Before Steelers' training camp began in 2003, Kendall Simmons' weight had plummeted so far his wife suggested he play basketball rather than football.

But even before he learned why he had shed 43 pounds in one month, he found himself almost unconscious on an examination table in a doctor's office.

		Video Kendall Simmons talks about diabetes

The doctor's guess was type 2 diabetes, but the official diagnosis did not come until after Mr. Simmons' blood-sugar level had spiked to almost 1,000 -- 10 times higher than normal -- putting him on the cliff's edge of a diabetes coma.

So Mr. Simmons spent the first two weeks of training camp practicing insulin injections rather than quarterback protection schemes. And before he could even attempt to block linemen, he had to learn to curb the carbs and test his blood sugar.

Mr. Simmons, 24 at the time, got a crash course in diabetes -- a difficult disease for anyone to control, but especially so for those who are insulin-dependent and even more so for someone with such a physically demanding job.

With type 2 diabetes, the body becomes insensitive to its own insulin, the hormone produced in the pancreas that allows glucose to enter cells and be used as energy.

The result is high blood glucose levels that, without treatment, can lead to a diabetic coma. Tight control is necessary to avoid chronic high blood sugar levels that can lead to heart disease, strokes, renal failure, blindness, circulation problems often resulting in lower-limb amputations, and a host of other ailments.

Initially, Mr. Simmons said, he had no clue about what diabetes entailed. His grandmother had had type 2, and it was a factor in her death at 92. But nobody in the family ever discussed it, even though he remembers her giving herself shots of insulin and eating peppermint to prevent low blood sugar.

"I don't have time to be sick right now," he remembers telling his doctor. "I just came off a good year, and I'm trying to avoid the sophomore slump. I need to gain ground."

The previous season he'd won the Joe Greene Great Performance Award, given to the Steelers' top rookie. The career of the first-round draft choice was soaring.

But the disease probably had stalked him for months in the off season, if not longer, given his severe symptoms at time of diagnosis. In June that year, he weighed 330 pounds, prompting him to begin working out and dieting, as he always did, to lose 15 to 20 pounds before camp.

But not 43 pounds.

Dropping to almost linebacker weight, at 282 pounds, proved puzzling. But in retrospect, his symptoms were classic. He was drinking gallons of liquids and urinating often. He felt tired because his body couldn't turn glucose into energy. He was losing weight, despite eating and drinking large volumes. "It came on slowly and continued taking over," he said.

Then, during his 13-hour drive to training camp, he said, he drank more than a case of water, along with Gatorade and Cokes. Upon arriving at St. Vincent College near Latrobe, he was sent to the doctor -- and luckily so.

Mr. Simmons, nearly unconscious, found himself facing something far more threatening than a defensive lineman.

"Why me?" he said he asked himself repeatedly after diagnosis. He said he "questioned the man upstairs" and wrestled with fear that his football career might be over.

After two weeks, Mr. Simmons returned to training camp, this time with his blood sugar under better control and with a management strategy he had to refine so he could play football. The fact he started and played all 16 games that year was a sizable accomplishment.

"It was hard to bounce back. It was hard to control it," he said of his diabetes-induced sophomore slump as a Steeler. "It was one bad year."

But in retrospect, he said, "things happen for a reason." He said it provided him balance necessary to pursue a healthier life for him, his wife, Chelsea, and their two children.

"It made my family life better, and we have grown together as a result," he said.

Awareness that the diabetes gene is present in his family cannot be ignored. He said his family now eats healthier foods.

His daily goal is balancing insulin and sugar levels so he can compete without worrying whether his blood sugar is too high or low.

He accomplishes that with the oral medication, Glucophage, and two types of insulin -- Lantus, which works for 24 hours, and Humalog, a quick-acting insulin of short duration. At his size, he sometimes goes through 70 or more units per day.

Using a blood-glucose monitor to test his blood three to six times a day, he said he got over a general fear of needles quickly. Keeping everything in balance is somewhat like keeping opponents from reaching the quarterback: Most times he's successful, but once in a while a sack occurs.

Mr. Simmons said it took several years "to come to grips with" diabetes.

"It was like playing with one arm tied behind my back," he said of his first year after diagnosis. "I had ups and downs. Even when I would feel good, I really didn't feel good because of the ups and downs."

But four years after diagnosis, Mr. Simmons takes his diabetes in stride, employing the knowledge and discipline he's acquired to keep the disease under control on and off the field. He said he reads food labels, and knows the number of carbs on each item on his favorite restaurants' menus. He counts those carbs and knows how much insulin is needed to counteract them.

His A1C -- an average of his blood sugar over several months -- is 6.3, or just over the normal range of 4.5 to 6 but within the levels of compliance established by the American Diabetes Association.

This year, he said, he's focused on his role as a starting offensive lineman for the Steelers: "Now I'm at the point where I've had it so long I know how to get through it," he said.

But in past seasons, diabetes has had an occasional impact on his game.

He has experienced episodes of low blood sugar, which he describes it as weak feeling, which can get much worse if he isn't careful.

Although it's yet to happen during games, more extreme incidents of low blood sugar make him feel like hyperventilating. "I sweat real bad," he said. "I shake all over."

On the field, Mr. Simmons said he knows his sugar is low when he loses pep in his step, and begins feeling unusually weak and tired.

Good control is a balancing act.

When his sugar runs high, he said, he feels like he's trying to run in quicksand. Thus the goal, especially during games is a safe zone of 100 to 160, which provides just enough excess sugar to power his performance.

Before a game, he tests several times with the target of starting the game at 160. That is an above-normal reading but destined to drop quickly with exercise.

By halftime, his blood sugar drops to 100. Sometimes, he takes glucose tablets to raise it high enough to get him through the second half.

After a game he typically is at 70 or 80 -- a low reading, but not yet dangerously low. At that point he's ready to head straight to a restaurant to eat.

Teammates, including defensive lineman Aaron Smith, who has diabetes in his family, keep an eye on him and react when Mr. Simmons blood-sugar levels dip too low.

"I try not to think about it because then I'll mess up on other things," Mr. Simmons said. "When I get to the sidelines, they do a really good job of looking out for me."

During a game against the Tennessee Titans, he said, his sugar levels dropped too quickly, but he did not have the freedom to come out of the game. When he finally reached the sideline, he took glucose tablets to boost his blood sugar.

But Mr. Simmons' trials and tribulations led to an upbeat ending.

He helped the Steelers win a Super Bowl in 2006, with Steeler rushing yards throughout the years typically leading the league. For now, he is working to maintain his starting position under new head coach Mike Tomlin.

Once he retires, he will need to lose about 50 pounds to maintain his blood-sugar levels and even get off insulin injections, he said. He also knows he must eat a healthy diet and exercise the rest of his life.

"If you get it, it's not the end of the world," he said. "I learned how to deal with the highs and lows, and I learned to prepare."

Mr. Simmons also offered this thought -- one that would have surprised the 24-year-old shortly after that 2003 diagnosis.

"It made me stronger," he said.