy that we worked through it and we're doing the things that we're doing now. My mother is the most important and strongest person I know because it takes an unbelievably strong woman to do what she did."

Besides the US Open, Zverev also won the French Open this year and finished runner-up at Wimbledon. Add his Olympic gold medal from Tokyo 2020 to that haul and his stature in the sport is evident. Competitive tennis is physically tough any way, but for a player with Type 1 diabetes, managing the additional demands can make the challenge even more complex.

Malad-based Alisdair Sequeira, 43, a fitness entrepreneur, who trains a few clients dealing with Type 1 diabetes, puts Zverev's situation in perspective. "I ensure utmost care while training clients who are Type 1 diabetic. Since their glucose needs to be constantly monitored, I ensure they get enough breaks. However, for a professional sportsman like Zverev, the challenges are manifold. For starters, we must understand that tennis is a continuous, physical activity, where muscles burn glucose quickly, which could cause hypoglycemia [low blood glucose]. Tennis also demands aggressive work in short, sharp bursts, and this could push your adrenaline, which can raise glucose levels [hyperglycemia]. Both are dangerous medical conditions. Not maintaining blood glucose levels continuously could lead to serious consequences like severe dizziness or disorientation and/or collapsing into unconsciousness," explains Sequeira.

To avoid such emergencies, Zverev monitors his glucose levels while on court using a sensor and has a limited window - during changeovers - to respond to fluctuations. "So, if Zverev's glucose levels drop while playing, he will have to quickly consume some glucose, most probably a fast-acting gel. Conversely, if his glucose levels rise, he has to self-administer an insulin shot," says Sequeira.

There is also the risk of a sensor malfunction, something Zverev experienced during his match against Taylor Fritz at the Halle Open earlier this year. Just before the match, a faulty glucose meter showed elevated levels, prompting Zverev to inject himself with a high dose of insulin. After realising the error, he had to consume around 350 grams of sugar in gel form during the first 45 minutes of the match to bring his glucose levels back to normal. The episode took a physical toll, and Zverev eventually lost 7-6, 4-6, 5-7.

The physical challenges of the condition apart, Zverev has also had to deal with its mental burden. For years, he concealed his diabetes from opponents because he feared revealing it could give them a psychological edge. He went public with his condition in August 2022, when he launched the Alexander Zverev Foundation in Hamburg, Germany, to provide insulin and essential medical equipment to children in underprivileged countries.

For a glimpse of the impact of his foundation's work, browse through the comments section of the Instagram handle, alexanderzverevfoundation. It is flooded with messages from children (patients) and their parents worldover, expressing their heartfelt gratitude to the tennis champ for his not-for-profit initiative.

For them, Zverev truly is Alexander, the great!

mid-day's Sports Editor Ashwin Ferro loves to play ball, fair and square, and everywhere.

He tweets @ashwinferro

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