Tag: education

Fuel for football: post-match recovery

Posted on by thediabetesfootballcommunity in Uncategorized

Ask the expert – we put your questions to a leading expert in type 1 diabetes, exercise, and nutrition

Author: Dr Matthew Campbell | PhD ACSM-CEP MIFST RNutr FHEA BSc hons.

A REMINDER – this blog post is written by a healthcare professional but no changes should be made to the treatment of your condition without consultation with your own Diabetes team. 

Read time: 5-10 minutes

Introduction

The primary objectives for a footballer with type 1 diabetes after a match is to reduce the time needed to fully recover and to reduce the risk of developing a hypo later in the day. To meet both of these objectives, it is important to replenish the body’s carbohydrate stores which may have been (partially) depleted during exercise.

How much carbohydrate should I eat after exercise and when?

After exercise, muscle cells that have sustained a depletion in carbohydrate stores are metabolically primed for rapid carbohydrate repletion. In simple terms, glycogen use during exercise turns on glycogen synthesis during recovery. When carbohydrates are eaten soon after exercise, insulin sensitivity in muscle cells, glucose uptake from the blood by muscle cells, and the conversion of glucose to glycogen in muscle cells all increase. Collectively these responses provide the best physiological opportunity to replenish carbohydrate stores. Although the responses can be increased for up to 48 hours1,2, there is a golden window of opportunity shortly after exercise (within the first hour after exercise) where these responses are dramatically upregulated and carbohydrate stores will be replenished more quickly. Consuming 1-1.2 grams of carbohydrate per kilogram of body weight for the first hour after exercise will take advantage of these metabolic circumstances to stimulate high rates of carbohydrate storage. Continue to focus on carbohydrate intake for 24-48 hours after the game, aiming for 6-8 grams of carbohydrate per kilogram of body weight in the 24 hours following a game to ensure that carbohydrate stores are continuing to be replenished; don’t exceed 10 grams of carbohydrate per kilogram of body weight per day – beyond this level does not seem to confer any additional advantage and it may make insulin dosing difficult. Furthermore, simply overconsuming carbohydrate has been shown to be ineffective at preventing post-exercise hypoglycaemia – read this article about preventing post-exercise hypoglycaemia

 

Does the type of carbohydrate matter?

Carbohydrates with a high glycaemic index (i.e., those that easily digested and rapidly absorbed) tend to replenish muscle carbohydrate stores quicker than lower glycaemic index carbohydrates (those that are difficult to breakdown and are absorbed slowly)3. However, consuming large amount of high glycaemic index carbohydrates is not recommended for people with type 1 diabetes, because this can result in large blood glucose spikes which are difficult to control. However, one potential option to trial is changing type of carbohydrate consumed. Carbohydrates come in many different forms and their structure, composition, and delivery method all impact how they affect glucose levels. Glucose is a type of simple sugar that is easily and rapidly digested resulting in spikes in blood sugar. However, mixing glucose with other types of sugar – in particular fructose (which can be bought as a powder) results in a lower glucose spike whilst maintaining total carbohydrate intake4. Figure 1 shows data pooled from several different research studies investigating the effect of different types of carbohydrate consumed after exercise in people without type 1 diabetes. As shown in Figure 1A, changing the type of carbohydrate neither increased nor decreased the rate of muscle glycogen repletion. Interestingly however, most studies report lower insulin levels when glucose and fructose was taken together which implies that this has less of an impact on blood glucose levels. Furthermore, liver glycogen repletion rates were increased when glucose and fructose was taken together as compared to glucose alone. This is potentially important for people with type 1 diabetes, because repletion of liver carbohydrates stores reduces the risk of late-onset hypoglycaemia – read this article about late-onset hypoglycaemia.

Figure 1. The impact of different types of carbohydrates on restoring muscle and liver carbohydrate stores after exercise. Figure reproduced from Gonzalez at al5. GLU = glucose alone, GLU+FRU = glucose and fructose taken together, SUC = sucrose (table sugar).

 

Protein is also (very) important for post-exercise recovery

Sore muscles after exercise are a key indicator of muscle damage – tiny microtears in muscle fibres. To speed up the repair process, and also enhance physiological adaptions, 20-35 grams of high-quality forms of protein should be eaten at regular 3-4 hour intervals6,7. The aim of this is to increase muscle protein synthesis rates – the rate at which cells build and repair muscle. Although protein intake after exercise increases rates of muscle protein synthesis, this is a slow process. This means that protein intake should be increased to a minimum of 1.2-1.4 grams per kilogram of body weight in the days following a match or heavy training session and trying. Where possible, you should try and spread out the total amount of protein to be consumed over the day in the form of smaller but more regular meals. As described above, there is a ‘golden window of opportunity’ shortly after exercise (within the first hour after exercise) to coordinate nutrient intake with the upregulation of key metabolic processes. During this window, muscle protein synthesis rates are rapidly increased if easily digestible and rapidly absorbable protein is consumed. Alongside carbohydrate intake, 30-45 grams of leucine-rich protein (such as whey protein) can be taken to maximise muscle repair and recovery; whey protein can be bought in powered form and taken as a drink but other whole food sources rich in leucine are also available – cottage cheese is an excellent example. As well as lean meat, legumes, and fish, another excellent source of protein is milk which can be drank on its own or mixed with protein powders. The benefit of drinking milk in the post-exercise period is that this has been shown to reduce muscle soreness and quicken recovery8. Additionally, before sleep, a slowly digested and absorbed protein can be taken to provide a gradual and sustained availability of protein9. Aiming for around 30-60 grams of slow-releasing protein (such as casein which is found in milk and can be bought as a powder) as a bedtime snack will be effective in minimising muscle protein breakdown during the night9. Figure 2 shows the pattern of how muscle protein is built-up and broken-down during the day. Timing protein-rich meals to be consumed during periods of protein breakdown will improve muscle reconditioning, especially during long periods of protein breakdown such as sleep.

Figure 2. The pattern of muscle protein breakdown (MPB) and build-up (MPS) during the day. Eating protein stimulates the build-up and repair of muscle protein and allows for net muscle protein accumulation (green areas). In between mealtimes (termed the post-absorptive state), rates of muscle protein breakdown exceed rates of muscle protein build-up, resulting in a net loss of muscle protein (red areas). As shown by Figure 1A, overnight sleep is the longest post-absorptive period of the day (expect for Ramadan for those who observe this). Figure 1B ingesting protein before bedtime stimulates overnight protein build-up rates thereby improving muscle reconditioning during the night. Figure adapted from Trommelen & Loon10.

 

What about supplements?

Vitamins and minerals are important for maintaining key physiological processes including the body’s repair mechanisms. You should try and obtain sufficient amounts of vitamins and minerals naturally through eating a well-rounded healthy diet. This is because dietary sources of vitamin and minerals are more effective than taking isolated vitamins and minerals in supplement form. One supplement which is recommended for most individuals is vitamin D – especially those in the northern hemisphere because most people who live in Northern regions are vitamin D deficient11. If taking vitamin D, this should be coupled with sufficient calcium intake as this helps vitamin D to be absorbed12. Vitamin D is important for several health outcomes, as well as reducing the risk of bone fractures which are common in football, and may contribute to improved muscle recovery13. In addition, dietary iron is important for muscle recovery and repair13. Iron-rich sources of food include red meat as well as green leafy vegetables, eggs, seafood and fortified breads and cereals. Iron-deficiency is common is women, because blood is lost during menstruation, vegans and vegetarians who may struggle to obtain sufficient amounts of iron through diet alone, and teenagers who have increased iron requirements during maturation14.

Some studies have shown that taking branch-chain amino acids can help with recovery14, however the overall effects are small and may make little contribution to the recovery process15. Consuming foods rich in antioxidants have been shown to reduce inflammation and accelerate muscle recovery in difference sports16, but more recent investigations in football failed to show an improvement in recovery or subjective muscle soreness. An issue with this is that certain foods (like beetroot) which are rich in antioxidants are typically found in boiled or pickled form which is known to reduce their antioxidant value meaning that these are large quantities of these foods are likely needed to have any effect. Also, reducing muscle inflammation, particularly with large doses of antioxidants (including vitamins C and E) may interfere with adaptative processes in muscle17, which, if taken after training may reduce the training adaptation. Therefore, based on the available evidence, antioxidant supplements are not recommended.

If you are interested in learning how to improve managing your type 1 diabetes around exercise book a consultation with the author, Dr Matthew Campbell: matt@t1dcoaching.co.uk

About Matthew

Matthew is an internationally recognised research scientist specialising in exercise, diet, and type 1 diabetes. He also provides consultancy and diabetes coaching to people living with type 1 diabetes and those that support them.

Matthew has a PhD in nutrition and exercise metabolism, is author to over 150 research publications, and holds honorary titles with the University of Cambridge and University of Leeds. He is a certified clinical exercise physiologist accredited by the American College of Sports Medicine, a registered nutritionist, and a member of the Institute of Food Science and Technology. He also provides consultancy to professional bodies and professional athletes including NHS England, the World Health Organisation, and TeamGB.

If you are interested in learning how to improve your type 1 diabetes management, contact Matthew at: matt@t1dcoaching.co.uk

References

  1. Burke LM, van Loon LJ, Hawley JA. Postexercise muscle glycogen resynthesis in humans. Journal of applied physiology. 2017;122(5):1055-1067.
  2. Mikines K, Farrell P, Sonne B, Tronier B, Galbo H. Postexercise dose-response relationship between plasma glucose and insulin secretion. Journal of applied physiology. 1988;64(3):988-999.
  3. Burke LM, Collier GR, Hargreaves M. Muscle glycogen storage after prolonged exercise: effect of the glycemic index of carbohydrate feedings. Journal of applied physiology. 1993;75(2):1019-1023.
  4. Fuchs CJ, Gonzalez JT, Van Loon LJ. Fructose co‐ingestion to increase carbohydrate availability in athletes. The Journal of physiology. 2019;597(14):3549-3560.
  5. Gonzalez JT, Fuchs CJ, Betts JA, Van Loon LJ. Glucose plus fructose ingestion for post-exercise recovery—greater than the sum of its parts? Nutrients. 2017;9(4):344.
  6. Koopman R, Saris WH, Wagenmakers AJ, van Loon LJ. Nutritional interventions to promote post-exercise muscle protein synthesis. Sports medicine. 2007;37(10):895-906.
  7. van Loon LJ. Role of dietary protein in post-exercise muscle reconditioning. In: Nutritional Coaching Strategy to Modulate Training Efficiency. Vol 75. Karger Publishers; 2013:73-83.
  8. Rankin P, Landy A, Stevenson E, Cockburn E. Milk: an effective recovery drink for female athletes. Nutrients. 2018;10(2):228.
  9. Kouw IW, Holwerda AM, Trommelen J, et al. Protein ingestion before sleep increases overnight muscle protein synthesis rates in healthy older men: a randomized controlled trial. The Journal of nutrition. 2017;147(12):2252-2261.
  10. Trommelen J, Van Loon LJ. Pre-sleep protein ingestion to improve the skeletal muscle adaptive response to exercise training. Nutrients. 2016;8(12):763.
  11. Holick MF. Deficiency of sunlight and vitamin D. In. Vol 336: British Medical Journal Publishing Group; 2008:1318-1319.
  12. Christakos S, Dhawan P, Porta A, Mady LJ, Seth T. Vitamin D and intestinal calcium absorption. Molecular and cellular endocrinology. 2011;347(1-2):25-29.
  13. Bello HJ, Caballero-García A, Pérez-Valdecantos D, Roche E, Noriega DC, Córdova-Martínez A. Effects of Vitamin D in Post-Exercise Muscle Recovery. A Systematic Review and Meta-Analysis. Nutrients. 2021;13(11):4013.
  14. Pasricha S-R, Tye-Din J, Muckenthaler MU, Swinkels DW. Iron deficiency. The Lancet. 2021;397(10270):233-248.
  15. Doma K, Singh U, Boullosa D, Connor JD. The effect of branched-chain amino acid on muscle damage markers and performance following strenuous exercise: A systematic review and meta-analysis. Applied physiology, nutrition, and metabolism. 2021;46(11):1303-1313.
  16. Drummer D, Pritchett K, Many GM, et al. Montmorency Cherry Juice Consumption does not Improve Muscle Soreness or Inhibit Pro-inflammatory Monocyte Responses Following an Acute Bout of Whole-body Resistance Training. International journal of exercise science. 2022;15(6):686-701.
  17. Peternelj T-T, Coombes JS. Antioxidant supplementation during exercise training. Sports medicine. 2011;41(12):1043-1069.

Savannah’s Story – A TDFC Story

Posted on by thediabetesfootballcommunity in diabetes, Football, sport

A story from our community shared in the words of Natalie the mother of Savannah. We hope you can connect with their story and we want to thank them both so much for getting in touch to share what they’ve been through. It’s an incredibly powerful post and we hope you all can resonate with their experiences… Over to you Natalie:

“At the tender age of six, Savannah’s life took an unexpected turn when she was diagnosed with Type 1 diabetes. I remember the day like it was yesterday. Savannah was struggling to breathe, and her energy seemed to have vanished into thin air. With a call to 111, followed by a swift ride in the ambulance with those flashing blue lights, we found ourselves at Northampton General Hospital. The journey was frightening, but little did we know, it was also the beginning of Savannah’s incredible resilience and bravery.

In the children’s ward, surrounded by compassionate nurses and caring doctors, Savannah began her journey of understanding and managing her diabetes. Despite the challenges she faced, Savannah’s optimism shone through like a beacon of hope. I’ll never forget the relief on her face when she discovered that even with diabetes, she could still indulge in her favourite breakfast of pancakes and Nutella and still play football! That smile of hers could light up the darkest of rooms!

As we returned home armed with needles, insulin, and bags full of information, we knew that our journey was just beginning. Learning to navigate the intricacies of managing diabetes was like embarking on a rollercoaster ride full of highs and lows. From monitoring her food intake to keeping an eye on her activity levels, Savannah showed incredible maturity beyond her years.

There were bumps along the road, and we found ourselves back in the hospital a couple of times. But through it all, the unwavering support of the Northampton Diabetes team kept us going. Their 24-hour support line became our lifeline, even during family holidays when we called our dedicated nurse for guidance.

Despite the challenges, Savannah never lost her spark. She faced each day with determination and grace, bravely enduring the countless injections and finger pricks that became a part of her daily routine. As a parent, I couldn’t help but marvel at her resilience and strength.

Savannah’s zest for life knew no bounds. Despite her diagnosis, she continued to pursue her passion of football with unwavering enthusiasm. From scoring goals on the football field with NN29 Titans in Podington to representing MK Dons, Savannah’s spirit remained unbreakable. Her recent achievement of reaching 100 goals for the Titans club is a testament to her tenacity and dedication. Her goal is to become a professional footballer and she is well on her way at the tender age of 8!

 

As Savannah’s journey continues, I am filled with awe and gratitude for the incredible young girl she has become. She is not just my daughter; she is my inspiration, my hero. And with that infectious smile of hers, she reminds me every day that no matter what challenges life may throw our way, we have the strength and courage to overcome them together. ”

Thank you so much again to Natalie and Savannah for sharing your experiences with us, and if you want to share your story to feature on our website, please do get in touch with pictures and videos!

Team TDFC

 

Fuel for football: half-time strategies for maintaining performance with type 1 diabetes

Posted on by thediabetesfootballcommunity in diabetes research

Ask the expert – we put your questions to a leading expert in type 1 diabetes, exercise, and nutrition. Thank you to JDRF and Matt for the support in the creation of this content. For more information, support and resources from JDRF, click here

Author: Dr Matthew Campbell | PhD ACSM-CEP MIFST RNutr FHEA BSc hons.

Read time: 5-10 minutes

 Introduction

The two main nutritional considerations for football are eating enough carbohydrate and drinking enough fluid. Whereas this is important in the time leading up to a match, it is also important to take on additional energy and fluids during the match.

 What should I eat during exercise?

Research studies consistently show performance benefits during simulated football matches when carbohydrate is consumed during exercise at a rate of approximately 30-60 grams per hour (41-44), or up to 60 grams before each half (45). The 30-60 grams of carbohydrate can be taken after warm-up and again at half-time to meet these guidelines. Consuming 30-60 grams of carbohydrate in the form of food such as energy bars can sometimes be difficult and result in stomach upset. However, carbohydrate-based drinks and gels can often minimise potential stomach issues – it will also help with hydration as discussed below. A major consideration about carbohydrate intake immediately before and during exercise will be managing the impact of this on blood glucose levels. You will need to make a judgement about how best to manage your insulin dose to minimise blood glucose spikes, and, to ensure that you do not have excessive insulin ‘on-board’ during the game which could cause hypoglycaemia – read this article about insulin dosing strategies for exercise.

What should I do if I struggle to manage blood glucose levels when consuming carbohydrate during a match?

If controlling blood glucose levels is difficult for you during football and you’re worried that eating carbohydrate might make this worse there is another, rather strange, but very special technique to try – carbohydrate mouth rinsing. The body is equipped with specialised receptors within the mouth that can detect carbohydrate. This detection of carbohydrates sends signals to the brain that reduce the perception of effort1. Carbohydrate mouth rinsing, which involves rinsing, but not swallowing, the mouth with a carbohydrate-based solution – like you would with mouthwash – has been shown to increase self-paced jogging speed with likely benefits in sprint performance during intermittent types of exercise2,3. There is limited research investigating this technique within applied football settings, although it is logical to think that this strategy could be effective. Using the carbohydrate mouth rinsing technique during breaks in match play (like half-time periods, extra-time, injury stoppages, and medical breaks) could potentially improve performance in situations where eating carbohydrate is either impractical or likely to cause stomach upset or unwanted blood glucose spikes. If your glucose levels tend to be stable during the match and managing hyperglycaemia isn’t too much of an issue for you, then you can combine mouth-rinsing and swallowing. Swallowing a carbohydrate-based drink following a short (approximately 5 second) mouth rinse allows for both the activation of brain signals to reduce perceived effort and will provide extra fuel to the body. This type of strategy might be particularly effective towards the end of games where fatigue may start to impact decisions making processes.

How much fluid should I drink during a match?

Although you can buy isotonic sports drinks, you can also make your own by simply adding a little salt to some squash. It is well established that dehydration impairs both physical and mental performance4,5, although some people are more sensitive to the effects of dehydration than others. The amount of fluid your body requires during a match is determined largely by the amount that you sweat, which, differs from one person to the next, and is dependent on the intensity of exercise, external factors like humidity and temperature, and how well you are acclimatised to the conditions6. Sweat rates in male footballers have previously been reported to range from 0.5-2.5 litres per hour7-9, whereas lower values are generally reported in female players largely because women tend to be smaller than men and expend less energy during exercise10-12. As well as water, sweat also contains electrolytes – primarily sodium (salt) – the amounts of which, again vary from person to person9. As a general guide, footballers should aim to drink sufficient fluids to avoid a reduction of 2-3% of pre-match body weight during a match13 and avoiding gains in body weight to prevent over hydration. As a starting point, measure your weight before and after a match (or even better during training), if you have lost more than 2-3% of your starting body weight then you need to drink more during matches when you can!

 If you are interested in learning how to improve managing your type 1 diabetes around exercise book a consultation with the author, Dr Matthew Campbell: matt@t1dcoaching.co.uk

 About Matthew

Matthew is an internationally recognised research scientist specialising in exercise, diet, and type 1 diabetes. He also provides consultancy and diabetes coaching to people living with type 1 diabetes and those that support them.

Matthew has a PhD in nutrition and exercise metabolism, is author to over 150 research publications, and holds honorary titles with the University of Cambridge and University of Leeds. He is a certified clinical exercise physiologist accredited by the American College of Sports Medicine, a registered nutritionist, and a member of the Institute of Food Science and Technology. He also provides consultancy to professional bodies and professional athletes including NHS England, the World Health Organisation, and TeamGB.

If you are interested in learning how to improve your type 1 diabetes management, contact Matthew at: matt@t1dcoaching.co.uk

References

  1. Carter JM, Jeukendrup AE, Jones DA. The effect of carbohydrate mouth rinse on 1-h cycle time trial performance. Medicine and science in sports and exercise. 2004;36(12):2107-2111.
  2. Rollo I, Homewood G, Williams C, Carter J, Goosey-Tolfrey VL. The influence of carbohydrate mouth rinse on self-selected intermittent running performance. Internatonal journal of sports and exercise metabolism. 2015;25(6):550-558.
  3. Rollo I, Williams C, Gant N, Nute M. The influence of carbohydrate mouth rinse on self-selected speeds during a 30-min treadmill run. International journal of sport nutrition and exercise metabolism. 2008;18(6):585-600.
  4. Mohr M, Krustrup P. Heat stress impairs repeated jump ability after competitive elite soccer games. The journal of strength & conditioning research. 2013;27(3):683-689.
  5. McGregor S, Nicholas C, Lakomy H, Williams C. The influence of intermittent high-intensity shuttle running and fluid ingestion on the performance of a soccer skill. Journal of sports sciences.1999;17(11):895-903.
  6. Smith JW, Bello ML, Price FG. A case-series observation of sweat rate variability in endurance-trained athletes. Nutrients. 2021;13(6):1807.
  7. Shirreffs SM, Aragon-Vargas LF, Chamorro M, Maughan RJ, Serratosa L, Zachwieja JJ. The sweating response of elite professional soccer players to training in the heat. International journal of sports medicine. 2005;26(02):90-95.
  8. Baker LB, Barnes KA, Anderson ML, Passe DH, Stofan JR. Normative data for regional sweat sodium concentration and whole-body sweating rate in athletes. Journal of sports sciences. 2016;34(4):358-368.
  9. Maughan R, Shirreffs S, Merson S, Horswill C. Fluid and electrolyte balance in elite male football (soccer) players training in a cool environment. Journal of sports sciences. 2005;23(1):73-79.
  10. Da Silva RP, Mündel T, Natali AJ, et al. Pre-game hydration status, sweat loss, and fluid intake in elite Brazilian young male soccer players during competition. Journal of sports sciences. 2012;30(1):37-42.
  11. Horowitz M. Heat acclimation, epigenetics, and cytoprotection memory. Comprehensive Physiology. 2011;4(1):199-230.
  12. Kilding A, Tunstall H, Wraith E, Good M, Gammon C, Smith C. Sweat rate and sweat electrolyte composition in international female soccer players during game specific training. International journal of sports medicine. 2009;30(06):443-447.
  13. McDermott BP, Anderson SA, Armstrong LE, et al. National athletic trainers’ association position statement: fluid replacement for the physically active. Journal of athletic training. 2017;52(9):877-895.

 

Fuel for Football: The Pre-Match Preparation

Posted on by thediabetesfootballcommunity in diabetes research

Ask the expert – we put your questions to a leading expert in type 1 diabetes, exercise, and nutrition. Thank you to JDRF and Matt for the support in the creation of this content. For more information, support and resources from JDRF, click here

Author: Dr Matthew Campbell | PhD ACSM-CEP MIFST RNutr FHEA BSc hons.

Read time: 10 minutes

Introduction

Food is made up from a combination of macronutrients and micronutrients. Macronutrients are nutrients that the body needs in large amounts and include carbohydrates, fats, proteins, and fibre, whereas micronutrients include vitamins and minerals. Achieving the right balance of macronutrients and ensuring adequate intake of micronutrients is important for maintaining energy balance – i.e., meeting, but not exceeding the body’s energy demands – as well as maintaining normal physiological processes that are important for day-to-day and long-term health.

What fuels are important for football?

Our bodies preferentially and predominantly use carbohydrate and fat as fuel sources. The amount of energy used, as well as the proportion of energy derived from carbohydrate and fat is influenced by several factors including genetics, training status, as well as what fuels are available – all of these factors differ between individuals meaning that generic, one-size-fits-all recommendations are usually inappropriate1. One constant however is exercise intensity and duration2. At lower exercise intensities (about 60%-70% of maximum heart rate – calculate your maximum heart rate by subtracting your age in years from 220), the body predominantly uses fat. With increasing exercise intensity and duration however, your body will turn to carbohydrate, such that at very high intensities (90%-100% of maximum heart rate) your body will be utilising carbohydrate almost exclusively2.

Why is having enough carbohydrate on-board important?

Having enough carbohydrate available to the body is important during football because low levels of carbohydrate availability is a major cause of early fatigue, decreased performance, reduced concentrations, and hypoglycaemia, especially towards the later stages of a match, extra-time, or long or intense training sessions3. Because the body has only a limited capacity for carbohydrate storage4, it is important to eat enough carbohydrate in the time leading up to a match. Data from a number of research studies show that carbohydrate intake before (and during) a match can delay fatigue5, enhance the capacity for intermittent high-intensity activities6,7 (such as sprint speed and recovery), and prevent hypoglycaemia when insulin doses are adjusted too8. It’s not known how much of the body’s carbohydrate stores are depleted during football, although previous research has suggested that  about 50% of muscle fibres are empty or partially empty after a game9. Players who begin a game with lower muscle carbohydrate stores are known to cover less distance and much less at speed, especially in the second half and during extra-time periods, than those who have ensured adequate carbohydrate stores10.

How much carbohydrate should I eat?

On the days leading up to a match, training is usually light or avoided completely. During this time and on match day itself, carbohydrate intake can be increased to about 6-8 grams per kilogram of body weight per day11 (for a 70 kilogram person this equates to approximately 490 grams of carbohydrate across the whole day). This sounds a lot, but it can be easily achieved by incorporating carbohydrate-based foods (bread, pasta, and potatoes) into each meal. If you are playing in a tournament with congested match fixtures then carbohydrate intake should be maintained at about 6-8 grams per kilogram of body weight per day11 whilst you’re between games in order to replenish carbohydrate stores that may have been (partially) depleted. Although carbohydrate intake in the hours before a game is important, try and avoid eating immediately before (within an hour) and chose easily digestible foods (low in fibre) to avoid exercise-induced stomach upset12.

Is there a way to increase the amount of carbohydrate stored?

Interestingly, although there is an upper limit to the amount of carbohydrate that the body can store, this varies from person to person and can be improved using the right training and feeding strategies. For example, research has shown that training with low muscle glycogen levels can lead to ‘supercompensation’ – i.e., an increase in the amount of carbohydrate stored above and beyond an individual’s normal baseline level13. The challenge for people with type 1 diabetes adopting this strategy, however, is managing glucose levels during exercise to avoid hypoglycaemia. You can also try manipulating the type of carbohydrate consumed which has been shown to increased carbohydrate stores in some tissues14

Does it matter what time I eat carbohydrates?

The timing of carbohydrate consumption is important and can be manipulated to optimise carbohydrate storage. Carbohydrate-rich meals can be consumed on heavy training days, or specific times in the day when stored carbohydrate levels are low. For example, at breakfast the liver has partially depleted its carbohydrate stores because it has been releasing glucose during the night to maintain blood glucose levels15. When carbohydrate stores are low, the body is metabolically primed to preferentially restore these supplies, meaning that less of what you eat will be stored as fat, or ‘burnt-off’ as extra energy. Conversely, when carbohydrate stores are full, the body will is unable to store excess carbohydrate and so some of this will be stored as fat and some will be ‘burnt-off’ as extra energy.

 Aside from carbohydrates, what else should I focus on?

Hydration is also key. Players should aim to start the match fully hydrated – you can tell if you are fully hydrated by the colour of your urine; anything darker than a pale-yellow colour and you need to drink more fluids. General recommendations are to drink 5-7 millilitres per kilogram of body weight in the 2 to 4 hours before kick-off (for a 70 kilogram person this equates to about half a litre. This allows sufficient time for excess fluid to pass through the system and achieve urine that is pale yellow in colour16. Make sure that your drinks are largely sugar-free (to avoid big glucose spikes) and try adding a pinch of salt (1 gram of table salt for every litre of water) as this helps increases hydration rates17.

If you are interested in learning how to improve managing your type 1 diabetes around exercise book a consultation with the author, Dr Matthew Campbell: matt@t1dcoaching.co.uk

 

About Matthew

Matthew is an internationally recognised research scientist specialising in exercise, diet, and type 1 diabetes. He also provides consultancy and diabetes coaching to people living with type 1 diabetes and those that support them.

 

Matthew has a PhD in nutrition and exercise metabolism, is author to over 150 research publications, and holds honorary titles with the University of Cambridge and University of Leeds. He is a certified clinical exercise physiologist accredited by the American College of Sports Medicine, a registered nutritionist, and a member of the Institute of Food Science and Technology. He also provides consultancy to professional bodies and professional athletes including NHS England, the World Health Organisation, and TeamGB.

References

  1. Venables MC, Achten J, Jeukendrup AE. Determinants of fat oxidation during exercise in healthy men and women: a cross-sectional study. Journal of applied physiology. 2005;98(1):160-167.
  2. Melzer K. Carbohydrate and fat utilization during rest and physical activity. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 2011;6(2):e45-e52.
  3. Costill DL, Hargreaves M. Carbohydrate nutrition and fatigue. Sports medicine. 1992;13(2):86-92.
  4. Acheson K, Schutz Y, Bessard T, Anantharaman K, Flatt J, Jequier E. Glycogen storage capacity and de novo lipogenesis during massive carbohydrate overfeeding in man. The American journal of clinical nutrition. 1988;48(2):240-247.
  5. Holway FE, Spriet LL. Sport-specific nutrition: practical strategies for team sports. Journal of sports sciences. 2011;29(sup1):S115-S125.
  6. Phillips SM, Sproule J, Turner AP. Carbohydrate ingestion during team games exercise. Sports Medicine. 2011;41(7):559-585.
  7. Russell M, Benton D, Kingsley M. Influence of carbohydrate supplementation on skill performance during a soccer match simulation. Journal of Science and Medicine in Sport. 2012;15(4):348-354.
  8. Campbell MD, Walker M, Bracken RM, et al. Insulin therapy and dietary adjustments to normalize glycemia and prevent nocturnal hypoglycemia after evening exercise in type 1 diabetes: a randomized controlled trial. BMJ Open Diabetes Research and Care. 2015;3(1):e000085.
  9. Krustrup P, Mohr M, Steensberg A, Bencke J, Kjær M, Bangsbo J. Muscle and blood metabolites during a soccer game: implications for sprint performance. Medicine and science in sports and exercise. 2006;38(6):1165-1174.
  10. Jacobs I, Westlin N, Karlsson J, Rasmusson M, Houghton B. Muscle glycogen and diet in elite soccer players. European journal of applied physiology and occupational physiology. 1982;48(3):297-302.
  11. Collins J, Maughan RJ, Gleeson M, et al. UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research. British journal of sports medicine. 2021;55(8):416-416.
  12. De Oliveira EP, Burini RC. Carbohydrate-dependent, exercise-induced gastrointestinal distress. Nutrients. 2014;6(10):4191-4199.
  13. Burke L. Fueling strategies to optimize performance: training high or training low? Scandinavian journal of medicine & science in sports. 2010;20:48-58.
  14. Gonzalez JT, Fuchs CJ, Betts JA, Van Loon LJ. Glucose plus fructose ingestion for post-exercise recovery—greater than the sum of its parts? Nutrients. 2017;9(4):344.
  15. Nilsson LH, Fürst P, Hultman E. Carbohydrate metabolism of the liver in normal man under varying dietary conditions. Scandinavian journal of clinical and laboratory investigation. 1973;32(4):331-337.
  16. Armstrong LE, Pumerantz AC, Fiala KA, et al. Human hydration indices: acute and longitudinal reference values. International Journal of Sport Nutrition & Exercise Metabolism. 2010;20(2).
  17. Pratama RY, Muliarta IM, Sundari LPR, Sutjana IDP, Dewi NNA, Griadi IPA. Provision of Coconut Water as Good as Packed Coconut Water and Isotonic Beverages on Hydration Status in Football Athlete. Journal of Physical Education Health and Sport. 2022;9(1):18-26.

Match play demands: how does football impact blood glucose levels?

Posted on by thediabetesfootballcommunity in diabetes research

Ask the expert – we put your questions to a leading expert in type 1 diabetes, exercise, and nutrition. Thank you to JDRF and Matt for the support in the creation of this content. For more information, support and resources from JDRF, click here

A REMINDER – this blog post is written by a healthcare professional but no changes should be made to the treatment of your condition without consultation with your own Diabetes team. 

Author: Dr Matthew Campbell | PhD ACSM-CEP MIFST RNutr FHEA BSc hons.

Read time: 10 minutes

 

Introduction

During a football match, you will find yourself walking, jogging, running, sprinting, jumping, dribbling, striking the ball, changing direction, as well as coming into contact with the opposition (and possibly arguing with the referee). This places a significant demand on our body’s physiological energy systems as it tries to cope with repeated changes in exercise intensity1.

 

How does the body use blood glucose during exercise?

The body requires energy to exercise, and this is generated by breaking-down various fuels. The main fuels used for exercise are carbohydrate and fat. Everyone (including professional footballers) has enough fat stored away to the meet the body’s fat-derived energy requirements for a football match. However, for higher intensity exercise the body relies more on carbohydrate but has only a limited storage capacity. Carbohydrate is stored in the form of glycogen – bundles of individual glucose molecules packaged together. During exercise, muscles convert stored glycogen into glucose which is then converted into energy. Muscles are also able to extract glucose directly from the blood to help meet their energy demands, and as exercise intensity and duration is increased more and more glucose from the blood is pulled into muscle – this can cause low blood glucose levels, even in people without type 1 diabetes.

 

Why do people with type 1 diabetes have an increased risk of hypoglycaemia during exercise?

In people without type 1 diabetes, insulin levels are regulated and are reduced in response to exercise. This enables two things; firstly, it limits muscle tissue from extracting excessive amounts of glucose from the blood; secondly, lower insulin levels allow the liver to release more glucose into the blood2. Think of this as trying to fill a bucket with a hole in the bottom… if the liver can release enough glucose into the blood to meet the rate at which glucose is being removed by muscle (and other tissues) then blood glucose levels will remain stable. If the rate at which glucose is removed from the blood exceeds the rate at which blood glucose is being replaced, then fatigue, reduced performance, and potentially hypoglycaemia will ensue. Importantly, in type 1 diabetes, insulin levels are the result of the previously administered dose and/or background insulin. This means that once in the body, insulin is unregulated and does not decrease in response to exercise. This results in two things; firstly, higher insulin levels promote excessive glucose removal from the blood; secondly, higher insulin levels prevent the liver from releasing sufficient glucose into the blood to meet demand. This will result in hypoglycaemia.

 

Does playing football mean I will have a hypo?

Although most people associate exercise in type 1 diabetes with hypoglycaemia3 – i.e., the ability of exercise to lower blood glucose to potentially dangerous levels – not all forms of exercise lower blood glucose acutely4-8. Whereas continuous or prolonged aerobic-based exercise (like running a 10K or half-marathon at a steady pace) carries with it a heightened risk of hypoglycaemia8, high-intensity types of exercise (like lifting weights or sprinting) often cause a short-term rise in blood glucose levels4,6,9. Intermittent types of activity which involve repeated bouts of high-intensity activity interspersed with lower and moderate intensity activities, like football, tend to produce more stabilised glucose levels during the activity5,10-13. For example, Figure 1 below illustrates the average change in blood glucose levels during 45-minutes of a simulated match in people with type 1 diabetes. Compared with running (red trace), a simulated first half of football (blue trace) tends to, on average, induce a lower drop in blood glucose levels even when the total amount of energy used (termed energy expenditure) is similar5. Note however, the long bars that stretch above and beyond each data point – this illustrates the amount of variability around the mean response; in other words, it demonstrates how much people can vary in their response to the average…. It’s quite a bit!

Figure 1. The impact of different types of exercise on blood glucose levels during and immediately after a simulated first half of football running (blue trace) and continuous running (red trace) in people with type 1 diabetes. Hashed area indicates exercise period. Figure reproduced from Campbell at al14.

 

Ok, but how are glucose levels maintained or even increased during football?

Although insulin is a very important hormone for blood glucose regulation, other hormones also play important roles. Intense activity produces a marked increase in the release of stress-hormones9, like adrenaline, noradrenaline and cortisol which can help preserve (or even increase) glucose levels during, and for a short-time after, exercise. This is illustrated in Figure 2 where cortisol levels were shown to be elevated in response to 45-minutes of a simulated match (blue trace) compared to continuous running (red trace) in people with type 1 diabetes. Cortisol – which is produced and released by the adrenal glands on top of the kidney – as well as adrenaline, is also partly responsible for those glucose rises that you might see with pre-match nerves or a poor night’s sleep15.

Figure 2. The impact of different types of exercise on blood cortisol levels during and immediately after a simulated first half of football running (blue trace) and continuous running (red trace) in people with type 1 diabetes. Hashed area indicates exercise period. Figure reproduced from Campbell at al14.

 

How do stress hormones increase glucose?

These stress-hormones stimulate the body to break down stored glycogen into glucose2. In the muscle, glycogen broken down into glucose is simply converted into energy because this tissue lacks a special enzyme that prevents glucose being released into the blood. The culprit for increased blood glucose levels is the liver. Unlike muscle, the liver has a special enzyme that enables the conversion of glycogen to glucose for release into the blood. With high levels of stress hormones circulating, the liver is stimulated to increase its release of stored glucose2. In contrast to football, continuous moderate-intensity activity achieves only achieves a modest increase in stress-hormones5 meaning that they have only a minor impact on glucose levels.

 

How long will the effects of stress hormones last?

Although these hormones can have dramatic effects on blood glucose levels, they are usually very short lasting – for example, adrenaline is usually cleared from the blood within 5-10 minutes16. Importantly however, the hormonal and metabolic responses during repeated intense bouts are additive when recovery intervals are short17. This means that in a typical football match (especially those that are physically demanding, and for certain positions like wingers or attacking wingbacks) that there is likely insufficient time for full clearance of these hormones from the circulation before the next high-intensity bout. This means that you could see a gradual rise in glucose levels over each playing half.

 

How long will it take my glucose levels to normalise after football?

Hormones act for a relatively short time meaning that once levels drop, their influence on glucose levels will also be short-lasting. Although football might confer a lower risk of hypoglycaemia during and immediately afterwards, there is still an increased risk of developing hypoglycaemia later after exercise, so much so that the risk of developing late-onset hypoglycaemia seems to be comparable to other forms of exercise like running or lifting weights5. Read our other article to learn more about post-exercise hypoglycaemia and how to avoid it.

 

Are there other factors that can affect blood glucose levels during exercise?

Yes. Lots. Of course, with all aspects of type 1 diabetes, blood glucose responses to any form of exercise will to some extent vary from person to person, and from match to match. Your own physical fitness, technical ability, playing position, tactical role, style of playing, as well as ball possession of the team, quality of the opponent, importance of the game, seasonal period, playing surface, and environmental factors like humidity and temperature18 (to name but a few) will all influence both performance and diabetes management. As such, careful planning of training, nutrition, and insulin dosing strategies are required in preparation for training and match days in optimise performance and manage diabetes effectively and safely.

About Matthew

Matthew is an internationally recognised research scientist specialising in exercise, diet, and type 1 diabetes. He also provides consultancy and diabetes coaching to people living with type 1 diabetes and those that support them.

Matthew has a PhD in nutrition and exercise metabolism, is author to over 150 research publications and holds honorary titles with the University of Cambridge and University of Leeds. He is a certified clinical exercise physiologist accredited by the American College of Sports Medicine, a registered nutritionist, and a member of the Institute of Food Science and Technology. He also provides consultancy to professional bodies and professional athletes including NHS England, the World Health Organisation, and TeamGB.

If you are interested in learning how to improve your type 1 diabetes management around exercise, contact Matthew at: matt@t1dcoaching.co.uk

References

  1. Dolci F, Hart NH, Kilding AE, Chivers P, Piggott B, Spiteri T. Physical and energetic demand of soccer: a brief review. Strength & Conditioning Journal. 2020;42(3):70-77.
  2. Marliss EB, Vranic M. Intense exercise has unique effects on both insulin release and its roles in glucoregulation: implications for diabetes. Diabetes. 2002;51(suppl_1):S271-S283.
  3. Cockcroft E, Narendran P, Andrews R. Exercise‐induced hypoglycaemia in type 1 diabetes. Experimental physiology. 2020;105(4):590-599.
  4. Turner D, Luzio S, Gray B, et al. Impact of single and multiple sets of resistance exercise in type 1 diabetes. Scandinavian journal of medicine & science in sports. 2015;25(1):e99-e109.
  5. Campbell MD, West DJ, Bain SC, et al. Simulated games activity vs continuous running exercise: a novel comparison of the glycemic and metabolic responses in T1DM patients. Scandinavian journal of medicine & science in sports. 2015;25(2):216-222.
  6. Yardley JE, Kenny GP, Perkins BA, et al. Effects of performing resistance exercise before versus after aerobic exercise on glycemia in type 1 diabetes. Diabetes care. 2012;35(4):669-675.
  7. Hasan S, Shaw SM, Gelling LH, Kerr CJ, Meads CA. Exercise modes and their association with hypoglycemia episodes in adults with type 1 diabetes mellitus: a systematic review. BMJ Open Diabetes Research and Care. 2018;6(1):e000578.
  8. Campbell MD, Walker M, Trenell MI, et al. Large pre-and postexercise rapid-acting insulin reductions preserve glycemia and prevent early-but not late-onset hypoglycemia in patients with type 1 diabetes. Diabetes care. 2013;36(8):2217-2224.
  9. Fahey A, Paramalingam N, Davey R, Davis E, Jones T, Fournier P. The effect of a short sprint on postexercise whole-body glucose production and utilization rates in individuals with type 1 diabetes mellitus. The Journal of Clinical Endocrinology & Metabolism. 2012;97(11):4193-4200.
  10. Guelfi K, Ratnam N, Smythe G, Jones T, Fournier P. Effect of intermittent high-intensity compared with continuous moderate exercise on glucose production and utilization in individuals with type 1 diabetes. American Journal of Physiology-Endocrinology And Metabolism. 2007;292(3):E865-E870.
  11. Guelfi KJ, Jones TW, Fournier PA. The decline in blood glucose levels is less with intermittent high-intensity compared with moderate exercise in individuals with type 1 diabetes. Diabetes care. 2005;28(6):1289-1294.
  12. Bussau V, Ferreira L, Jones T, Fournier P. A 10-s sprint performed prior to moderate-intensity exercise prevents early post-exercise fall in glycaemia in individuals with type 1 diabetes. Diabetologia. 2007;50(9):1815-1818.
  13. Bussau VA, Ferreira LD, Jones TW, Fournier PA. The 10-s maximal sprint: a novel approach to counter an exercise-mediated fall in glycemia in individuals with type 1 diabetes. Diabetes care. 2006;29(3):601-606.
  14. Campbell MD, West DJ, Bain SC, et al. Simulated games activity vs continuous running exercise: a novel comparison of the glycemic and metabolic responses in T1DM patients. 2015;25(2):216-222.
  15. Briançon-Marjollet A, Weiszenstein M, Henri M, Thomas A, Godin-Ribuot D, Polak J. The impact of sleep disorders on glucose metabolism: endocrine and molecular mechanisms. Diabetology & metabolic syndrome. 2015;7(1):1-16.
  16. Goldstein DS, Eisenhofer G, Kopin IJ. Sources and significance of plasma levels of catechols and their metabolites in humans. Journal of Pharmacology and Experimental Therapeutics. 2003;305(3):800-811.
  17. Bogardus C, LaGrange BM, Horton ES, Sims E. Comparison of carbohydrate-containing and carbohydrate-restricted hypocaloric diets in the treatment of obesity. Endurance and metabolic fuel homeostasis during strenuous exercise. The Journal of clinical investigation. 1981;68(2):399-404.
  18. Al‐Qaissi A, Papageorgiou M, Javed Z, et al. Environmental effects of ambient temperature and relative humidity on insulin pharmacodynamics in adults with type 1 diabetes mellitus. Diabetes, Obesity and Metabolism. 2019;21(3):569-574.

Chris Bright Reviews 2021 at TDFC

Posted on by thediabetesfootballcommunity in diabetes, sport

Well, here we are… On the cusp of 2022 after a year which followed probably one of the toughest years of many people’s lives. I think at this stage of the pandemic so many of us have lost someone we know or know of and I just want to add to the condolences if you’re one of those people who have lost a loved one during the last year to COVID or anything else. My thoughts are with you.

There’s no doubt that at TDFC we’ve faced some big challenges in the last year. From company finances, to ongoing restrictions which curtailed many of the project ideas we had, through to the challenges of supporting our community during a period of uncertainty, pressure and ultimately fear. It’s been tough to move forward but move forward we have. Because for me, that’s the mindset I’ve always had, when you want to make something happen and there’s a barrier in the way, you don’t run away from it, you find a way to leap over it and that’s how we’ve approached 2021. We’ve tried our best to adapt and overcome the challenges we’ve been faced with. It’s not been easy, but nothing worth doing in life is made easy for us.

So, we’ve given it a good go.

With the start of 2021 in the UK being a period of lockdown, much of the support we could offer was via our online tools. So, we maxed this out as much as we could. We had great engagement in the Men’s whatsapp group which continues to be an incredible resource for support, awareness and troubleshooting around type 1 Diabetes. This year we’ve had discussions on the impact of vaccines on our Diabetes, the effect of COVID on our condition and how long it may have impacted on people, all the way through to the performances of Mikel Arteta’s Arsenal (too often a conversation in my opinion!). It’s incredible to see and as the founder who envisaged this idea in 2017, to see how we’re able to help so many people in this way is mind blowing sometimes. We’ve changed lives and we continue to influence the way the healthcare system views peer support, and for this I’m always grateful. Our community, our vision and our direction.

In amongst that vision has always been to shed a spotlight on the incredible people involved in football living with Diabetes. Storytelling is one of the greatest gifts that we all have available to us and the power a story can have, if told in the right way, can be profound. We’ve told stories on our social media, through our blog and in the media before but we felt with the growth of podcasts, it was time to start telling stories using this popular medium. So, during the early part of 2021, myself and peachy launched The Diabetes Dugout to do just that. We’ve interviewed people from the community, told stories from people involved in professional football and most importantly shed a light on our condition which educates others. I’ve thoroughly enjoyed it and I hope those who have tuned in to the episodes have done too (I even got to speak with the legend that is Gary Mabbutt MBE!) … It’s a resource now that we will always be able utilise and if you haven’t checked it out, search for The Diabetes Dugout on spotify or apple podcasts or head to www.thediabetesfootballcommunity.com/the-diabetes-dugout

As the early part of 2021 turned into spring and summer, the impact of the vaccine was felt widely across the UK with life returning to something which looked a little bit more like our previous normal. This allowed myself and the teams to get back to playing. We opted to bring the UK Men’s team back together but outdoors throughout the summer to maximise the safety of the players. It proved to be really well received and the guys welcomed the sessions back with open arms. We had a number of new attendees who had found our work during the pandemic who came to experience the environment we create for the first time. The below podcast link outlines how that session played out, so make sure you go and check that out because I think it really demonstrates what it’s all about:

UK MEN’S TRAINING SESSION PODCAST EPISODE

Whilst myself, I got to make my comeback to playing competitive Futsal after the pandemic and after my post-concussion syndrome. I was back playing for Birmingham Futsal club in the National Futsal series, where for the first time in the sport’s history in England, games were being shown on TV through FreeSports and then live on BT Sports later in the year. The sport finally had the coverage it deserved, and it was great to be back doing what I do. I even got to get on the court alongside an Aston Villa legend in Stiliyan Petrov who I’d grown up watching as a teenager at Villa Park.

 

Another group which also got back playing this year was our TDFC London team. They were back on the Futsal court and just like the wider men’s team, their numbers had grown during the pandemic. Honestly, this group has given me so much pride this year with the way they’ve come together as their own community as well as how they’ve performed on the court. They’re enjoying themselves, supporting each other and they’ve even managed to feature on Channel News Asia TV too (video below)! They’re an incredible example of the TDFC ethos spreading and expanding. This hub idea is something I hope to see more growth around in 2022 and beyond as we reach more corners of the UK and beyond.

 

 

But alongside this growth in the men’s groups, we’ve seen the development of the Women’s project for the first time in TDFC history. We now have a great group of Female leaders shaping the strategy & direction of the TDFC Womens project as we head into 2022. The team now have their first date in the diary for a meet up in Worcester on March 12th (Yes right next to International Women’s Day!) to really push this and keep an eye out for the girls appearing on social media in 2022 as they look to grow the awareness of the project. We have to also thank the incredible team at HerGameToo who we partnered with to support this project and they’ve since provided us with really generous donations to help the girls get going! So, a huge thank you to everyone at HerGameToo and to Caz and Amy specifically who I’ve spoken to.  You’re doing an incredible job!

 

 

Alongside the success of creating the women’s project, I also had the chance to celebrate The People’s Award at the QIC Diabetes awards. The award was given to me as an individual but for me it’s all about the way the community came together during the pandemic to provide the guidance, moral support and positivity we all needed to get us through a challenging time whilst living with Diabetes. I’m just the fortunate one who created this idea but the voices within our project and community win awards like this, not me. Nevertheless, as a project it was wonderful to be recognised in an awards ceremony designed to celebrate the excellent care provided by healthcare professionals in the Diabetes sector, so for us it was brilliant to raise awareness of our project to more and more of the professionals up and down the country who work tirelessly to make our lives easier. Check out the result of the award below and one of the pictures… It was also pretty cool to meet the voice of Strictly Come Dancing Mr Alan Dedicoat.

 

 

https://www.qualityincare.org/diabetes/awards/results/qic_diabetes_2021_results/the_peoples_award

Awards help us with awareness, and I can’t deny that, however they’re not something I dwell on too much. I’ve always had this saying coached into me since I was as a kid “you’re only as good as your last game.” Obviously, this relates to my Football background but it’s true of life too, we’re only as good as we are right now in the moment, what we’ve achieved or done has already been written and what’s to come is now our focus. This always helps me to get me focussed on what’s next. In 2021, I’ve had a couple of great opportunities on behalf of TDFC to help position ourselves to influence “What’s next” for the overall Diabetes Community. Firstly, I was invited to become part of a steering group to help expand peer support across England with NHS England at the heart of leading it, with the vision of those of us with the condition very much helping to steer the ship. TDFC is recognised and commended widely by those in healthcare teams up and down the country, so it was really exciting for us to be invited to be involved in pathing the way for wider adoption of peer support in the healthcare structure and treatment pathways of the future for people with Diabetes. This project is just gathering momentum so keep an eye out on developments in this area in the next few months. Whilst this project has been gaining traction, I’ve also been working away with Professor Gyozo Molnar from the University of Worcester on the first academic publication related to my research on The Diabetes Football Community ( If you haven’t come across the research before check out the blog post by clicking here). We’ve now submitted our first draft to the editors and will await amendments in preparation for final submissions & publication later in 2022/ early 2023. Another important step having our community’s example being utilised within academia to inform the next generation of researchers and policy makers within the healthcare industry regarding the impact of peer support.

But as always…. We’re a long way from being finished.

To begin 2022, we have the exciting launch of The Diabetes Awareness education program for schools, aimed at kids aged between 5-11. Our hope is that this will raise awareness of the condition, whilst encouraging healthy lifestyle choices and understanding the differences between the 2 main types of diabetes. An awareness program to help make Diabetes a bigger, more understood conversation for the next generation, as we attempt to tackle the longstanding stigma and stereotypes many of us have faced over many years with the condition. It’s an exciting development and if you want to find out more or point your schools in the direction of it head to www.ajbactiveminds.co.uk

Below are some pictures from our recent trip to Everton in the community to promote the work and to talk about future links for the programme.

This isn’t our only foray into education & resources for 2022 as we’re hoping to develop further resources and CPD opportunities for those involved in football, so watch this space! Ideas will be progressing in the early part of 2022 and as always if you want to help or support us please do get in touch.

Whilst on the participation front, we’ll be delivering futsal sessions for our men’s and women’s teams in 2022 and I hope for the first time we will be doing something for a kids participation day (I’ve said this a lot but the pandemic did put pay to this idea for a while!)…. Who knows, we may even manage to participate in DiaEuro 2022 if the pandemic allows us a safe time to do so….But as always we have lots of ideas to focus on.

As usual though, we’re going for it. We don’t sit back and wait for things to happen at TDFC, we strive for positive change and that’s what will be doing in 2022. But, we can’t do this alone and these efforts aren’t always the easiest to fund or find a way to deliver, so if you could help us financially to continue to do what we do, please head to our donate page: www.thediabetesfootballcommunity.com/donate or head over to our patreon page to subscribe to exclusive content www.patreon.com/thediabetesfootballcommunity

However before I finish, I just wanted to say a huge thank you to the incredible TDFC team behind the scenes…. You all know who you are but a special mention to the man who helps keep us on the straight and narrow, my fellow podcast host, director and really good friend Jon Peach who’s made a huge difference to me in the last year since stepping onto the board. Thank you mate!

But most importantly to me, I wanted to end this blog with the views of our community… So I reached out to them on WhatsApp and I simply said to them finish this sentence:

Being part of TDFC in 2021 has been…..

“Informative, really helpful and great knowing I’m not alone. Great Football banter too.”

“An arm of support I didn’t really know I needed until times got hard. Support, guidance and laughs.”

“The most supportive and helpful tool I have used to help manage my T1D since first being diagnosed, whilst also feeling part of a special with a great bunch of lads.”

“A useful source of information and humour, at a time where both have been hard to find elsewhere.”

“A great source of comfort and knowledge in a subject that’s lacking in information in the public domain.”

“Really great and useful. Helped me through some struggles and getting to know people in the same situation.”

“A big eye opener into how good of a community we have. The support has been amazing and being a part of TDFC is something I highly recommend people get involved with.”

“Inspiring and encouraging! It’s amazing to be connected to so many people who understand what I go through every day, and all through football.”

“Like being part of a family, I’ve enjoyed bringing diabetes and football together to raise awareness and inspire others.”

“A great experience allowing me to connect with other girls within football living with type 1 whilst working on inspiring others. Can’t wait for what the next year will bring.”

“So far brief! But for the short time I’ve been part of TDFC, it has been great knowing there’s a whole group of people who share your passion and understand the difficulties of diabetes. Having that support system is incredible and I’m really looking forward to seeing what we can achieve in 2022.”

“The continuation of a fantastic support network for all things diabetes and football (could even change that to sport!)”

And their responses continue to show me why we do what we do. Happy New year everyone here’s to another year of changing the perception of Diabetes.

Chris

Back in the saddle by Tim Ward

Posted on by thediabetesfootballcommunity in diabetes, Football, sport

Guess what, it’s been a weird 18 months hasn’t it, but as the restrictions end and some form of normality returns it was great to get the message from TDFC HQ that the futsal sessions are back on and a couple of summer meet ups are in the diary. Get in!!

As many us will know (especially if you’re a parent or carer) you must wear different heads daily, nurse, best friend, coach, Darth Vader. All of which had to been worn in increasingly difficult lockdown circumstances. Having worn all of these (including the new Key stage 2 teacher head) I was driving down to Worcester for the session thinking I haven’t worn the futsal keeper/skipper one for over two years.

A light bulb moment that almost felt like imposter syndrome, as if I was stepping into someone else’s shoes. I’d felt a little like this going to the first ever meet up back in 2018 when I felt like the old guy who had come for the dads v lads’ game. Believe me that feeling disappeared almost instantly in 2018 and the same in 2021.

The reason why, it’s easy, it is the people. The strength and support of community is powerful. Something you don’t (or I didn’t at least) realise until you’re involved, meeting and listening to others, simply having a chat, a laugh or empathising with the issues they are encountering. The WhatsApp group that all who join TDFC are invited to has been fantastic in keeping in touch with everyone but meeting up with some old and new faces, getting the boots on and simply having a game, that is a life saver.

I have family down in Worcester, so we decided to make a day of the first session and catch up, so the Ward clan turned up on mass at Worcester FA HQ.

The meet up followed the usual routine the hello’s, how are you doing, nice to meet you, take the mickey out of each other and have a laugh (mostly at my lockdown barnet), yes Tob’s I know the barbers are open now but I’m going full Zlatan! 😊

There were loads of new faces and although I didn’t get to chat with everyone it was great to meet you all, apart from Bryn who megged me 3 times, you mate, can stay in Aberystwyth next session!

The presentation and discussion with Chris and Jon that opened the session was a real eye opener with the differing level of access to diabetic support across the country, be that physiological support, CGMs, pumps, and dietary & lifestyle advice offered was frighteningly varied, far from consistent and really not great to see. The tireless work Partha Kar and others are doing to remedy this is vital for people with type 1 across the country.

A special shout out to Mo Ismail, who has been an absolute legend throughout the pandemic and well ever since I’ve met him. His advice and guidance (he’s a qualified Pharmacist and T1D brother working in the NHS) on all the questions posted in the group has been a real source of inspiration and support and the recognition he received during the session is well deserved! Well done and thank you pal from us all.

After the presentation and discussion, it was down to the pitch for the futsal, but first media duties for me and Mo discussing the project with Active Herefordshire and Worcestershire, who have provided us with some great support to get back on our feet. It was great to chat about TDFC and the return to playing and training.

The training was great as usual (apart from the megs) and it’s always nice to learn as well as get chatting to Tom about Goalkeeping and his master’s Studies in the USA too!

I coach academy and grassroots football, so I am on a pitch most days of the week but being out there playing and being coached is such a release, you don’t know how much you miss it.

A nice end to the day was having my picture taken by Chris from Reaction Photography of me with Brighty and my boys all of us in TDFC kit, I think they are expecting to be on the flight to Bosnia now for the next DiaEuro.

It was great to be back to see some old and dear friends and make some new ones. I can’t wait to catch up with the rest of the lads and keep meeting new people within TDFC.

In a thousand different ways the day was a real family affair.

We are back… Diabetes Futsal Returns!

Posted on by thediabetesfootballcommunity in diabetes, Football, sport

It’s been a long time since we’ve been able to write this, but…….. WE ARE BACK! This weekend coming, we will be resuming our Men’s Diabetes Futsal sessions at the Worcestershire FA headquarters after a gap of 15 months due to the impact of the Coronavirus pandemic.

It’s been a tough break for us all. We know so many of the group took a lot from the sessions in the past and we’re hoping to bring back all of that positivity, engagement and support to our upcoming sessions. We know there’s a lot of excitement amongst the ranks from existing and new players to the project so we can’t wait to get back out there!

We will be starting back on the 27th of June with another session planned in for the 25th of July as well so if you want to get involved please do get in touch!

For us these sessions will be about re-engaging with our community, getting our squad back together to play as well as welcoming new faces to the pitch. We should have a good laugh and a lot of fun which is what it’s all about.

We must also say a big thank you to The Tackling Inequalities fund created by Sport England and put into practice by Active Herefordshire and Worcestershire. They’ve supported us with funding and support to help get us back off the ground after what has been a really challenging period during the pandemic.

It’s going to be a really exciting month for us as the sessions get back underway whilst we also continue to grow the women’s arm of the Diabetes Futsal squads…. However, ahead of this first session we thought we’d invite one of the newest members of the community, who will be attending his first session this weekend, to describe how he’s feeling ahead of Sunday…. Over to you Bryn:

“I’m really excited to be finally meeting up with the lads from TDFC. Ever since I watched Chris’ story I just knew it was something I would love to be Involved in. So to be invited to training with them is really special.

I was so inspired by the work of TDFC I even held an active fundraiser for the charity through my sports coaching business ‘BMO Coaching’ – we managed to raise £377.50 for TDFC and £900 in total, which we shared with other local charities.

Living in the Welsh coastal town of Aberystwyth, I have only met a total of two T1D players that are still playing senior football so It’s going to be a fantastic experience playing / meeting with other T1 diabetics in a football environment.

I’m passionate about raising awareness and passing on knowledge about diabetes, especially throughout my area of Wales. I’ve been playing football with T1D for 20 years and I’m keen to show people that it doesn’t stop me from playing sport and doing the things I love.

The lads have been really welcoming on the group chat so I’m looking forward to a session with them to break the ice. “

Thanks for sharing your thoughts Bryn and isn’t it great to be back!

TDFC

The Impact of Stigma on Identity Formation within a Diabetes Football Community… A Research Project

Posted on by thediabetesfootballcommunity in diabetes research

For the last 3 and a half years The Diabetes Football Community has been doing its best to be a leader of peer support for sporty people with Diabetes and those specifically with a passion for Football….. As we’ve seen growth, an increase in engagement and increase in awareness there has been widespread acceptance that there is a need for this group to come together, to provide help for a population of people who felt under-supported before TDFC arrived. However, a big question loomed for me from the off…. Why has it taken until now for this group of people to feel supported? And why has the community continued to develop?

In the pursuit of these answers I decided I needed to expand my knowledge and investigate the issue. So, just under 3 years ago I took the decision to study for a master’s degree in Socio Cultural Studies of Sport and Exercise. By choosing this particular path it allowed me to create my own research project which followed the degree’s subject, but in a field I was passionate about. This gave me the opportunity to search for the answers in the hope that I could glean insight which may help alter the narrative that people with type 1 Diabetes have been up against in Football throughout my entire life.

So, I’m really delighted to say that I’ve now completed my degree and am awaiting the final results. It’s been an incredible 3 year journey which has taught me a lot, but in this blog post I want to give a bit of background and discuss some of the reasons why I feel it’s a hugely important step for the community, as well as the concepts and findings which have been presented within the conclusions of the study.

The Why?…

I wanted to provide academic foundations for why this incredible community continues to grow, support and enhance the lives of those who are involved. Academic research remains at the forefront of change globally and I felt this was the right way to try to influence leaders across the globe, into considering how the narrative for Diabetes care should not be completely focussed upon medical enhancements and technology, in improving the lives of those with T1D.

The How?…

The research I conducted involved analysing some of the online content of blog posts, Facebook posts and tweets as well as interviewing several type 1 members of the community who had volunteered their time to support with the project. This allowed me to collect a substantial amount of data to analyse and compare with previously written academic literature.

What was found…

So, the really important bit…. What were the findings? What did the analysis show about our community and how stigma impacts on members of our Diabetes football Community living with Type 1.

Well… there’s plenty to choose from.

As most people would expect stigma towards Diabetes was shown again to impact the lives of those interviewed, whilst also driving the success of particular online content, as posts which were uplifting, dispelled stigma and provided education against it, were all highly viewed and extremely important to community.

I don’t think that would come to the surprise of many involved in TDFC, however the strong feelings of discontent surrounding type 2 related stigma imposed upon those living with type 1 was an area which I was a little surprised by. The feelings demonstrated were strong and it may have something to do with the particular field the study was focussed in, Football. With Football an unforgiving sport, where weakness is often exploited and ostracised you can potentially see why some of the participants felt strongly towards a stigma bestowed upon them which doesn’t actually represent what they live with. Yet, in their eyes it affects how they could go about their business on a Football pitch or Futsal court.

But it’s there on that very Football pitch or Futsal court where one of the most surprising findings from the study really comes to fruition…

As I’ve already mentioned, the show no weakness culture, masculinity and macho approach that’s embedded in Football really pushes players to hide anything that could be perceived as a weakness by fans, players, coaches or the media. This is why for example there’s not a single player in any professional Football league in England who has come out as gay for example… It’s a perceived weakness which goes against the image of masculinity and strength within the sport so therefore must be hidden. In all other parts of society that stigma is beginning to break but in Sport it still remains, and I believe that it forms the basis of why those in our community, who strongly identify themselves as a footballer, hide the fact they live with T1D. In using secrecy as a coping mechanism for avoiding stigma, academic research has demonstrated that this may increase the likelihood of poorer self-management and thus health outcomes. This is a highly significant finding because for the first time I’m suggesting, with support from the research, that the culture of the sport I’ve grown up with may have a detrimental impact on my health, as a result of the culture within Football, which depicts difference as weakness and ultimately attaches it with negative stigma.

So, with greater identification towards football, you’re more likely to hide your condition, and in hiding your condition you’re less likely to do the right things to self-manage it. With this academically evidenced throughout this study it’s a finding which really needs much more investigation to test its transferability. Nonetheless, when I consider my own experience as young person growing up with the condition, this finding resonates very closely to my experience. I love the sport I’ve played but I now question the impact that it’s had on my mental health, choices and behaviours.

However, there are also questions that stem from this which could really open the door for some interesting exploration. For example, is this just as a result of the Football culture, a team sport surrounded by mainstream players, traditionally with a working class – middle class background? Does it differ with other team sports such as Cricket or Rugby, where the tradition of the game may encourage a different culture and demographic background? Could we also consider a difference between Men’s Football and Women’s Football? Is there a cultural difference between the genders?

But then what about individual sports? Is this an issue which disappears or lessens in individual sports because there isn’t the need to hide from teammates, coaches, referees and opposition players what you need to go through to get out and play? Would we see a different view from a T1D Tennis player, Golfer, Badminton player, runner or cyclist etc?

Although the evidence of the study suggests a significant challenge for those with T1D accessing a sporting culture where weakness is shunned, I do think we’ve seen an opportunity in the findings to help alleviate some of that strain. It’s not all bad news!

This mechanic we’ve created through TDFC has helped to bridge the gap in identification for this population. Building identity with diabetes is important, it helps psychologically, socially and with the eventual medical outcomes for the condition. The research is out there evidencing this but in what we’ve created we’ve potentially helped people identify with T1D who otherwise may not have done. Those people have been so keen to keep it secret because of their life’s interests and passion in Football specifically, that actually by linking their passion to the condition we might have helped gain their attention enough to identify themselves with T1D, seek out others with their condition and ultimately receive help which betters their self-management.

Combining this with the use of Social Media as our prominent tool for communication actually increases this likelihood too. Through Social Media you can view content, see what people are up to and get support from posts without anyone else knowing you’re looking. This ability to temporarily and intermittently identify with T1D is something I would guess has happened a lot. In these moments the individual can see the benefits they may get from associating with the community, talking to others who share their passion within it and begin to develop their identity with the condition that in the long run, I certainly believe and so does the academic literature, will impact positively on self-management.

It’s no secret the positive impact that peer support has for people with T1D, this has been evidenced for years with strong support for it in this study too. However, if you have no inclination to seek out others, or no reason to identify with your condition because your favourite thing in life actively tells you not to, how on earth would you find it? You wouldn’t. So, this study really for the first time suggests we need to create a positive affiliation to draw people to their condition and break down some of the stigma for those who find it hard to identify with T1D. Without that, peer support is not able to cut through to those who may need it the most. It has a hugely significant impact on people who partake in this kind of support but why isn’t everyone doing it if that’s the case? I think this is an area and idea which may help to uncover some of that why….

Peer support is an incredible tool that buffers against stigma but another area that comes through strongly in the study is the idea that personal experiences in life and of stigma are a key driver in identification with T1D. I think for this population of people they are more likely to experience stigma as a result of their decision to put themselves in an environment where their condition is far from embraced, actually actively shunned. Only 2 weeks ago did I experience a pretty obvious stigma related slur, and in the last year I’ve experienced stigma on 3 different occasions all of which were related to Football/ Futsal. I don’t think it’s a coincidence.

This population struggles to come to terms with their condition in the face of it. Which is why TDFC has grown, expanded and continues to do the good it does. Because it tackles and dispels stigma whilst providing a positive view of our condition, which for the first time in our lives is celebrated rather than shunned. THIS is why TDFC has been successful. I knew the reasons deep down but now I’ve taken the time to research it and understand it from a social and cultural perspective, I believe my view of our direction is far clearer for the future, whilst I really hope it can help to influence decision makers within Diabetes care to look at niche populations in greater detail, and more importantly on the impact of stigma on self-management. I’d like to appeal to the Diabetes academic community to really consider this area in the future…. The below link shows a recent poll I ran to get a feel for how it’s affecting behaviour/choices and I think the results speak for themselves:

https://twitter.com/chrisbrighty1/status/1295416282695770116?s=21

With only really the Australian Centre for Behavioural Research in Diabetes (ACBRD) focussing in on this area globally, it needs more. I might add they’re doing a fantastic job with it and a number of their papers heavily influenced my thinking, but they can’t be the only institution driving this.

Evidenced in my study and on the TDFC website is the impact the community has had on altering behaviour positively. We’ve achieved identification with T1D for the first time in this population. Which I firmly believe has resulted in an upturn in the psychological and Hba1c measures that have been achieved within this population. This wasn’t achieved through the traditional models of care provided by Doctors and Nurses but through a new innovation which championed a new way of looking at the condition. Now this is not to diminish the contribution of our incredible Diabetes teams but rather to say, there’s more we can achieve, if we work closer together.

The overall outcomes of a condition determined by self-management is far more holistic than looking only to the medical professionals who support us for the answers. Sometimes, the answers come from ourselves, our choices and our behaviours…. Which may have been influenced.

I hope the blog gives some real insight into what I’ve been working away on in the background to try to drive change for our community as well as raising awareness of why TDFC is a special project.

Throughout all of this it’s important to know that TDFC stands right there beside our NHS and healthcare workers across the globe in trying to make life easier for people with Diabetes. We couldn’t do it without you and I hope we can help you more greatly in the future.

I must say a huge thank you to those who have shared the last 3 years of my journey and the research, projects and teams I’ve been a part of at the University of Worcester. Whilst I can’t forget the contribution of both the University itself and my supervisor Dr. Gyozo Molnar. Without their support it would not have been possible.

If anyone would like to discuss the study with me, its findings or any future collaborations with TDFC please do get in touch via email:

thediabetesfootballcommunity@gmail.com

Thanks for reading,

Chris

Jon Rosser: My life with Type 1 Diabetes

Posted on by thediabetesfootballcommunity in diabetes, Football, sport

I’m Jon Rosser, 27 years old from Bristol and have been a type 1 diabetic for 17 years. Being involved with TDFC has enabled me to link up with other diabetics of varying ages and share our experiences, however this is often very focussed on the present – what we are currently doing, learning or going through. Reading these blogs, I found gaining an insight into these people’s pasts and hearing of their journey has been really enlightening and valuable, even for someone who has already learned to an extent how to live with the condition. So the obvious next step was to try and somehow put down my story outlining the changes it has made to my life and the lessons I’ve learned in the hope that others can take something from it like I have done. So here goes…

My journey starts with diagnosis at the age of 10 and the very familiar story of the tell tale signs. I was always thirsty! I didn’t really notice this symptom but my dad whose late mother was a Type 1 noticed I was increasingly up and down to the kitchen tap, filling up pint glasses of water and knocking them back like no tomorrow. As a result of this I was back and forth to the toilet and it didn’t take long for him to step in. Looking back at it now I suppose I was quite fortunate that my dad noticed this going on and intervened pretty early as I can’t actually remember feeling too bad! He made me do a urine sample and booked me into the doctors. A quick ketone test and finger prick confirmed what my dad had feared and arrangements were made for me to forget about going back to school, pack a bag and get to the hospital. Being a 10 year old I can remember feeling a bit oblivious to what was actually going on, but I knew that something had ultimately shifted by the way my dad had reacted, he seemed gutted and spoke to me about how we were going to go about telling my mum when we got home. I had never even heard of diabetes and was still completely naive about what was to come. 

A few hours later I was at Southmead Hospital being admitted into the children’s ward. A flurry of nurses were showing me my bed, where the toilets were, where the common room was, a full on tour of the facilities and this was the point where I kind of started to realise that I was here to stay for a while and this whole situation was going to be the start of something that was going to change my life forever. I was on this ward for 5 days and during this time I had to learn the skills that would ultimately keep me alive. One event that sticks in my mind from this period was when a 16 year old boy got rushed into the booth next to me. Other kids on the ward were all chatting to their neighbours so I welcomed a new face to hopefully ease the boredom. However on admission his curtains were shut and I remember feeling that the nurses were actively discouraging me from trying to say hello, and no sooner had he arrived he was gone again. I didn’t find out until years later that this guy was also a diabetic and had not woken up one morning due to having a serious hypo during the night. Looking back now I realise it was the right call not to let a newly diagnosed 10 year old get wind of this! The ward had a classroom where I spent a few hours a day which was nice as it got me out of my bed, but I remember being pulled out at regular intervals to be finger pricked and stuck with syringes and this was another point where I started to realise this was going to be the new normal from now on, and I didn’t like it one bit. How was this going to work at my own school? What about at football? I was bang into scouts at this age so how will I go on the camps? Can I even still do all these things? The answer of course was yes, but the anxiety and worry about all of this was something I will always remember. 

Fast forward a bit and I’d settled into my new routines, teachers and coaches had all been really engaged in making things as easy as possible for me. But it wasn’t all plain sailing by any means. I was initially put on the 2 injections a day regime and it wasn’t long before I felt frustrated at the restrictions of this, especially when transitioning to secondary school. Having to inject my insulin at the same time morning and evening, and knowing I HAD to also eat at these times each day meant things such as after school sports fixtures, clubs, and even just hanging out with friends would all have to be arranged around my insulin and meals. It took so much planning and at times I found it exhausting and stressful. 

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I want to shift the focus largely on how I’ve dealt with my diabetes within football and sport and I guess I’ve never let it stop me, but there have been times when I felt it has hindered me. At the age of 15 I joined Forest Green Rovers from just previously playing local junior football, and the training stepped up which was great! But it was a much more competitive environment and although to a certain extent I had always tried to keep my condition under wraps (which seems to be a common theme from guys writing these blogs), in this environment I found myself doing this even more. I didn’t want to show any weakness and felt an obligation to keep up with the standards being set, often not recognising that in order to do this I needed to take time out of sessions to take on sugar or test my levels. Occasionally this led me to playing on through hypos and my standards suffered as a result. Sometimes coaches and players would confuse my hypo reactions with being lazy or uninterested, and I found trying to explain what was actually going on sounded like excuses. The fact I was still on the 2 injections a day meant that I would get home from school, have to hastily eat a carby meal (to avoid going low during training) before heading straight off to train on a full stomach which personally my body did not deal well with – I’d feel heavy and slow. It was the same with the games – we played in a floodlit league so fixtures would be midweek evenings so my preparations would never be ideal. These pressures ultimately led me to change onto the basal bolus regime and immediately after I did that I saw the benefits, not just with my football but with my day to day life. The flexibility was something I’d been longing for and I continued to play for 2 more successful seasons at Forest Green, winning individual awards at presentations and I remember feeling really proud and realising at this point that I had gotten the upper hand on my diabetes and vowed to never let it beat me.

Another event that always sticks out to me as a time where I felt I overcame the urge to keep quiet and let my diabetes win was in a tennis tournament when I was about 17. Over the course of about 6 weeks I had played a match every week and got through to the final without any diabetes related issues. In this final however I struggled from the start. There were a fair few people watching and I was putting my performance down to nerves and threw away the first set in record time. On the switch around I asked the umpire for 10 minutes just to check my sugars which for me at the time took a lot of courage, I was 3.1. I remember sitting there in front of the crowd openly testing my sugars and taking on food which is something at that age I always felt really self conscious doing. My opponent was getting restless as were his supporters watching on but I stabilised my levels and got back out there… I smashed him in the next 2 sets to win the tournament. Like I said this was a real moment of realisation that I could achieve things in sport regardless of having this condition and getting dealt hypos, and it gave me confidence to keep aiming high. 

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The next major milestone for me was gaining a place at Plymouth University. Leaving the family home to move to a new city with new people, new surroundings and new routines was pretty daunting, and when you throw diabetes into the mix it was quite a challenge. I was having to shop and cook for myself and it took a while for me to get used to having full responsibility for what I put into my body in order to maintain good control of my condition. Students’ diets are notoriously not the best so resisting the urge to follow examples of quick, convenient, often high sugar and high carb meals set by my new found friends was important and something I’m glad I focussed on, as it set me up well to continue to control my diabetes successfully. I quickly got involved with the Uni football club and was playing regularly, although the routines and rituals of a university football club were much different to what I was used to. One thing I struggled with was the fact that if we’d win on a Wednesday afternoon (and often even when we lost!) after the game it was shirt and tie and straight to the bars. A lot of these guys wouldn’t take time out to eat post match, and especially after a good win, wouldn’t go home until the next morning. Being diabetic, I felt a bit of a kill joy having to temporarily leave a buzzing group of lads for a few hours to go and get some food of substance and make sure I recovered well in terms of glucose levels, especially when there was alcohol involved! This was a small price to pay though as I found if I put my diabetes first, I would have a much better time celebrating later on knowing I’d done what I needed to do in order for my sugars to behave (as well as they could) during a night out in Plymouth’s finest establishments. These were some of my best times playing football, the social side of the club was immense and winning a varsity and a cup in my 3 years at Plymouth are things I remember for the achievements and not how my diabetes hindered me!

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The most recent landmark in my footballing life has most definitely been getting involved with TDFC. I remember turning up to the first session and experiencing an environment where everyone there would openly discuss the condition, openly test their sugars and inject insulin, there was an underlying bond straight away. I had been so used to dealing with diabetes in a changing room and on a pitch on my own – it was solely my problem, and to feel that problem shared by everyone else there was so refreshing. No feeling guilty for taking time out to test sugars, no strange looks for sticking a needle in my arm, just a feeling of understanding and support. I have played in both DiaEuro tournaments that the UK team has entered in Bratislava and Kiev, and both times were amazing experiences. Playing against some top nations and top players gives you that drive to improve and I feel since being introduced to Futsal (which I had never played before TDFC) I have learned and improved my game as well as my control of my diabetes. I have also found myself transitioning skills I’ve learnt from Futsal into my 11-a-side game which is great! I’ve also found my Saturday team mates have taken a real interest in what I’ve been involved with regarding TDFC, seeing it on my social media and things like that. One of the lads has even adopted a pre match ritual of eating glucose tablets with me before kick off and now swears by it! 

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So that’s my story (so far!) of my life, football and sport with type 1 diabetes. My message to anyone maybe struggling to adapt to life and sport with diabetes is not to hide it, be open and honest about the problems you may encounter, it’s not a weakness! Although it presents challenges I feel diabetes has made me stronger in many ways, especially with discipline and will power… so keep at it!

Thanks all!

Jon

Instagram: @rossergram