The laws still have no good answer for a diabetic athlete

Rules about leaving the field, permitted equipment and treatment during play were written as though every body regulates itself the same way.

A player needs to check a blood glucose reading and possibly take carbohydrate, now, in the twenty-eighth minute. What does the rulebook say? In most codes, nothing directly, which means the decision falls to a referee improvising from general provisions about injury and equipment.

That improvisation usually ends well. Officials are not monsters and a competent one will find a way. But relying on goodwill is a poor design, and it produces exactly the inconsistency you would predict: one referee stops play and permits treatment on the field, another requires the player to leave, which for a type one athlete can mean being off for two minutes at the precise moment they need to be managing a low rather than sprinting to the touchline and back.

The equipment side is worse. Pumps and sensors are worn devices, and worn devices fall under the same permissive-but-vague clause that governs braces and jewellery, so the legality of an insulin pump on a player's abdomen is, formally, a matter for the match official's assessment of danger. I have heard of players taping over a sensor so it reads as strapping rather than as equipment, which is a quiet indictment of a rule that makes disclosure risky.

Some governing bodies have written specific guidance and it works. A named permission for wearable medical devices, a defined right to a brief stoppage for glucose management that does not count as an injury break, and a requirement that the fourth official be told before kick-off. None of it is complicated. Most of it is unwritten in most competitions, and the gap between codes is large enough that an athlete can be fully accommodated in one sport and quietly discouraged in another.

There is also a doping dimension people forget. Insulin is a prohibited substance, so a diabetic athlete needs an exemption to use the drug that keeps them alive, and the administrative burden of that sits on top of everything else.

Write the rule. Name the condition, name the device, name the stoppage. Discretion is a kindness when it goes your way and a barrier when it does not, and nobody should need a sympathetic referee to manage their own pancreas.