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.
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%.
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.
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.
A day that I remind myself to thank the great Sir Frederick Banting for the gift he gave me, a chance to continue living my life despite being diagnosed with Type 1 Diabetes. His co-creation of Insulin in the 1920’s has saved millions of lives, including my own, from a life cut short by this condition. This day is about you my friend, as we celebrate your birthday and the gift you gave us.
With that extra time you’ve given me, I hope I’ve done you proud. I’ve done my best to defy the pitfalls of Diabetes and use the experiences I’ve worked hard for and been fortunate enough to have, to help others that share this condition with me. I feel that your gift to us all is one I won’t overlook or take lightly, and if I can gift anything back to others like me, then I will at least be living in a way which befits your legacy. I know I’m lucky I’m still here, with the developments of science, and in particular the incredible NHS, to thank for the life I’m able to live in 2019. Others round the world still aren’t as lucky as we are here in the UK and I’ll always be grateful for what we have.
Through the work of TDFC, the honour of representing my country within Futsal and my advocacy work for the condition, I hope I do what I can to ensure the time I’ve been given back is not wasted. I’m able to live a life which I decide upon, not my condition, which is all thanks to you, Sir Frederick Banting. There is another person I want to talk about though today…
A man whom I’ve rarely mentioned publicly when talking about Diabetes is my grandfather who also lived with Type 1 Diabetes. He was diagnosed at the age of 21 in 1956 and lived 40 years with type 1 before he died in 1997. 40 years of living with the condition whilst having only the use of animal insulin and without the medical support/devices we have nowadays to help us control it. I think to do that was pretty amazing and even though we met for just a short period in my life, I’m just glad I got the chance. A man with an incredible story, who defied the odds more so than I have in my opinion, that I wish I’d have had the chance to get to know more. I was very young at the time of his passing and at this point I hadn’t been diagnosed with Type 1. I’m grateful he never saw a day where I was diagnosed with the condition (My Mum is too!) , which had potentially passed on a generation to me, because I know he’d have been devastated. But more than ever I wish he’d have seen the work that has been done through The Diabetes Football Community. In the face of what we both lived with, I’ve tried to tread a positive path, which I’m hoping many others can follow. I know he will have been extremely proud of this project and I’m sure he’s looking down smiling upon it all from wherever he is.
I wanted to talk about both of these men, whom never knew I lived with Type 1 Diabetes, because of the lasting impact that they have had on my life. A day of remembering Sir Frederick Banting felt like the right time to remember my Grandad too. A day full of positivity surrounding Diabetes that I want to dedicate to them both.
My life now consists of ensuring I do them both proud by ensuring I live a life full of positive experiences, whilst sharing the journey and helping others with the condition fulfil their potential in sport. If I can do that I’ll be a happy guy and I think they would be too. I’ve now lived with the condition half as long as my Grandad did, with this year marking 20 years. I hope by the time I hit 40 years since my diagnosis, diabetes will be something we remembered we lived with not something we continue to.
So what’s my lasting message for World Diabetes Day?
Be grateful for what we have, treat the time we have as a gift and don’t let Diabetes define the way you live your life. See it as an extra hurdle to jump not a mountain to climb.
This one is for you Grandad & Sir Frederick Banting…. I hope I’ve done your legacies proud.
If you want to see an incredibly inspiring story from Katie McLean who’s sharing her story publicly with us for the first-time head to the below link:
And make sure you don’t forget to pick up your tickets to #SporT1Day this Sunday at the University of Worcester (17th November 2019)… We still have a few left and you can get your hands on them on the below link:
It’s something pretty special…. The opportunity to represent your country and your condition. DiaEuro or the European Futsal Championships for people with Diabetes is into its 7thconsecutive year of competition and through this wonderful tournament we are given a unique chance to live out every kid’s dream, to play for your country.
But this tournament isn’t just about winning every game (yes it’s important to us all!) as there’s more than that at stake. Each team uses the tournament as a chance to make as much noise and raise as much awareness as they can, to really showcase what people with this condition can do. When you often see misconceptions and irregularities in the way people talk about Diabetes in the media and society it’s so nice to see us all come together to talk about a European event which brings positivity and enthusiasm to the word Diabetes.
As you can see from the titles I have for our team, I’m doing a bit of everything to make the UK team happen but I wouldn’t change it. I’ve enjoyed each one of those roles but it does make it very challenging to do them all very well! Each one brings their own pressures but for the most part I try to take it all in my own stride and ensure the project runs as smoothly as possible. I would hope the team would say that we do a good job with it but you’d have to ask them haha.
I’m still coming to terms with the fact that 18 months ago this was all a dream and here we are talking about participating in our second tournament. This project and community has changed my life and the lives of many people whom are participating every day in our activities on social media or the projects we run physically. This team has been a huge source of inspiration for our community and a place to turn for information & support for the lads living with type 1 diabetes lucky enough to be involved. This was demonstrated by the amazing local TV coverage we received regarding our participation at the tournament. Seeing our project receive this media attention is great for its continuation but most importantly for reaching others who may not have heard of the work we do and who could really benefit from it… The reason we’re here is to support others with our condition and raise greater awareness of Diabetes in a positive light. To be featured in this way is not the goal we set out for but a bi-product of the hard work we put in to help the diabetes community out there. (TV feature below)
Back to the tournament itself though… To be completely honest after the months of work building up to it, I was just so happy when we got to the accommodation in Ukraine and the rooms were all sorted out! As the man responsible for getting the squad & staff there that was the biggest relief. The stress of booking flights, speaking with the organisers, sorting out the transport & the tournament schedule, organising our players & itinerary to get there as well as all of the finances is a huge strain. I think next year I’d like to find some more help for this because it consumed my life for weeks beforehand. But crucially we got there without much of a hitch or issue!
For much of our preparation for the tournament I’d played more of a coaching/managerial role alongside Harley to help us tactically & technically prepare. It was myself and Harley who picked the final squad, worked through the playing style & finalised our matchday approaches. However, we felt that in spite of this I’d need to contribute on the court again this year rather than from the sidelines. So with that being said and a last minute continuation of an injury to our main pivot JT, I handed over my coaching hat to Harley & JT for DiaEuro 2019. Concentrating on just playing wasn’t without it’s drama though…. I actually pulled up in a training session for my football club 10 days out from the tournament, which actually meant I had to sit out of our final training session before heading to the Ukraine….. Not ideal at all. I spent the whole week leading up to the tournament unable to train and unable to even run. I actually ran properly for the first time after pulling up, just 2 days before the tournament and it felt just about ok… I had my fingers crossed I’d be alright for the first game on the Monday. Whatever happened with my injury though, I was determined to ensure that from an overall perspective the tournament was going to be a positive experience.
Once the games arrived on Monday, after a day of settling in and reviewing our tactics, we went into them optimistic we could really give a good account of ourselves. I felt for the most part we did just that! Our group draw was really tough, we faced last year’s champions Bosnia, Portugal (tipped to do well!), Slovakia (Finished 4ththe previous year) and Ireland who came into their first tournament. WHAT A GROUP. We were all so excited about the prospect of pitting our wits against the very best and having the chance to play a local derby with our friends in Ireland (which I think could be a more regular thing too 😉 )!
Our first fixture was against my very good friends from the Portuguese team. I can’t say enough positive things about these guys. They helped me shape the project we now have for our UK team and I’ll forever remember that. In 2017 I flew over to Portugal with Karl & Noel, to further the TDFC cause and they let us in to train and see their development. It was a special trip and Bruno, Joao and all of the boys have become great friends of ours and in both DiaEuro tournaments we’ve been involved in we’ve been drawn against them. I think it’s fitting with our connection. Unfortunately, they beat us 6-1 last year and in this year’s game it was 5-1 but as the scoreline suggests we made a better game of it and if anything it was a little harsh the margin. They have some very talented players and their technical & tactical knowledge supersedes ours by a distance but we’re catching up. We have a talented group who demonstrated throughout this year’s tournament, despite the results, that we’ve made strides forward on the court. Nevertheless, it was a tough opening defeat but we knew we had to pick ourselves up from it quickly because the day after we had 2 games. From a personal playing perspective, I had my injury playing on my mind which meant I didn’t perform at my usual level, but I knew that and just needed to build my confidence up in it to push myself the following day. It was great to see from a coach’s perspective the lads employing tactics and techniques we’d worked on all year and something we certainly continued to show throughout.
As Day 2 arrived, I’d had an awful night’s sleep ( 3 hours roughly!) tossing and turning thinking about the day before and the day to come. But we had two games to play and I needed to get over it….. I picked myself up and went all out with the positive mindset. I was up and focussed from the off to get my mindset right to tackle those games. With the organiser’s and coaching cap taken off me by Rosie, Harley & JT I certainly felt a bit of a weight off my shoulders following a staff discussion the night before. I think it showed as we played our first fixture of the day vs Slovakia. I went into it with more confidence, having tested the injury out and having had Milly put me through some rehab/stretching too. We knew that today was the important one for performances and results as on the final day of group fixtures we’d be facing the reigning champions with a really tough task to get any kind of result. We knew it and in that first game we played like it…. We came out of the blocks firing. We threw the kitchen sink and more at Slovakia and somehow they stood firm. To this day, I still can’t quite believe that we didn’t get a result from this game (watch the highlights and you’ll also see why!). The lads were fantastic… The whole squad played to the levels we needed and the ball just didn’t quite go in the goal for us. There’s an argument we could have been more clinical but the luck just wasn’t with us and we lost 1-0. We were gutted but encouraged all at the same time. We’d just completely outplayed a team that had finished 4that DiaEuro 2018. So as much as we were disappointed with the result we’d shown to everyone what a thoroughly decent side we were.
But after 2 games we still hadn’t got any points on the board so as much as we were satisfied with our performances, we were desperate to get off the mark. No easy task though as up next was the local derby with our friends in Ireland. For me the Irish and Portuguese teams will always have a special connection with me. Portugal inspired us into the DiaEuro family and I like to think a trip that myself and Zak Brown went on to the Diabetes Ireland Junior Cup in August 2018, where we met Cathal (Ireland Team Manager), inspired their creation & participation at DiaEuro 2019. So for me it was a special moment for our teams to face each other.
I knew they’d recruited well with several players who’d played at a good level of Football in Ireland so we knew it was going to be a tough game. It turned out to be exactly as I’d imagined. They sat in and frustrated us as we dominated the ball. However, they looked dangerous on the counter attack. It made for quite an exciting game for the neutral but my overall feeling was that just like the Slovakia game the ball didn’t want to go in the net for us. A game full of commitment and passion ended in a 1-1 draw. We just couldn’t convert our dominance of the ball into goals and it’s where we struggled against Slovakia as well. We missed one of our star men from DiaEuro 2018 JT, who’s goals we could’ve really used this year. He’s a natural finisher in front of goal, it’s a simple as that. But, that being said I felt that we showed to everyone the strides forward we’d made as individuals and collectively. I was proud of how we’d conducted ourselves in game 2 and 3 and had it been another day we’d have won both games, but it wasn’t to be.
This left us with a mammoth task of needing a result against the reigning champions Bosnia to have a chance of staying in the competition. With our legs in absolute pieces from 3 games in 2 days we knew it was going to be a tough task. Within 5 minutes we were 3-0 down and it was every bit of the challenge we thought it would be! We gave it all we had but came up short losing the game 11-3. As we all predicted Bosnia then went onto win the tournament. The ability they have throughout the squad is frightening for an all type 1 team. One of the best teams I’ve faced collectively and individually and a huge congratulations to them for defending the title and really showcasing the levels you can achieve despite living with type 1 diabetes.
From our perspective going out of the tournament on goal difference at the first stage was frustrating and disappointing especially with the distance we travelled and money we’d spent to get there. We’d given it our best shot and at another tournament the ball would’ve gone in and we could’ve finished 5th/6th/7thbut it wasn’t to be. However, the strides forward off the court, within our coaching team, our tactical knowledge and overall approach was really pleasing. I couldn’t be prouder of everyone involved. I’m honoured to know each and every single one of the players and staff. Their commitment to TDFC and our vision is impeccable, and I’ll never be able to thank them enough for all that they’re doing to help push this cause to the next level.
But what can you say about trying to manage your glucose levels with 4 futsal games in 48 hours….. Reactive, guesswork and without a CGM like the Dexcom G6 I think it would be an extremely difficult challenge. I felt as though I prepared as best as I could but for me the key was always have the ability to adjust. I was always carrying Lift Glucose tabs around with me as well as my insulin pen to ensure I was able to react to any levels which were falling out of range. I mean how do you prepare for something you’ve never done before? 4 games in 48 hours is not something you’re likely to experience so I just focussed on eating well, consuming lots of carbs & protein for recovery and trying to minimise the amount of short acting insulin there was in my system for games (unless I required an adjustment!). We all did it and for the most part managed it quite well. It was quite a testing environment to have type 1 but the understanding amongst our squad and management is there to ensure we’re all comfortable in shouting up if we don’t feel right. It was a challenge that we all adapted to but one that was made easier than it could’ve been by the use of a continuous glucose monitor.
As anyone who knows me or has heard me talk about DiaEuro before, I will always say that it is much much more than just a Futsal tournament for people with Diabetes. It forges bonds and friendships with people across Europe who share the same challenge. We come together to demonstrate what people with the condition can do through the medium of Futsal. It’s a unique experience which has us travelling to destinations all over Europe to experience different cultures and ways of managing the condition as well as playing the sport. It’s a tournament and message I believe strongly in…. I hope that in the future we can continue to develop it as a product and receive greater recognition & awareness of it. It was fitting that the final ceremony was conducted at the Olympic stadium and Ukrainian TV were there to film it. For me this tournament deserves that, the talent, commitment and statement that this tournament makes is epic… I just wish we could see our condition represented like this more regularly and through other sports too!
For me, another tournament and another step forward. Results may not have shown that but with the project, coaching and players there was every reason to come away from Ukraine full of optimism. I take great pride in representing my country and condition. For me it’s a special feeling which is hard to explain but one I hope I can continue to do on and off the court for many years to come.
Finally, I want to say a huge thank you to the players, Harley, JT, Milly and Rosie for all of their hard work and commitment in Ukraine. Without your efforts the experience wouldn’t have been what it was so thank you again for all that you do…. Whilst we must also say a big thank you to our sponsors Dexcom, Lift & JL Property Solutions who’s support we couldn’t have done without. Thank you so much for everything you did to help us get there!
And with my final words of this post I just want to look ahead to the 2 exciting projects still to come in 2019….
We have our children’s participation event and sessions based from the new Worcestershire FA HQ launching in autumn/ winter 2019, where we will for the first time encourage active participation in Football for children with type 1 diabetes, with support from adults and coaches fully aware of how to manage the condition. Hopefully an exciting step change for our community and if you want to register your interest in what’s ahead head to the below survey monkey:
Whilst we also have the #SporT1Day conference on the 17thof November at the University of Worcester to come. A number of talented and inspiring individuals living with type 1 diabetes sharing their experiences and management techniques for their sports whilst managing the condition they live with. A fascinating insight and learning environment for anyone looking to expand their knowledge, further their exercise and sporting goals or even just get started. A wonderful day and you can find more info on the below link:
On the most important day in the Diabetes Calendar we wanted to reach out to the community and ask them to share their messages for World Diabetes Day 2018.
Much of our work is about inspiring our community into believing that this chronic medical condition won’t hold you back in your football, and in your life more generally, so this video is all of those things rolled into 5 minutes!
No matter the age, the gender, the ethnicity, your fitness or your wealth, Diabetes doesn’t discriminate against who it affects but its important we stand together and show this condition it won’t stand in our way.
Please help us share our video and message to help others who may be finding Diabetes tough this World Diabetes Day!
On one of the most important days in the calendar for people with Diabetes, I wanted to share a small snippet of my story represented by these 2 photos. I was at very different stages of my life with Type 1 Diabetes in both images and they both really help me reflect on what it’s been like to live with a chronic medical condition.
The photo on the left: A scared kid (10 years old) one year after diagnosis still struggling to find his feet with it all, who was battling away to play football and compete with the other kids. Still doing well and holding trophies aloft but the management, the hypos and the worries of adjusting to this new way of life were dreadful…. My potential in what I could do in school and with my football was hindered and I remember being upset numerous times asking “Why me? Why has this happened to me?” It led me to years of never openly talking about it through fear of judgement and lack of understanding. Kids can be cruel, and at times they were, so I tried to keep my head down and didn’t tell people about it until I absolutely had to. Ultimately I didn’t really accept who I was and what I had properly….
Fast forward that to the photo on the right: 16 years later, and this is where I proved myself wrong. I think it took me until the moments when I played for my country at futsal for me to truly believe type 1 Diabetes wouldn’t hold me back. Something you battle with 24/7 will always be carried around with you like a chip on your shoulder, which I used to fuel the fire of my motivation. I put in the hard work, learning and dedication to managing my diabetes to help achieve what I had set my heart on within my sport. I’m by no means the best footballer, futsal player or example of type 1 diabetic control, but I learnt from my mistakes, persevered and never gave up believing in goals I set myself. By achieving those goals it gave me the confidence to open up about my condition and I now don’t shy away from sharing the trials and tribulations of what I live with, to help educate and advocate for greater awareness.
I’m just a normal 27 year old, who’s worked extremely hard to get the things done in my life that others may take for granted or might not think are that impressive. When you’re type 1 diabetic just going through a day without having a hypo is impressive!!!
I try to ensure I’m driving the car of my life and my chronic medical disability sits on the backseat where I know where it is, but it doesn’t affect the direction of where I’m heading.
So what’s my lasting message for World Diabetes Day ?
Don’t let it define you… be open and talk to others about what you’re going through. It changed my life opening up about it and I’ve now got better control of my condition than ever before. Be brave, be determined and use Diabetes to power your motivation to keep moving forward. Yes it can be tough, but with the right attitude it’s just an extra hurdle to jump, not a mountain to climb.
Let’s talk, educate and raise awareness this world Diabetes day.