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

 

Insulin dosing strategies before Football

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 minutes

Introduction

The objective of adjusting insulin doses before exercise is to prevent hypoglycaemia during a match whilst minimising hyperglycaemia during the run up to kick off. Important factors to consider are the insulin dose, where insulin is administered, the blood glucose level before exercise, the type, amount, and timing of the last meal or snack eaten, the intensity and duration of the match (difficult opposition? Will you play a full 90 minutes?), as well as recent hypos1.

What is the best blood glucose level to have during football?

Blood glucose levels are individual; some people feel (and perform) worse with higher glucose levels before exercise, whereas others don’t. The consensus amongst the medical research community is that a reasonable starting range for most footballers would be between 5-10 mmol/L depending on whether blood glucose levels usually decrease, stay stable, or increase as well as the expected difficulty of the match and the likely duration of play (are you a super-sub?). This range generally balances performance considerations against the risk of hypoglycaemia, although achieving and maintaining glucose levels in this range can be very challenging.  If starting exercise below 5 mmol/L it is recommended that you eat 10-20 grams of glucose beforehand and delay (if possible) the start of exercise until glucose levels are more than 5 mmol/L. If glucose levels are between 5-10 mmol/L then most people will be ok to start playing football, although some people may see a rise in glucose levels during the match. If glucose levels are above target (10-15 mmol/L) most people will expect a further rise in glucose during a game. Importantly, if glucose levels are above 15 mmol/L it is recommended to check blood ketone levels; if ketones are elevated up to 1.4 mmol/L then a small correction dose might be needed; if ketones are elevated over 1.4 mmol/L then exercise should be suspended and glucose management should be initiated rapidly.

What should I do if I struggle to avoid a hypo during a game?

People who tend to develop hypoglycaemia during exercise will usually turn to eating carbohydrates as a technique to avoid it. There is an issue with this, however. Firstly, if you find yourself eating lots of carbohydrate to prevent glucose lows the extra calories eaten might contribute to unwanted weight gain in the long-term. Secondly, eating carbohydrates does not necessarily tackle the underlying cause of a hypo.

The reason for the fall in glucose during exercise is at least partly due to high insulin levels. Whereas insulin levels fall in people without type 1 diabetes (in order to preserve blood glucose), in people with type 1 diabetes insulin levels are the result of the previously administered insulin dose or the rate of insulin being infused by an insulin pump. Irrespective of the method of insulin delivery, once insulin is in the body, it is unregulated and does not decrease in response to exercise; this results in excessive glucose removal from the blood. Even if individuals with insulin pumps half their basal insulin rates up to an hour before exercise, circulating insulin in the body does not decrease sufficiently before the start of exercise. Moreover, insulin levels tend to increase during exercise even when insulin pump rates are reduced because of changes in blood flow2. Although aggressively lowering insulin levels through reducing insulin administration or skipping an insulin dose can prevent hypoglycaemia during exercise3,4, this often causes hyperglycaemia and raises ketone levels before and during exercise5. For people using insulin pumps, a basal rate reduction, rather than a suspension can be attempted 60-90 minutes before the start of a game. An 80% basal reduction at the onset of exercise helps to mitigate hyperglycaemia after exercise more effectively than basal insulin suspension and appears to reduce the risk of hypoglycaemia both during and after the activity. For individuals treated with insulin pens, mealtime insulin dose can be reduced by about 50% when taken with a carbohydrate-based meal around 1 hour before the start of a game3. However, it must be stressed that people respond very differently to any strategy and there is no one-size fits all approach.

What should I do if struggle to avoid hyperglycaemia during a game?

High blood glucose levels can raise ketone levels, increases the perception of effort, and reduces performance. As discussed elsewhere, carbohydrate intake before a game is important for both performance and managing the risk of hypoglycaemia. If hyperglycaemia is an issue prior to a match, try eating earlier in the day and maintaining a normal mealtime insulin dose; most mealtime insulins peak in strength by 2-3 hours meaning that a normal insulin dose can be administered with an earlier meal and taking a small snack before exercise omitting insulin – this may reduce the risk of starting exercise with high glucose levels whilst ensuring adequate carbohydrate availability and lowered insulin levels for the game. If hyperglycaemia is a continual issue, starting glucose management preparations earlier in the day gives a longer window to achieve glucose targets. Unless glucose levels are above 10 mmol/L it is not recommended to take a correction dose of insulin because of the increased risk in developing hypoglycaemia.

If you are interested in learning how to tailor strategies like the ones presented to your own individual requirements, contact Matthew at: matt@t1dcoaching.co.uk

References

  1. Bally L, Laimer M, Stettler C. Exercise-associated glucose metabolism in individuals with type 1 diabetes mellitus. Current opinion in clinical nutrition & metabolic care. 2015;18(4):428-433.
  2. McAuley SA, Horsburgh JC, Ward GM, et al. Insulin pump basal adjustment for exercise in type 1 diabetes: a randomised crossover study. Diabetologia. 2016;59(8):1636-1644.
  3. West DJ, Morton RD, Bain SC, Stephens JW, Bracken RM. Blood glucose responses to reductions in pre-exercise rapid-acting insulin for 24 h after running in individuals with type 1 diabetes. Journal of sports sciences. 2010;28(7):781-788.
  4. 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. 2013;36(8):2217-2224.
  5. Berger M, Berchtold P, Cüppers H, et al. Metabolic and hormonal effects of muscular exercise in juvenile type diabetics. Diabetologia. 1977;13(4):355-365.

 

Award Winning TDFC London: The Power of Peer Support

TDFC London – Quality In Care Diabetes Award Winners 2022. I can’t quite believe it. It’s been a huge team effort and after a few weeks to let it settle in, I thought I’d share mine and the team’s journey.

I was diagnosed with type 1 diabetes over ten years ago, and needless to say it was quite a shock! There was so much to get my head around, but one of my biggest concerns was being able to get back playing football. I went years before meeting a fellow type 1 and it took a long time to work out how to manage the condition while playing sport.

And then there was a breakthrough moment. I came across a fledgling initiative called The Diabetes Football Community (TDFC). I signed up to one of their first ever meet-ups, and what a journey it’s been since.

Suddenly I was playing competitive matches against other people with type 1 diabetes. In between games, team members exchanged insights about new glucose tracking technologies, different methods of delivering insulin and practical tips on managing diabetes whilst playing football. After just one match I picked up so much useful advice and diabetes life-hacks that I wouldn’t have known otherwise.

At DiaEuro 2018 we realised that there was the enough players to potentially set a team based in London and if we did so we’d be the first ever all-type 1 diabetes team to compete in a mainstream league. Hence TDFC London was formed, with the aim of providing open and inclusive football-based meet-ups for people with type 1 diabetes, and to help show that the diagnosis doesn’t need to be a barrier to participation. This diverse group celebrates each individual as their own entity. We’ve helped each other gain access to diabetes technology and referred individuals to health services they were unaware of prior to joining.

COVID-19 put a long pause on the group meeting up, but the peer support element of the project really kicked in, with teammates all sharing support and guidance in dealing with the dreaded ‘COVID-type 1 combo’ via WhatsApp. Post-pandemic, we came back even stronger, going on a winning streak to eventually fulfil our goal of becoming champions of the North London Futsal League 🏆

https://twitter.com/TDFCLondon/status/1482765960637468674?s=20&t=MfnsfwlVLra3I1_4tKtDwQ

 

I work at the Royal College for Paediatrics and Child Health alongside a great team as part of the National Diabetes Quality Programme. We see first-hand the issues around drop-out rates when transitioning from paediatric to adult services. I’m convinced that projects like TDFC can directly support diabetes services in enabling self-management and help to signpost people back into diabetes services to ensure things like technology access.

My teammate Muhammed Ismail has been an amazing ambassador for the project and secretly submitted our team’s concept and achievement for this year’s Quality in Care Diabetes Awards. To our amazement, we won the Unsung Heroes award! The judges commented:

“TDFC London was an inspirational, heart-warming and feel-good entry that has offered support to a group of young Type 1s. This could be replicated nationwide. It is a great example of peer support, ingenious and particularly focusses on young men – a notoriously difficult group to connect with and an often-overlooked group.”

 

 Much like my glucose levels, there’s been lots of ups and downs over the years since being diagnosed. However, I’m very grateful to have stumbled across TDFC and my experience with this group has been a standout highlight.

Peer support is a powerful tool for empowering those with long-term conditions. Sport is a powerful vehicle for bringing people together. Combining the two has so much potential!

 Bryn White

TDFC London Manager

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…

My First Session by Anthony Parker

I attended my first TDFC session in July following an introduction to the project by Mo who found my Facebook profile on a Type-1 diabetes page & saw from my profile photo that I was a football fan.

I have been a Type-1 diabetic for over 30 years and could probably count the number of fellow Type-1’s who I have met during this time on one hand.  However, during the challenges of the past 18 months and after experiencing some side effects caused by diabetes, the want & need to meet with people going through similar life experiences was heightened. The TDFC project provided this; the fact that everyone also had a passion for the sport I have loved for the past 35 years was a bonus!
In a strange coincidence, one of the other guys who was also planning on attending the session in July lives literally around the corner from me, a mere 7-min drive away! Buncy and me agreed to travel the 2.5hrs to Worcester (from Berkshire) together and got to know each other through an exchange that covered blood glucose levels, diabetes management, hypo symptoms and of course, football. Turns out Buncy is a Watford fan, so there was much fun to be had….
Once we arrived into Worcester, I found the meet & greet/get to know each other session really powerful.  I have not before realised the benefits of such a session.  They empower people to work to solve their own problems.  Everyone in attendance are equals and I felt that this made people feel much more comfortable opening up about their diabetes journey and related experiences. After a very tough last 18 months with Covid & the various lockdowns, I believe that sessions like this can reduce any anxieties, whilst improving self-esteem, and providing a sense of well-being overall.
The actual training session was itself a surreal experience. Playing futsal/football with other guys who were flicking their phone across the Libre on their arms to monitor their BG levels every so often whilst having conversations about various diabetes management strategies adopted for a rigorous football/futsal session was something I hadn’t seen before. Somehow, it almost seemed ‘normal’ to take mini-breaks to take BG readings and to read them out to the group with no judgments made.  I personally awoke with a BG of 12mmol so spent the whole car journey up trying to get it to a suitable level, but I did too much of a good job of this and ended up starting the session with a 3.3mmol highlighted in red flashing up on my own phone via my Libre.  Thankfully, there was an assortment of glucose options supplied to support the treatment of a low BG.
I have been playing a decent standard of football for over 30 years, but futsal is a very different game; more tactical, more structured and more intense with less time to recover from a period of attacking or defending.  Having put in a couple of additional pounds during the lockdowns, I’d admit that I need to better prepare myself to suitably compete for the next session!  The standards were pretty high and were refined by the guidance and coaching of Brighty, culminating in a very good team goal during the actual practice match.  Thankfully, the goal was scored by the team that I was on…
After a competitive and enjoyable session, I managed to join a couple of the guys for a quick ad-hoc lunch before we all departed for our return journeys home.  We all shared some more stories on our diabetes journey.  A couple of the guys were newly diagnosed, so it was empowering for me to share my own 30 year story of diabetes & to highlight what I had achieved, both personally & professionally to send a message that diabetes shouldn’t hold you back.
Personally, for me, the whole experience was humbling, empowering & enlightening whilst providing a much-needed boost to my mental mindset. I also got to find out that I ‘wasn’t the only type-1 in the village’….

Looking forward to the next gathering….

Back in the saddle by Tim Ward

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.

A review of 2020 from one of our own… Jon Peach

After Jon’s incredible commitment to the work of our cause he has recently been added to the Board of Directors at The Diabetes Football Community C.I.C after a recent organisational meeting… Congratulations Jon and following that he sat down to write his thoughts on what’s been going on for himself in 2020…
“2020. What a stinker of a year. Diabetes and football both suffered for me this year. It started off recovering after shoulder surgery in November 2019. January brought the first few football training sessions and I was finding my fitness again. Then I broke a rib training when an innocent collision with a team mate caused me a ridiculous amount of pain. So another recovery and just as I was getting started again, we entered lockdown! Roll on August when we started pre season training. It was going well and I’d played the first few games of the season when I had a nasty accident on my bike resulting in a horrible concussion, keeping me off football for another 10 weeks off after a month of constant headaches. On top of that, I’m also suffering with 2 frozen shoulders, which really limit the movement and impact massively upon my sleep every night (any advice welcome!) Frozen shoulders are another one of the added complications that people with Diabetes are prone to, with no known evidence as to why. Add to this the mental impact of working from home that so many of us have suffered with, and it’s not been great on that front.
Then there’s the blood glucose…..all the periods of inactivity make it harder to maintain tight control for me. Some days have been great, some awful! When you factor in the increase in body weight meaning it’s another factor to have to deal with when calculating the regular insulin, it’s been a tough battle, but one I’m determined to win.
So what about the positives? Our TDFC WhatsApp group has been far more active, with lots of advice and mickey taking going on as people are facing new situations and have more time on their hands. I also took on the role of updating the social media accounts during lockdown, so was responsible for posting and editing all the toilet roll challenge posts and the player profiles. While it was time consuming, it was also great to interact with so many people, and realise the difference that TDFC was making to so many. It was great reading the comments posted on the clips sent in, and the encouragement and advice that the community were offering each other.
I also got involved with Diabetes UK and a couple of their campaigns on being active with diabetes and diabetes and technology, and have featured on their website a few times, social media channels and recently in balance magazine.
I also recorded a podcast with a veteran of the podcast Chris Bright! We were lucky enough to be invited to do one with Stevie Ward, captain of Leeds Rhinos (my team!) and the charity he has set up to support means mental health, Mantality. We’ve had loads of positive feedback from it which is great to receive and if you haven’t heard it yet check it out by clicking here .
So 2021. Here’s hoping for a better year for sport and diabetes!”
it’s ok to not be ok and always reach out when things are tough… 2020 has been a year like no other and we just want to say we’re always here for anyone who needs to reach out. So many of us have had a tough year and we need to stick together.
Here’s to a happier and healthy new year.

Diabetes Month 2020 – Thoughts from Muhammad Ismail

It’s been a tough year for many of us. 

 

The world, what we value, how we see the future, jobs, the economy, sport, social activities, health etc have all been affected this year by Covid-19.

 

This piece was written to focus on the positive, and is focussed on gratitude 😊

 

Moving on to where we are now; Diabetes month! 

 

Throughout the years I’ve seen people post images of how many injections they’ve had to endure over their lifetime, images of libre scans, hypo treatments, Hba1cs, the DKA and diagnosis in hospital, how people have overcome their diabetes challenges and all those additional things we have to endure…..just to function everyday. 

 

This year I’ve had a think about what’s important to me, what has helped me keep ticking, year on year, and ultimately has led me to meet up with, and work with some of the most inspiring people I’ve ever met.

 

The story begins a few years back, sometime in 2017. I had a decent job, life was great on the outside, my diabetes control was awesome, but I was, at the time, not feeling good inside. There were two parts to why I wasn’t feeling great, one was diabetes related.

 

I was struggling with diabetes burnout. It was something I never knew existed as I’ve had t1 since the age of 2.5, and so not known what life was like otherwise. I guess when “not being okay” becomes a routine, it ends up being normal.

 

I’d figured out through my understanding of medicine and pharmacy, how rapid acting insulin worked. The bottom line was that I could get away with measuring my sugars less than a handful of times a day, guesstimate doses extremely well, have limited hypos and have an a1c of below 6.5. I could manage exercise well and only really struggled when I went out for a three course meal and desert at a posh curry place. 

 

I couldn’t really see the point of bothering really, even my hospital appointments were pointless. I’d turn up, be asked for my diary (which didn’t exist), someone would have a proper go at me for a bit, then open up my record. 

 

After this point they’d take some time to double check my hospital notes, scroll through my history and say well done. I often felt it was more out of shock than praise. That was it. No “sorry” for making me feel like the smallest thing on planet earth, no “is there anything I can do for you?”, no “how do you manage to dose”, no “how are things?”. Then I’d get an appointment a year later and rush back to work. 

 

One time at work (I work as a hospital Pharmacist) I had a brief discussion with a dsn about care. She asked where my care was and I mentioned the hospital. She asked whether I thought about moving my care to my workplace. I didn’t know this was possible. I thought about it for a bit, and concluded that it would be hugely beneficial as I wouldn’t have to travel back to work by train, saving about 1 hour of my time, once a year. 

 

So I worked really hard to move my care over. Contacted the GP, my DSN and after a while, I got the appointment notification in the post. 

 

A few weeks before my appointment, I was working in a GP surgery, running a clinic that aimed at preventing blood clots. A routine patient came in, mentioned that they were really worried at the time as their sibling was unwell. They lived nearby and asked if I could do a quick blood test for their sibling, who was also part of our service. I stated that I’d do their consultation, and if I had time, would look into it as I had other patients waiting. 

 

Later on, I read through the sibling’s discharge summary and was shattered. There was a lot on there about poor compliance, complications of diabetes…….it was a mess. I took the kit I needed and headed to the home. The person was in an awful state. I took the blood test needed and they used the blood to test their sugars. I could tell this wasn’t going to be good. 

 

They were throwing up, dehydrated and their sugars were 17. It was a bad mix. They asked for advice and I couldn’t give any, as my clinic wasn’t a diabetes one. It really broke my heart, but you have to be professional. I advised they seek medical attention, and left. As I got back to the clinic, I realised I forgot one of my monitoring devices. I headed back to the home and an ambulance was there. I got the device, wished them well, headed back to the clinic, tidied up and went home. 

 

There are times in my job I experience these things and often ask myself many questions. Most of them are “Why not me?”, “Why does diabetes lead to so many bad outcomes?”, “Why do I find people in situations I’ll probably never find myself in?” and it usually ends up with “Why bother?”. 

 

Afterall, it’s a lot easier hiding from a condition, not having to think about it, than grinding your way through your daily routine only to be seeing others suffering, with you not having the ability to influence or change their outcomes in a positive way. That stuff is soul destroying, but I guess at the time I couldn’t see any way to process that in a positive way. I thought, “who would understand, and who could, if they would understand, be able to do anything about it?” 

 

I guess weeks went past, and I cared a little less, it gets better from here onwards, promise!

 

So I turn up to my appointment, expecting the same response. Hopefully this year, a little quicker as I won’t have to travel back to work. 

 

So I get called up, knock on the door, open it. “Hi can I come in?”. “I haven’t had a chance to read your notes yet….do come in.”

 

From then onward it was quite an interesting consultation:

 

“Where’s your diary?”, “I don’t have one” (expecting a massive lecture/some condescending remarks at this point….).

 

“So how do you monitor?”, “I dose according to how I feel” (probably the first time in years someone has actually taken the time to ask the question, rather than judge straight away). 

 

Usually I get a sarcastic smile or a brief laugh. Instead I got a look of someone who was genuinely interested, trying to take a moment to understand.

 

I felt bad at this point and decided to pull out my phone to show a pic of a day I had with a libre, showing a full 24 hours without a sugar over 9mmol/L.

 

“Not a single sugar over 9?!”, “Yeah…” (I couldn’t really be bothered about a conversation at this point).

 

At the time I just wanted the consultation to end and go back to work. The checks (though understandably important), were just a tick box exercise of me. Nothing ever changes, so I decided to answer all the questions with short answers. It was the quickest way back to work, and the quickest way to forget I had a chronic condition to manage. 

 

Towards the end of conversation, doc was like “Have you ever thought of seeing a health psychologist?” 

 

Again, I just wanted to be out as quick as possible so decided to ask for their recommendation and then say “can’t be bothered, can I go now?”

 

To this day I will never forget what happened next. I asked “What would you recommend?”

 

“I’m not going to recommend anything, here is some information.”

 

I was stunned into silence I guess, and didn’t know what to do next. The freedom of choice is one thing, but it’s extremely powerful for a clinician to be extremely non-judgement. To understand the dark places a chronic condition like diabetes can take you is something you can’t really learn from a book, nor pick up from experience; you have to have a personal connection with diabetes to do that. 

 

“Do you have diabetes?” I asked, trying with all my years of having t1, to figure out how someone could pick up so much from so little information given.

 

“No I have a relative and growing up…….”

 

For the first time in years, I had a meaningful conversation about t1 with someone. I was still demotivated, and managed to negotiate a yearly appointment instead of a 6 month one. Doc was still okay with that, which was really nice. 😊

 

I thanked them for their time and went on my way, doc even managed to convince me to see the DSN and dietician at a later date. 

 

After that point I thought to myself, there must be some “good” out there. Over the next few months I searched for diabetes groups online, attended some in person meetups and actively searched for some diabetes stuff.

 

I even went to the health psychology appointment and it did help put things into perspective. 

 

A few months later I went to a diabetes tech event where Chris presented how the dexcom had helped him manage his sugars with sport. I caught up with him after and said “I think you should start a diabetes football team.” He was like, “There is one!.” 2 years in, it’s had a massive impact on people across the country (all the way from the Isle of Wight to Scotland!). 

 

 

It’s truly changed some people’s physical and psychological health – for the better! There’s even a local London team and every day it’s growing. It’s also got so much more to offer too! This is a must watch video if you want to find out more! 

 

https://www.youtube.com/watch?v=19T9M5944E4&t=6s

 

I even turned up to the annual diabetes picnic in London. This is where I met Tim Street and learnt about looping. What an amazing concept I thought. This eventually led me to building a loop system, making managing diabetes slightly less of a burden. I’ve seen the #WeAreNotWaiting movement take huge strides to making t1 safer, more manageable and less psychologically draining.

 

I also joined loads of T1 facebook forums and have seen so much positive support, and positive change coming from them. A big shoutout to Louise Troubridge, who helps to effectively manage the “Type 1 diabetes uk” facebook page. It’s got over 8,000 members! 😮

 

My favourite facebook group (sorry to disappoint Louise!) is “Libre line art”. Do have a look as you don’t need to be a facebook member to appreciate it!

 

 

There’s also the amazing “GBDoc” (Great Britain diabetes online community) on twitter, who are never far away to provide help and support if you tag “#gbdoc”. They even hold insightful and entertaining “TweetChats” on Wednesdays at 9pm. Follow ”@GbdocTChost”

 

 

Furthermore, this year I’ve fasted a whole month for the first time in my life (see my 30 day graph below). A huge thank you to Dr Sarah Ali (@AliRacaniere) and Dr Sufyan Hussain (@sugarydoc) for making this an achievable reality, despite Covid and it being my first ever attempt! 

 

 

I feel really good to get that off my chest. 

 

Just remember you are not alone! Sometimes it takes a human to just listen and “try” to understand. I know this year has been extremely tough psychologically, financially and socially. 

 

Reach out, know that you’re not alone, bounce off people, celebrate the small wins, take it one step at a time, love yourself, be grateful, there is a lot of good in this world and I’m thankful I’ve found it when I needed it most.

 

I dedicate this post to my awesome endocrinologist Dr Karen Anthony, and my now, unfortunately retired 😢 DSN and dietician; Susan Olive and Janice Mavroskoufis. 

 

Sometimes you just need to take a step back, listen, be non-judgemental and “try”.

 

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

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

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