Managing Type 1 Diabetes for Football & Futsal in 2020…

The new year is always a chance to take a fresh look at things and alter the path or journey we’re on…. At the start of every year I try to look at the context I’m surrounded by and set myself new goals or challenges which drive my motivation for what’s ahead.

But what I thought I’d do, to help some of you out there who might be thinking about starting a journey with Football/Futsal & Type 1 Diabetes or taking it up a level, is give you some insight around how I manage my condition. 2019 was a pretty good year for me with my sport so it’s probably a good time to share with you some of the ways I go about trying to get the best from my glucose levels to allow me to play to the best of my ability.

So I thought I’d outline some of the ideas, most of which I shared at the #SporT1Day conference, to hopefully provide some insight and support to anyone out there who might need it.

Here’s my general thoughts on what I try to do or think about for my management before any sport or exercise:

  • A plan of how to approach the sport/exercise/game – What type of exercise is it (interval, aerobic, anaerobic etc)? Intensity? Duration? Time of day? Timing of meals? Last Bolus?
  • Consistency of Routine – If it’s working, I keep using it.
  • Good night’s sleep.
  • Plenty of time between pre match meal insulin dose and starting the game (3 hours + ideally)
  • Lots of Testing – As much as you can or utilising a CGM such as the Dexcom G6 which has been the best I’ve used so far. This way you can learn about the effects of types of exercises, intensities, durations etc on your glucose levels.
  • Small adjustments of insulin & carbs to try and find the right glucose level for your best performance or for you to just enjoy it.
  • I aim for 7-8 mmols throughout the duration of any game to try and achieve my best performances.
  • Having my quick acting hypo treatments and insulin available and accessible for any adjustment I might need.
  • Consider the weather… Is it cold or hot? They usually play a part in how our glucose levels respond.
  • Am I in good general health? Have I been ill recently? Can play a part in less predictable glucose levels.
  • Keeping on top of my hydration… I find my levels drop more quickly if I’m dehydrated.
  •  Stress Levels – Do I feel nervous? Am I calm? Sometimes bigger games cause a bigger adrenaline spike in glucose levels. Do I need to account for this?
  • Have I fuelled up well before the exercise? Have I eaten enough calories/carbs in general for the energy I’m going to expend.
  • Always consider how much activity you’ve been doing around the particular sport or exercise you’re about to take part in, because the more active you are, the more sensitive to insulin you are!

Below are some of the generic details about my day to day management…

• My daily carb intake is around 180g. ( + or – depending on activity levels). I’m on MDI and CGM, No pump.
• Carb Ratios are roughly 1:15 g breakfast, 1:10g lunch, 1:7.5 g for dinner.
Much of what I’ve said above is linked to a generic way I tackle my Football or Futsal but there are some subtle differences I employ between the two because the intensity of the two sports is very different. This has a drastic impact on the reaction of my glucose levels and the way I manage them during and afterwards especially. So I’ll show you some of the key differences below:
Football (Example is preparation towards a Saturday 3pm Kick Off)
  • Aiming to be 7-8mmols to start the game and throughout.
  • Ensuring my pre-game meal & bolus is 3 hours before kick off.
  • Reducing pre-game meal bolus by roughly 10%.
  • Half time testing and adjusting based on level. If I’m below 9mmols I’ll take on 10g of carbs to cater for the second half dip and even more if my levels are below 5mmols. These choices very much depend on length of time you’re going to play and how hard the game is. If it’s a tough game with a lot of chasing then I sometimes have an extra 5-10g of carbs. If I’m over 13mmols I’ll take on a unit of insulin.
  • Post game meal I reduce my bolus by 25-50% depending on how much I’ve played and the intensity of the game.
  • I try to make my post-game meal both full of protein and carbohydrate to help with the recovery of glycogen stores and muscle growth/repair.
  • I will have a bed-time snack of 10-15g without a bolus to try and alleviate the nocturnal hypo risk. (If I’ve played a whole 90 minutes, I’ll scale all of this back if I’ve played less than that)
  • I don’t adjust my basal insulin because I use Tresiba, which is an ultra-long acting insulin and this will have no effect on my risk of a nocturnal hypo.

Futsal

  • I like to start the game at 5mmols if I can, because despite being lower,  I’m still likely to need a small bolus before the game or at half time to manage my levels rising as a result of the higher intensity and expected spike.
  • Because of the roll on, roll off substitutions within Futsal, there’s a lot more opportunity for adjustment. So I always come off from the court and immediately check my CGM and look for the trend arrows and glucose level.
  • I always tend to carry a bit of short acting insulin in my system because for me within Futsal, knowing I have frequent breaks and the likely impact of the intensity (levels rising), I’d rather be lower and taking on some glucose, as it reacts quicker than my insulin, than being too high and waiting for my insulin to kick in. The important factor for me is having a glucose level which allows for performance, not the number of adjustments I have to make.
  • I will always have a protein bar/snack post game of around 20g of carbs because I tend to have a sharp drop in my levels post game. Probably as a result of carrying short – acting insulin during my sport and the intensity.
  • I don’t make any bolus adjustments post – game to my meals. Again I’ll eat a meal heavy in protein and carbohydrate.
  • No basal adjustments as a result of using tresiba.
  • If I want a bed-time snack I’ll bolus for it with a small reduction of 25%.
Wales vs Northern Ireland - 2019 Home Nations Match 1 -62
I really hope that this is a useful post for people out there trying to tackle football or futsal for the first time, or who might be finding it challenging currently. If something from this article helps someone out there get more from their performance or just allows them to enjoy it more I’ll be happy!! Please give it a share if you can because I’m sure you’ll know someone who may also find this useful.
I’ve also added my slides from the #SporT1Day Conference to the bottom of this post if you wanted to see what I shared on the day, which also has much of this detail in.
Thanks for reading and I wish you all a happy and healthy new year! Please also be aware of the below disclaimer.
Chris
Disclaimer – Always remember that this a personal perspective and is not endorsed by a medical professional. So any advice or ideas you take from this post is at your own risk and should always be cleared by your diabetes team. 

Chris Bright Presentation 2019 ( #SporT1Day Conference )

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DiaEuro 2019: UK Player Perspective (Jon Peach)

I have just fulfilled the dream of every schoolboy and girl who loves sport. I have represented my country at an international tournament. Belting out the national anthem before each game as loud and proud as I could, wearing the union Jack on my kit – this is something I have always dreamed of, but never really thought could happen. But it has. And it has happened with an amazing bunch of team mates, all with the same thing in common. Diabetes.

Since I was diagnosed with diabetes age 5, I have had a love hate relationship with it. When I’m on top of it, and I’m winning, I love it. However, far too often it gets the better of me and I hate it. However, if it wasn’t for diabetes, I wouldn’t have met such an amazing community of people.

A year aģo, I watched on as Chris took the first ever UK team to the 2018 DiaEuros. I hadn’t kicked a ball in 3 years and had retired due to persistent injuries. 10 operations had taken their toll on my body and I’d had enough. However, this was an amazing project that he had set up, and one I wanted to be involved in. But my knowledge of futsal was incredibly limited. However, I didn’t want to be going along all the time if I wasn’t playing. So I decided to rejoin my old 11 a side team in Bristol as well as coming along to all the training sessions with TDFC. I had no intention of putting myself forward for the DiaEuro squad, but wanted to be part of the project. I was enjoying going along to the sessions, and when Chris asked for the final time who wanted to be part of the squad, I had a decision to make; did I want to put myself forward?!  I’d heard so many positive things from the previous year that I thought I would. I had no expectation that I’d come close to going, but the thought of it was too good to not try out for. Fast forward a few months and I had been chosen to go to the Ukraine!

My only experience of going away with other diabetics was a kids camp I went on with my family when I was young. While I don’t remember much about it, I didn’t really enjoy it!! This was different though. Every one of us was type 1 diabetic, but we also loved sport, especially football, and in this case futsal. We were able to share stories and help each other out where necessary. Advice was always there if needed, and there was such a range in terms of years of having diabetes. We talked about levels before sporting performance, treatments, different types of insulin….In fact diabetes was quite often one of the main  subjects we talked about (as well as football!)

Meals were a challenge, as it was a buffet every meal, we weren’t entirely sure of the carbohydrate content. Some managed it better than others, which was great to see. There was often talk of how much insulin people had given themselves, as well as at what point people gave their insulin.

Going in to the tournament, I thought my bloodsugar control was fairly good. However, being around other diabetics 24-7, I learnt that there is always room for improvement. People who felt 9 was too high to have our blood glucose for a game inspired me to think differently. Whereas before, I might have ignored that, I soon realised that this wasn’t okay, and starting a game with a blood glucose level of 10 might impact upon  my performance. I also learnt better treatment of hypos. Too often I over eat and then end up shooting sky high. However, watching other diabetics being patient having had a couple of tablets or some of the amazing lift liquid products we’d been given helped me massively.

We were also incredibly fortunate to have the use of the dexcom G6 for the tournament, which helped my blood glucose levels no end. I started off setting the high alarm at 16, but by the end of the tournament, I had moved it to 10.5. This wasn’t necessarily to treat, but to be aware. It also helped by having arrows, single and double, showing which way my levels were going and at what rate. We have been able to keep this going since returning from Ukraine, and I’m now aware via an alarm when my levels are getting to 4.2, meaning I can treat it before I actually go low.

So after a week where I’ve been so proud to represent my country at futsal, I have also got tips and seen first hand how others also manage their diabetes. Inspired by others, not just from our team and country.

On the playing side of the tournament, sadly the results didn’t reflect the performances we put in. We were well beaten 5-1 by a very good Portugal team in our first game, but the second day was a tough one to take. We outplayed Slovakia but went down 1-0, then again outplayed Ireland, but only managed a 1-1 draw. We had chances, but just couldn’t seem to score the goals. We moved the ball around and the rotations that we’d worked on were going well, but not the results. The next day we were soundly beaten 11-3 by eventual champions Bosnia. By this point we were struggling physically having played the last game on day 2 (our 2nd game that day) and then the first game on day 3. But that’s sport, and we all love it!

The organisation and management was great. We’d get a text the night before telling us our plans, meeting times and what we had to wear or have with us the next day. We then also got one from the amazing physio, Milly, asking if anyone needed treatments, fixing or taping up the next day. As I was sharing a room with fellow old man and captain Tim, Milly spent her fair share of time in our room sorting us out so we could even get out of bed, let alone play!! We had enough kit to be able to have some taken to the laundrette whilst still having enough to wear around and about, train in and travel to and from matches.

There was also a bit of time for sightseeing. We looked around Kiev, and some of the squad were lucky enough to visit Chernobyl on the last day, which was an amazing cultural experience. Without doubt, this is my sporting highlight of my career. Representing my country at a major tournament. But with an amazing group of people who just seem to bond so well. And we all happen to have shown that diabetes can’t hold you back!

My Story: Kendall Higgs

At The Diabetes Football Community we love to share the stories of those of you who follow us. With the diverse nature of the community we support it’s always amazing to share stories from all over the world. So here we are bringing you a story from Kendall who’s based in the USA. No more words from us other than to say if you enjoyed reading Kendall’s blog please give it a share. Over to you Kendall…..

“My name is Kendall Higgs, I’m from Loxahatchee, Florida , and I’m 20 years old. I fell in love with the game of soccer at four years old. I remember feeling unstoppable with the ball at my feet. On August 3rd, 2009 my world changed. I got diagnosed with Type 1 Diabetes at 10 years old. The first three questions I would ask anyone who came into my hospital room was 1. Can I still play soccer 2. Can I still drink milk 3. Am I going to die.. in that order 😂 to some people, my priorities may have been a little off.. but for me, if I couldn’t play soccer anymore, I might as well be dead. Even though most doctors told me I most likely couldn’t continue to play, I did it anyways. I refused to allow something to take over my life. I traveled to Costa Rica at 14 and Brazil at 16 to play soccer with region 3 ODP (Olympic Development Program)

I graduated early from high school and went to University of Pittsburgh in 2017. After 3 semesters there I transferred and now play at Kennesaw State University in Kennesaw, Georgia. Soccer has been my way to connect to people, to new places, and to different cultures. When I’m not playing soccer, I feel out of place.. and at first my T1D contributed to that “out of place” feeling. I didn’t want to embrace my Diabetes..I wanted to pretend I didn’t have it. It wasn’t until this past year that I really started to take care of myself and to fully embrace my disease. I recently started T1D1 Diabetic Athletes as a way to spread awareness, give a platform to other diabetic athletes, and to show young, aspiring T1D athletes that it does not limit, control, or lessen their ability to be successful.

Within this journey I have realized that soccer isn’t my only way to connect to people.. T1D has allowed me to connect to others battling the same illness, to learn, to empower, and so much more. I am so grateful to be apart of the T1D community.”

A big thank you from all of us at TDFC for sharing your story Kendall and if anyone else would like to share theirs please get in touch !

#DiabetesWeek 2019… See Diabetes Differently

As the motto for Diabetes Week 2019 is “See Diabetes Differently” it’s great to be able to share an interview that Chris conducted with DigiBete (www.digibete.org) which focusses upon mindset and the approach to sport/exercise that he takes in the hope it may help others living with Diabetes. It’s different to the usual articles/content on the physical management of the condition for sport but we hope it proves to be useful!

A huge thank you to DigiBete for asking Chris and putting the time into creating this amazing video. If you want to check out their resources for people with type 1 diabetes surrounding sport & exercise head to the below link:

https://www.digibete.org/resources/sportsandexercise/

We must also thank the University of Worcester who gave Chris & DigiBete permission to shoot on their campus. Thank you!

We hope you enjoy the video and we’d love to hear your feedback on it! Please share far and wide if you enjoyed it as you never know who it may reach!

Thanks,

TDFC Team

Mo’s Story with TDFC so far…

Mo, is one of the newest members of the Diabetes Football community family having recently finding us! We wanted to get his initial thoughts on what it’s been like since he joined in with our Adult diabetes Futsal teams in Worcester and London. No more words from us over to Mo to tell us about the experience so far.

“I came across the diabetes football community by chance; having attended a type 1 diabetes technology event where Chris Bright presented.

Since that point in time it’s been brilliant, as you’ll see from reading on.

I was diagnosed age 2.5, some 27 years back. Throughout my school life I was always held back from sport as teachers wouldn’t risk me having a hypo. I felt left out many times, but it did spur on a desire to ask “why not?”. I always used to challenge restrictions brought on by society and more often than not was able to prove people wrong.

Through this, I played a lot of sport and it helped me during those early years keep good control of my diabetes and pick up a few hobbies. I also had an amazing paediatric team which inspired me to pursue a career in healthcare (hospital pharmacy).

However, back then diabetes communities were relatively scattered and so I did not know many other type 1’s. I managed the condition entirely on my own, taking on the burdens of life without having a community to share it with.

The diabetes football community totally changed this. The very first training session was brilliant! It was professionally organised, I met fellow type 1’s with respectfully unique stories and had tonnes of fun in a competitive environment. The best bit was having the knowledge that you had each other’s backs if anyone had a hypo (something I had never experienced before in my life).

The toughest thing for me to process as part of my diabetes is my job. I feel heartbroken on many days when I treat people with diabetes who have not been fortunate with their health outcomes. Many are in situations that cannot be reversed and a huge number suffer from mental health problems directly relating to the burden of managing diabetes. I often feel that many of these issues could have been prevented if people were in the right environment and had a drive to manage their condition well.

This is probably what I value most about this community. I feel that it provides an environment for people to enjoy sport, push themselves, feel supported and ultimately get better. It’s unique in this regard. I’m glad I’m part of this project as I feel it’s got a long way to go yet!

Furthermore, throughout my life I’ve always been the sportiest person with Diabetes I knew of. On the first training session, I was surrounded by stronger, faster, more skilful and fitter individuals. This has motivated me to up my game, and also to work hard to try out for the national team next year.

I’ve had the privilege to be part of the London Futsal team that started this year and have already learnt so much from the invaluable experience of other members. We’ve already made history by taking part in a league game against an all deaf team.

Can’t wait to see what the future brings!”

A great account from Muhammad on his initial thoughts on the magic of TDFC and the way we encourage, inspire and support our players with Diabetes to keep going no matter the challenges the condition puts in front of us!

Thanks Mo. 🙂