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

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.

 

The 2022 Review – What’s been going on at TDFC?

It’s been a little while since I’ve found the time to sit and reflect on all things TDFC but the end of a calendar year always presents me with that opportunity… But as we do in every year since our existence, we’ve tried our best in 2022 to provide a project that is progressive and a reflection of what the diabetes community want. We’ve had some amazing things going on this year and I just want to say a massive thank you to those who help lead on everything at TDFC and to those who commit to what we do and make all of this possible! It continues to motivate me to keep pushing the boundaries and to strive for more for our community.

There have been some significant changes in my own circumstances which have meant this year we’ve also transitioned to a situation where I’ve been a little less hands on with the day to day running of our project due to my new full time role working at JDRF UK. The prospect of working for the charity has been an amazing chance for me to continue my development more widely and learn more about the UK and global context that exists surrounding type 1 diabetes. I’ve really enjoyed it and the impact my role in the organisation has on supporting the community… Here’s hoping for more of the same in 2023! Despite the change in my world, the support for what TDFC does has never been greater as so many people recognise the importance of our work and are really stepping up to help myself and the directors with continuing to push what we do onto the next level. Together we are stronger and so is TDFC.

With this review of our year, I obviously wanted to run through some of the key things which have been happening in 2022 but this time round I’m going to do it in alignment with our strategic pillars of Educational improvements and increasing participation opportunities for people with Diabetes in Football.

So firstly, a look back on the developments we’ve made in Education in 2022:

The continuation of our podcast has led to some incredible episodes on the channel as we saw Adam Smith and Reece Parkinson share their stories of living with type 1 and working in the media industry. Whilst we also added a chat with Joe Wright (Current Millwall FC Goalkeeper) as he discussed life with type 1 as a professional player… We also got Lucy Wieland on the podcast to talk about something else I’ll come onto in a little while… (Can’t give all the key details away in the first few paragraphs haha!). The Diabetes Dugout still remains a great source of stories, information and support from those in our community, so if you haven’t checked it out yet click here and you can listen to all of the episodes we’ve released so far.

Alongside those all-important lived experience stories we’ve shared, we’ve also been able to help create a structured education programme called Active Minds in partnership with our friends at AJB Sports in Education. The idea was to utilise physical activity to educate on the differences between type 1 and 2 diabetes, as well as to educate on lifestyle to prevent the development of type 2 diabetes. In my opinion, educating the next generation on the condition will in future reduce the level of misinformation, stigma and stereotypes which are prevalent in society surrounding Diabetes. It’s been something that I’ve experienced regularly since I was diagnosed in 1999 and it’s an area which I’m extremely passionate about tackling… Education will make this happen, but it takes time to implement and there has to be a “carrot” for the mainstream to engage them in the conversation of raising awareness and learning more about Diabetes. As numbers rise and people see the condition more regularly day to day, many more people are receptive to the idea that society at large needs to know more about this condition… I think there will be many more developments like this in years to come and I’m really glad we’ve been able to co-produce a series of lessons to support with this education… Make sure you head over to our page to check out the Active Minds programme.

This year also saw the development of a piece of work I’ve been trying to create for over 4 years… To see it land was a big moment and something which I hope will help so many people across our community in the years to come. I am of course talking about the Coaches Guideline & Webinar co-produced by ourselves, JDRF UK, Diabetes UK and The Football Association of Wales (FAW). I’ve always felt that the organisers & coaches of our sport, haven’t had the support to help them with creating an environment and support system around a type 1 player as the condition hasn’t been well understood. So, to now have a guideline which coaches can utilise to help with the foundations of what a player with Diabetes goes through can only be a huge step forward. To have this supported by the 2 big patient charities and the FAW is also vital in seeing this rolled out more widely to the sporting community. More awareness and education for physical activity providers can only help with participation and the feeling of comfort in a sporting environment for those with the condition… A massive moment and if you haven’t seen these resources yet click here and take a look!

Then we’ve also seen the foundations laid for the inclusion of Peer Support as part of the recognised treatment pathway for those living with Type 1 Diabetes within the NHS in England… A monumental step in chronic health support and a move that we at TDFC have been championing for a long while. I was invited to be involved in the group of people who have helped shape the principles of Peer Support in conjunction with the NHS England team and the patient charities (Diabetes UK & JDRF UK). The process of shaping “what good looks like” collaboratively has taken just over a year and it’s been brilliant to see the release of those principles on World Diabetes Day… As someone who’s personally seen the impact of peer support changing my own life, and others through our work, this is a HUGE moment. It’s been my belief for the last few years that good peer support deserves its place within the healthcare structure for the contribution it can make to health outcomes for those with type 1 diabetes. I’m now excited to see where these principles will take us as we now focus on the delivery and growth of peer support… Keep your eyes peeled for more from the NHS Diabetes Programme and if you haven’t checked out the principles yet take a look here

To build on this further, the research conducted into the development and creation of The Diabetes Football Community will be included within an academic publication for the first time in the early part of 2023. This was always a huge goal of mine following the conclusion of my masters degree programme in 2020. I wanted to ensure the lessons I’d learned from developing our project could go onto help us and others in continuing to develop projects/communities/groups which are reflective of how society and a sub-cultures like sport (football in this case!) operate. I feel the key to creating positives connections to the condition lies in the link to the areas of interest we have within our lives, to positively re-frame some of the identification with the condition. By doing this, identification with the condition may grow and healthcare outcomes improved as a result… It’s a topic of conversation I’m hoping the research opens up further, as we look to see how we can supplement the development of diabetes technological advancements, with further understanding upon the impact that society & culture has on those living with the condition. I’m sure there will be lots more to come in this area, and if you’d like to see the book where the research will be published, please click here whilst you can also check out the blog post I wrote on the research here . A big shout out to Professor Gyozo Molnar who has played a huge role in guiding all of the work on this research!

So, from an education perspective this year we’ve been pretty busy… But we weren’t done there! Our participation work has also been progressing…

Participation:

Because for the first time since we were created in 2017, we’ve been able to host an all-women’s training day, in the same year that the England National Women’s team won the European championships! 2022 has been a huge year for us and for Women’s football in the UK. In making this team we’ve also been able to link in with the incredible HerGameToo campaign to help us champion women’s participation in our sport. It was brilliant to welcome Caz May, one of the founders to a session to meet the team, as they continue to provide support for what we do. A huge thank you for the donations you’ve provided, which have helped us in developing the sessions and funding our first kit! As you’ll see from the images, alongside our new women’s kit, we’ve got an updated Men’s kit supported by Air Liquide, which we hope, will be worn at DiaEuro 2023 (The European Futsal Championships for people with Diabetes)… It’s looking likely that this will take place in Poland in June and we’re busy planning behind the scenes to try and get a UK team back in the tournament for the first time in 4 years! I also want to shout out our friends in Ukraine, who hosted us and the tournament in 2019, who have been going through an unthinkable year with the Russian invasion of their nation. My thoughts are with you all!

Whilst our teams are a great opportunity to represent country and condition, they’re also an incredible opportunity to raise awareness of type 1 diabetes more widely in society… We take that on as one of the primary objectives of the team, alongside the support it offers the players, so to have BBC MOTDX attend a session to showcase T1D in Football was incredible! If you haven’t seen the feature yet, please do check it out here , in what was a great day for our men’s and women’s team. Awareness in mainstream TV makes a big difference to us all when it’s accurately portrayed, and with having Reece involved it gave Football a real insight into what our lives look like when tackling the sport whilst living with T1D.

 

 

 

 

 

 

 

 

The magic of what makes our community great has also been recognised in 2022 with our TDFC London team awarded with a QIC (quality in care) award for all of their amazing work across this year. It’s thoroughly deserved, and the team continues to go from strength to strength as they grow their numbers and look to win another league title in 2022, after winning one of the London Futsal League North iterations previously! They’re a brilliant group and I’d urge anyone in the south east/London to get in contact with them to find out more about what they’re up to…

Not only do these teams serve a purpose on the court but away from it as well… Because most of the players within them have originally come through one of our peer support WhatsApp groups to help continue the discussions and support in football surrounding T1D after the full-time whistle sounds too… We now have a WhatsApp group for men, women and we’ve recently introduced one for parents of children living with Diabetes. As with the men’s and women’s groups, we now hope we can take the support online into a physical session and team in the future for kids with type 1. We’ve had discussions about this within the group and keep a look out on our social media for any developments coming in 2023… We’re excited about this!

Sooooo, what a year it’s been! We’ve faced changes, we’ve adapted, and we’ve grown. Our community is special. It’s coming up to 6 years since TDFC started and as the community’s founder it always amazes me what we’re able to achieve collectively… It’s an honour to still be doing this and while the need is still there for us, I’ll be there helping to push what we do forward…

Thank you so much for taking the time to read my musings and for all of the support this year, I hope you’ve enjoyed a great festive period with families and friends, and I wish you an amazing 2023…

We will be there with you, when you need us…

Happy New Year!

Chris Bright

Founder of The Diabetes Football Community

 

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

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.

Diagnosed at 34 and trying to adapt to Football again…

It’s been a little while since we shared a blog on the website, so we thought it was a great opportunity to share the story of one of our newest members to the community… Thank you Tom for sharing what you went through upon diagnosis and we hope that your story will provide comfort and support to those who may face this in the future… No more words from us, over to you Tom to talk us through what happened.

“Football was the first sign

The last game of the 2021/2022 season was a mid-week evening fixture on the 20th April, away in a small village outside of Lincoln. A very scratchy 11 players were put together with a couple of late stragglers turning up to fill the subs bench after work and family commitments… Sunday league football in England at it’s finest. Playing at centre half, the dream of being a marauding midfielder has long been forgotten since turning 30! After around 70 minutes something happened which I had never experienced in my whole-time playing football, as I had excruciating pain in both of my calves as they cramped up. At the time, through lack of awareness and a large chunk of denial about my own health, I convinced myself that age had finally caught up with me and I wasn’t as fit as I once was! I struggled on for 10 more minutes before giving up and giving the gaffer the dreaded arm roll signal above the head to indicate I needed to come off. To add to the dismay of being subbed off, we managed to throw away a two-goal lead and concede two late goals to draw the game and consign ourselves to rock bottom of the 1st division after a long tough season! Unfortunately, our collective lack of footballing ability wasn’t the only thing to become apparent after this game.

Diagnosis

My ‘diaversary’, as I have often affectionately seen it referred to on social media, is 18th May 2022. The usual sore muscles and cramping up in the night after a football game occurred, which I attributed to dehydration from the game that evening. I also attributed my constant thirst and then spending most of the night getting up to go to the toilet to this! I felt could explain all these things with a plausible causality to feelings after a tough game so thought nothing more of it. I carried on my usual daily routine after this, a little bit tired and run down, still thirsty and still weeing a lot! I was a teacher, and we were coming to the end of a school year, and I told myself I must be ready for a break and ploughed on through, although the symptoms never went away. I always tell people never to google your symptoms, but you never follow your own advice and one word kept coming up whenever I put them into the NHS website……. DIABETES. I was 34, fit, healthy, a good weight, no family history anywhere of Diabetes, I was sure it wouldn’t be that. I couldn’t deny that I wasn’t well for much longer and finally succumbed to pressure from my partner to book a doctor’s appointment. Casually dropping off a urine sample and having some bloods taken at the doctors before setting off on my way to work. I received a phone call about an hour later containing lots of words such as: ‘DKA’, ‘Diabetes’ and ‘A&E’. Within an hour I was sat in A&E on a drip with more bloods being taken, more meetings with doctors and no more idea what was going on! A very long and scary night at home alone followed this and a phone call from the doctor in the morning confirming Diabetes and directing me straight to Clinic 1 at the hospital. I was greeted by Diabetes Specialist Nurse and walked out an hour later with a blood glucose monitor, 2 pens of insulin and a lot of leaflets. I had never felt more overwhelmed in my life!

Getting back to football

I am never ashamed to admit I cried for most of that evening. The gravity of what a lifetime of diabetes means really is something which is quite incomprehensible at times. I was convinced footballing life was over and I was going to be confined to a life of golf! I had no idea how playing sport whilst managing diabetes worked and it was one of my first questions in my follow-up with my diabetes nurse the next week. As always seems to be the way with diabetes, it could not have been anymore inconvenient, with a house move and job move all scheduled for June! It did however afford me a summer break to get my head around living with diabetes and my body’s responses to exercise. My first experience of getting back into sport was an attempted cricket game in early June. As could be expected this went terribly and after having a very sweaty, dizzy and shaky moment whilst batting, I spent most of our turn to field eating a banana and various sweets from my pocket – there was a lot to learn! I was luckily given a libre 2 sensor around 3 weeks after diagnosis and this made the start of preseason in late June a lot more successful. I’m sure I did over 30 scans in my first session! I turned up armed with chocolate bars for some sugar beforehand, enough Haribo for a kid’s party and more water than any one person would ever need. At any opportunity I would nip off to tap my arm with my phone and check my levels. After a 90-minute session with some highs and lows it was overall a positive result. Maybe this wasn’t the end of the road for me after all! I managed to negotiate most of pre-season training and matches without too many wobbles, although the heat nearly did me a couple of times if it wasn’t the diabetes. However, after every session, there was always advice and support to fall back on from the TDFC community if things had gone wrong with people always happy to answer any questions or offer advice.

TDFC

I stumbled across Chris whilst searching out other people with Diabetes on twitter, looking for insight, inspiration, advice and general empathy from people going through something similar to me. I found the TDFC twitter page and dropped it a message before carrying on my mindless scrolling and forgetting all about it. The next day I got a reply from Chris and before long he had introduced me to the TDFC community and added me to the WhatsApp group. To find a place where people had experienced the same thing or going through similar situations was a comfort and motivator. Being able to ask questions and get answers from people all over the country and beyond was brilliant. Not just on football topics but every life experience with diabetes you can think of! I am yet to make a TDFC training session and join in a kick about but look forward to hopefully making one and sharing synchronised glucose checking and hypo snacks!

From speaking to others about diabetes I realise that it is a marathon not a sprint and no one ever truly masters it. You are thrown in at the deep end on day one and must quickly adapt to the basics but with the pace at which things are moving with diabetes and technology there is so much more to learn. I recently listened to a discussion on Twitter speaking about exercise and my mind was blown listening to people talk about open and closed loop systems, basal rates, adjustments and insulin sensitivity. I’m sure it will all make sense to me one day and I am not the only newly diagnosed diabetic trying to make sense of it all.

Today

Game one of the season has just gone without a hitch (a boring 0-0 draw) and 90 minutes at centre half was successfully negotiated. This is thanks to some of the advice and routines I have put in place with advice from the TDFC group chat and the post which Chris had done on the TDFC website which helped a lot. I’ve managed to keep my sensor on which I thought would never happen and have had great support from my teammates! I’m hoping I have a few years left in me yet……”

 

Thank you for sharing your story so openly Tom and If you’ve enjoyed reading this blog and want to share your own story with us please do get in contact with us…

DiaEuro 2019: UK Player Perspective (Jon Peach)

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

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

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

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

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

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

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

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

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

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

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

Our Journey with Type 1 and Football…

Another amazing story to share with the community brought to you by Karen Brown, the mother of Ellen, a young type 1 who’s having a fantastic time with her Football/Futsal at the moment. Ellen & Karen have been big advocates and supporters of our work at TDFC from the very early days so it’s brilliant to be able to share their story! No more words needed from us, over to you Karen…

“Our daughter Ellen was diagnosed at age 8 with type 1 diabetes. As you all know it hits like a bomb and the early days are hard. Somewhere amongst the haze of diagnosis we made a decision that when we got Ellen home we would stabilise her doing all of the sport she usually did. So the day after discharge we took her to school for a few hours and the following Monday she started back swimming. I sat on the edge of the pool chewing my nails hoping she would be fine. Strangely enough the year she was diagnosed is the only year she hasn’t played football (played 1 year of netball and hated it!). Ellen prefers to manage her diabetes with a pump (Medtronic) and we use CGM periodically.

Since then it has been buckets of football and within the last 4 years she has also played futsal in the off-season. It is amazing how different the two are to manage. Football often sends her low- particularly in the cold Canberra winters (we live in Australia) whereas futsal sends her high due to the adrenaline. As futsal isn’t as big in Canberra her futsal club (Boomerangs FS) travel to Sydney to play in a Sydney comp. So every Sydney game we travel between 2 ½ to 4 hours each way (depending on what side of Sydney the game is) to play. The weather in Canberra is quite dry whereas Sydney can be humid which can affect Ellen’s BGLs (sends her low) so at the half way stop en route to the game we reduce insulin if she has any carbs and put a reduced temp basal on. We find doing low carb on the morning prior to the Sydney trips much easier to manage. At least we are only fixing the humidity problem. Then during the games she heads high! Sydney games we nearly always use CGM to help keep an eye on things. If it’s a home game its breakfast as usual. After the game she eats what she wants.

Ellen Brown Picture 3

Whilst having diabetes can be tough when you are playing football and futsal, we run at it with the attitude that if we have a tough day diabetes wise we look at why and see if we can do something different. There are days when you just can’t explain why the numbers are what they are! All of her coaches and teams have been really supportive and the boys often try and guess her Blood Glucose Level – she plays in the Boys National Premier League. Ellen also chooses to celebrate her ‘diaversary’, so the team usually hangs out for the cupcakes she takes along to celebrate another year kicking the butt of diabetes.

Having diabetes hasn’t stopped Ellen from achieving in soccer and futsal. The last 12 months have been particularly rewarding!!! 12 months ago her girls futsal team won both the premiership and championship in the Sydney comp. For outdoor her BBFC U16’s team made the Grand Final and won in a penalty shootout. She then made the ACT team (regional team) to play futsal at Nationals in January – they were runners up in the Grand Final in a penalty shootout. And a couple of weeks ago at the presentation night for Boomerangs FS, Ellen was awarded female player of the year. We are pretty proud of her. Winning isn’t everything but it is great to get some wins and they have been a while coming!! Though I must say the victories are much sweeter after the effort you put in to get the diabetes right. (excuse the pun!)

Ellen Brown Picture 1

As much as it is a challenge, there have been lots of good things about having diabetes in our lives for the last 8 years. We have made a whole new bunch of friends we wouldn’t have otherwise met. Whilst it is so nice being able to converse with those who understand the challenges and learn new things from. Ellen has had the opportunity to speak at JDRF fundraisers and she was recently asked to take part in some research at ANU.

Being part of TDFC has been a huge help though. It was so nice to hear from others who play football and be able to read about their experiences. With Ellen being a girl it was so nice to read about Noel and what she has achieved. We got to meet Zac (UK DiaEuro Player) at one of Ellen’s games in Sydney and hope to see him again soon. Whilst it’s also great to see that Chris represented his country in Futsal, which gives Ellen so much hope she can achieve the same.

Ellen Brown Picture 4

To any young footballer out there, chase your dreams. Ellen’s favourite saying is “I don’t live with diabetes, diabetes lives with me”.”

 

A really great blog written by Karen Brown and a huge thank you from us for putting it together. If there’s anyone out there reading this who’d like to contribute in a similar way get in touch! We’re always on the look out for blogs and stories to share…

It’s much more than just Football or Futsal… Part 4 (Zak Brown)

In our fourth instalment we feature Zak Brown… Zak is currently living and working in Australia but has been heavily involved in all things TDFC throughout 2018 as a pivotal member of the UK DiaEuro squad, whilst also heading out to Ireland with Chris to observe the Diabetes Junior Cup… Zak’s passion for the project is evident and in this post he shares his thoughts on how being involved has helped him! No more words from us, over to you Zak:

“I think firstly and foremost, the opportunity to meet several other T1D’s with a passion for football was amazing in itself! To then be able to discuss our condition as we went through very similar schedules during DiaEuro was great – having a diabetes discussion with your team-mates was like having 10 nurses beside us, as they added great value through personal stories and specialist advice.

The access to technology was a huge thing for me personally. I was a bit skeptical of the Dexcom G6 initially, as I have been on the same insulin and blood sugar testing strategy for a number of years and been relatively consistent (HbA1c usually between 50 and 61). It took a couple of days to adapt but several months later and I wish I still had the G6. I regularly see T1D’s on social media posting about how much the Dexcom has improved their control in recent times.

The other thing which was highlighted for me was the carb counting. I have generally just guessed my insulin based on what I am eating and knowing how it has affected my sugars in the past, but to see plenty of my UK team-mates measuring the carbs on their packets of food and calculating their dinner plate in the their head was a good insight for me; and pushed me to start making more calculated guesses with my own carb intake as life and diabetes continued after the tournament.

Whilst I wouldn’t say the experience has directly improved my control yet, I think it has acted as a gateway for me to access more information, attend diabetes meet-ups and possibly gain access to modern technology, which I expect will have a direct improvement on my Type 1 Diabetes control moving forward! Only time will tell…

Zak Brown

UK DiaEuro 2018 Player”

If you want to follow Zak’s journey on social media head to his twitter @mrzakbrown or his instagram @zakbtown

It’s much more than just Football or Futsal… Part 3 (Jack O’Brien)

In our third addition we share the thoughts of Jack O’Brien… Jack has a fresh outlook on the way Diabetes has impacted his life having been diagnosed quite recently! His account offers some great insight into how a newbie to type 1 Diabetes feels about the challenge of this condition coming into their life… No more words from us let Jack do the talking…

“First of all, I think I should point out that I am a relative newbie in the Diabetic world having only been Diagnosed 2 years ago today! (I wrote this on 6th Feb). DiaEuro was only the second time I was going to be away from home, and all the supposed safety that comes with that, since I was diagnosed.

To say I was nervous doesn’t really do it justice! I was fully aware that I was going to be spending the week with a group of people who have for the most part been Type 1 Diabetic for a long time. The fear or seeming like I don’t really know what I’m doing, or “messing up” all the time was playing on my mind because this was for me the first time I would be spending a prolonged period of time with other Diabetics. It’s funny how weird things like this can play on your mind! I was seriously still at a stage where I felt like it was only me who suffered from hypos because everyone else would have it under control!

The first morning we are there, we all go down to breakfast together as a squad to enjoy the spread of food that was being put on. It was this experience that alleviated all the pre concerns I had. Seeing most of us checking sugar levels and injecting insulin immediately eased my nerves. This was something that I found awkward to do beforehand.

Before you knew it, Diabetic chat was bouncing around the table. The same problems I found, others were also talking about. In a weird way, if felt so liberating! That sense of not being in something alone, that others have found ways to overcome similar situations and have come through them to find solutions was amazing for a newbie to hear.

You hear the phrase “trial and error” thrown around a lot when it comes to Diabetes, and I really understood that so much more after this journey. A corner was well and truly turned for me during this week. I am now playing sports more regularly, because I feel more confident. Understanding food on the day of playing football is something that is so important. Seeing other people using the Dexcom looked brilliant. Once I finished my trial run, I missed it so much that I signed up for 12 months.

 

 

 

 

 

The whole experience was invaluable to me. I learned more in that week than I would have done in years studying books and speaking to specialists. Seeing people who regularly play sport and manage their Diabetes gave me so many tips and ideas that I use myself now. There really is no better experience than experience itself.”

Thank you to Jack for sharing his thoughts on how TDFC has helped him and the UK DiaEuro team in particular. If you want to follow Jack on social media you can find him on Twitter @DalstonGooner … If you want to know what’s going on at Arsenal FC Jack’s your man to follow!!

It’s much more than just Football or Futsal… Part 2 (Scott Burrell)

In our second instalment of “It’s much more than just Football or Futsal” we look at the story of Scott Burrell. His journey with TDFC and type 1 Diabetes has been staggering and for those of you unaware of what Diabetes care was like without the technology that is available now, I’d urge you to read on… This is a fascinating account of how TDFC has effected and improved Scott’s life and another example of a social / community based project like ours supporting healthcare benefits and objectives for those living with the condition. No more talking from us lets hear from Scott in his own words:

“Being selected in the UK DiaEuro squad really changed my ‘diabetic life’ and that’s by no means an exaggeration! Firstly, and something a majority of the squad had said, was that they’d never met another T1 in ‘normal’ life so that was great. Like any football squad you tend to bond quite quickly with the other players but we bonded especially quickly as we all shared the condition. My knowledge of T1 has increased ten fold. It was great to share stories and bounce successes/failures off each other.

I was actually the only member on mixed insulin. I was taking Humulin M3 which was the same insulin I’d used since diagnosis in 1999! I’d been told for many years, probably close to 10, that a basal/bolus regime would be better for me, but me being a stubborn so and so I’d always thought I’d be better sticking with what I knew. Seeing all the other lads using the basal/bolus regime and many telling me how they had moved from mixed insulin and how much better it was really gave me the incentive to change.

A few months after we got back I eventually made the switch and now take Toujeo & Novo Rapid, I’m finding it much better and in hindsight wish I’d changed over many years ago. I’m certainly having less hypos which had always been a big problem for me before. As good as healthcare professionals are it was the kick from people living with the condition day in, day out which convinced me to finally change.

Finally I’m a lot more open about my Diabetes now… Growing up and even in my early 20s I’d try to hide it as much as possible, not talk about it and only tell people I was T1 if really needed. My mentality completely changed about that having been selected in the squad. I’ve now had newspaper articles written about me and appeared in a TDFC video filmed by BBC Hereford & Worcester which they shared on their social media platforms talking about the project and the condition. It actually made me feel ‘proud’ and gave me a desire to talk about diabetes for the first time…something I’d never experienced before in my time as a T1.”

Keep an eye out for more stories from some of the community and if you want to follow Scott on social media head to his twitter account @scottbufc to get in contact with him.

It’s much more than just Football or Futsal… Part 1 (Tim Ward)

In April 2018, we started something which had never been done before. We created the first ever Futsal team in the UK that contained only players that lived with Type 1 Diabetes… As much as we hoped it would inspire and raise awareness of the condition we also wanted it to change lives and demonstrate the value of doing things differently to the medical profession when looking after people with Diabetes. We think it’s done that and more! Hopefully organisations such as the NHS can see the value organisations like ours add and continue to grow their support and the opportunities to work more closely together.

However, that’s enough about what we think…. Let’s hear from Tim Ward the UK Diabetes Futsal Team Goalkeeper about how TDFC has changed his life:

“Since becoming involved in the Diabetes Football Community and representing the UK as a member of the DiaEuro Squad my view of and the way I approach and manage my diabetes has changed, dramatically and it’s all been positive.

My usual mind set for the dreaded annual review at the local Diabetes Centre was an appointment to be met with the same antipathy as some of the staff showed when I tried to discuss the dreaded topic of getting any “Flash Glucose Monitoring”?! I have had my “Lazy” pancreas now for 37 years and as you can imagine as the years pass the complications within your health and well-being can arise and you start to accept this as the inevitable. Not any more!

A group of lads with a shared love of all things Futsal and Football related (be it all with Diabetes) can be a base of support, encouragement and knowledge which goes against the stereotype many wish to portray, but this is exactly what I have found.

Gone is the stigma of testing my blood glucose levels in the changing room before a game, or taking in extra carbohydrates if my levels drop while playing.

I have found answers to questions that the local clinics were unable or unwilling to give, I have experienced flash monitoring which has had an amazing effect on my knowledge of how my diet and eating habits affect my levels and how to better manage them to keep within the optimum levels. I have through the members of the squad learned new diet ideas of more fibrous carbohydrates, of when and how to inject and different options on the insulin to use.  I now know that there are a myriad of options available to me to not just perform better in a sporting context but also live a healthier more energized life of less hypos, a better hba1c and greater trust in my own body.

The greatest impact has been that I do not have to be ashamed of my condition, it is not a weakness, don’t believe it and don’t let others convince you that it is. It is simply a bad hand dealt. Make the most of that hand, TDFC can and will support you in any way they can.

TDFC and especially the players, coaches and management of the DiaEuro squad have taught me through words, actions or just a smile and a nod that when you’re ready to play, take a deep breath, tie your boots, test your blood and go and beat whatever is in front of you, because you can.”

If you want to follow Tim on social media head to his twitter: @Tim_Ward07 or to his instagram: @timward16 and make sure you keep an eye out on the blog as we release more player thoughts on how TDFC has impacted their lives in the coming weeks.