sports nutrition – The Diabetes Football Community

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

Posted on December 12, 2022December 13, 2022 by thediabetesfootballcommunity in diabetes, diabetes research, Football, sport

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 acutely^4-8. 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 levels^4,6,9. 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 activity^5,10-13. 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

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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.
Cockcroft E, Narendran P, Andrews R. Exercise‐induced hypoglycaemia in type 1 diabetes. Experimental physiology. 2020;105(4):590-599.
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.
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.
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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.
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.
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.
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.
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DiaEuro 2019 Perspective: Chris Bright (Player / Coach / Organiser)

Posted on September 5, 2019November 9, 2019 by thediabetesfootballcommunity in diabetes, Football, sport

It’s something pretty special…. The opportunity to represent your country and your condition. DiaEuro or the European Futsal Championships for people with Diabetes is into its 7^thconsecutive year of competition and through this wonderful tournament we are given a unique chance to live out every kid’s dream, to play for your country.

But this tournament isn’t just about winning every game (yes it’s important to us all!) as there’s more than that at stake. Each team uses the tournament as a chance to make as much noise and raise as much awareness as they can, to really showcase what people with this condition can do. When you often see misconceptions and irregularities in the way people talk about Diabetes in the media and society it’s so nice to see us all come together to talk about a European event which brings positivity and enthusiasm to the word Diabetes.

As you can see from the titles I have for our team, I’m doing a bit of everything to make the UK team happen but I wouldn’t change it. I’ve enjoyed each one of those roles but it does make it very challenging to do them all very well! Each one brings their own pressures but for the most part I try to take it all in my own stride and ensure the project runs as smoothly as possible. I would hope the team would say that we do a good job with it but you’d have to ask them haha.

I’m still coming to terms with the fact that 18 months ago this was all a dream and here we are talking about participating in our second tournament. This project and community has changed my life and the lives of many people whom are participating every day in our activities on social media or the projects we run physically. This team has been a huge source of inspiration for our community and a place to turn for information & support for the lads living with type 1 diabetes lucky enough to be involved. This was demonstrated by the amazing local TV coverage we received regarding our participation at the tournament. Seeing our project receive this media attention is great for its continuation but most importantly for reaching others who may not have heard of the work we do and who could really benefit from it… The reason we’re here is to support others with our condition and raise greater awareness of Diabetes in a positive light. To be featured in this way is not the goal we set out for but a bi-product of the hard work we put in to help the diabetes community out there. (TV feature below)

YouTube Video

Back to the tournament itself though… To be completely honest after the months of work building up to it, I was just so happy when we got to the accommodation in Ukraine and the rooms were all sorted out! As the man responsible for getting the squad & staff there that was the biggest relief. The stress of booking flights, speaking with the organisers, sorting out the transport & the tournament schedule, organising our players & itinerary to get there as well as all of the finances is a huge strain. I think next year I’d like to find some more help for this because it consumed my life for weeks beforehand. But crucially we got there without much of a hitch or issue!

For much of our preparation for the tournament I’d played more of a coaching/managerial role alongside Harley to help us tactically & technically prepare. It was myself and Harley who picked the final squad, worked through the playing style & finalised our matchday approaches. However, we felt that in spite of this I’d need to contribute on the court again this year rather than from the sidelines. So with that being said and a last minute continuation of an injury to our main pivot JT, I handed over my coaching hat to Harley & JT for DiaEuro 2019. Concentrating on just playing wasn’t without it’s drama though…. I actually pulled up in a training session for my football club 10 days out from the tournament, which actually meant I had to sit out of our final training session before heading to the Ukraine….. Not ideal at all. I spent the whole week leading up to the tournament unable to train and unable to even run. I actually ran properly for the first time after pulling up, just 2 days before the tournament and it felt just about ok… I had my fingers crossed I’d be alright for the first game on the Monday. Whatever happened with my injury though, I was determined to ensure that from an overall perspective the tournament was going to be a positive experience.

Once the games arrived on Monday, after a day of settling in and reviewing our tactics, we went into them optimistic we could really give a good account of ourselves. I felt for the most part we did just that! Our group draw was really tough, we faced last year’s champions Bosnia, Portugal (tipped to do well!), Slovakia (Finished 4^ththe previous year) and Ireland who came into their first tournament. WHAT A GROUP. We were all so excited about the prospect of pitting our wits against the very best and having the chance to play a local derby with our friends in Ireland (which I think could be a more regular thing too 😉 )!

Our first fixture was against my very good friends from the Portuguese team. I can’t say enough positive things about these guys. They helped me shape the project we now have for our UK team and I’ll forever remember that. In 2017 I flew over to Portugal with Karl & Noel, to further the TDFC cause and they let us in to train and see their development. It was a special trip and Bruno, Joao and all of the boys have become great friends of ours and in both DiaEuro tournaments we’ve been involved in we’ve been drawn against them. I think it’s fitting with our connection. Unfortunately, they beat us 6-1 last year and in this year’s game it was 5-1 but as the scoreline suggests we made a better game of it and if anything it was a little harsh the margin. They have some very talented players and their technical & tactical knowledge supersedes ours by a distance but we’re catching up. We have a talented group who demonstrated throughout this year’s tournament, despite the results, that we’ve made strides forward on the court. Nevertheless, it was a tough opening defeat but we knew we had to pick ourselves up from it quickly because the day after we had 2 games. From a personal playing perspective, I had my injury playing on my mind which meant I didn’t perform at my usual level, but I knew that and just needed to build my confidence up in it to push myself the following day. It was great to see from a coach’s perspective the lads employing tactics and techniques we’d worked on all year and something we certainly continued to show throughout.

As Day 2 arrived, I’d had an awful night’s sleep ( 3 hours roughly!) tossing and turning thinking about the day before and the day to come. But we had two games to play and I needed to get over it….. I picked myself up and went all out with the positive mindset. I was up and focussed from the off to get my mindset right to tackle those games. With the organiser’s and coaching cap taken off me by Rosie, Harley & JT I certainly felt a bit of a weight off my shoulders following a staff discussion the night before. I think it showed as we played our first fixture of the day vs Slovakia. I went into it with more confidence, having tested the injury out and having had Milly put me through some rehab/stretching too. We knew that today was the important one for performances and results as on the final day of group fixtures we’d be facing the reigning champions with a really tough task to get any kind of result. We knew it and in that first game we played like it…. We came out of the blocks firing. We threw the kitchen sink and more at Slovakia and somehow they stood firm. To this day, I still can’t quite believe that we didn’t get a result from this game (watch the highlights and you’ll also see why!). The lads were fantastic… The whole squad played to the levels we needed and the ball just didn’t quite go in the goal for us. There’s an argument we could have been more clinical but the luck just wasn’t with us and we lost 1-0. We were gutted but encouraged all at the same time. We’d just completely outplayed a team that had finished 4^that DiaEuro 2018. So as much as we were disappointed with the result we’d shown to everyone what a thoroughly decent side we were.

But after 2 games we still hadn’t got any points on the board so as much as we were satisfied with our performances, we were desperate to get off the mark. No easy task though as up next was the local derby with our friends in Ireland. For me the Irish and Portuguese teams will always have a special connection with me. Portugal inspired us into the DiaEuro family and I like to think a trip that myself and Zak Brown went on to the Diabetes Ireland Junior Cup in August 2018, where we met Cathal (Ireland Team Manager), inspired their creation & participation at DiaEuro 2019. So for me it was a special moment for our teams to face each other.

I knew they’d recruited well with several players who’d played at a good level of Football in Ireland so we knew it was going to be a tough game. It turned out to be exactly as I’d imagined. They sat in and frustrated us as we dominated the ball. However, they looked dangerous on the counter attack. It made for quite an exciting game for the neutral but my overall feeling was that just like the Slovakia game the ball didn’t want to go in the net for us. A game full of commitment and passion ended in a 1-1 draw. We just couldn’t convert our dominance of the ball into goals and it’s where we struggled against Slovakia as well. We missed one of our star men from DiaEuro 2018 JT, who’s goals we could’ve really used this year. He’s a natural finisher in front of goal, it’s a simple as that. But, that being said I felt that we showed to everyone the strides forward we’d made as individuals and collectively. I was proud of how we’d conducted ourselves in game 2 and 3 and had it been another day we’d have won both games, but it wasn’t to be.

This left us with a mammoth task of needing a result against the reigning champions Bosnia to have a chance of staying in the competition. With our legs in absolute pieces from 3 games in 2 days we knew it was going to be a tough task. Within 5 minutes we were 3-0 down and it was every bit of the challenge we thought it would be! We gave it all we had but came up short losing the game 11-3. As we all predicted Bosnia then went onto win the tournament. The ability they have throughout the squad is frightening for an all type 1 team. One of the best teams I’ve faced collectively and individually and a huge congratulations to them for defending the title and really showcasing the levels you can achieve despite living with type 1 diabetes.

From our perspective going out of the tournament on goal difference at the first stage was frustrating and disappointing especially with the distance we travelled and money we’d spent to get there. We’d given it our best shot and at another tournament the ball would’ve gone in and we could’ve finished 5^th/6^th/7^thbut it wasn’t to be. However, the strides forward off the court, within our coaching team, our tactical knowledge and overall approach was really pleasing. I couldn’t be prouder of everyone involved. I’m honoured to know each and every single one of the players and staff. Their commitment to TDFC and our vision is impeccable, and I’ll never be able to thank them enough for all that they’re doing to help push this cause to the next level.

But what can you say about trying to manage your glucose levels with 4 futsal games in 48 hours….. Reactive, guesswork and without a CGM like the Dexcom G6 I think it would be an extremely difficult challenge. I felt as though I prepared as best as I could but for me the key was always have the ability to adjust. I was always carrying Lift Glucose tabs around with me as well as my insulin pen to ensure I was able to react to any levels which were falling out of range. I mean how do you prepare for something you’ve never done before? 4 games in 48 hours is not something you’re likely to experience so I just focussed on eating well, consuming lots of carbs & protein for recovery and trying to minimise the amount of short acting insulin there was in my system for games (unless I required an adjustment!). We all did it and for the most part managed it quite well. It was quite a testing environment to have type 1 but the understanding amongst our squad and management is there to ensure we’re all comfortable in shouting up if we don’t feel right. It was a challenge that we all adapted to but one that was made easier than it could’ve been by the use of a continuous glucose monitor.

As anyone who knows me or has heard me talk about DiaEuro before, I will always say that it is much much more than just a Futsal tournament for people with Diabetes. It forges bonds and friendships with people across Europe who share the same challenge. We come together to demonstrate what people with the condition can do through the medium of Futsal. It’s a unique experience which has us travelling to destinations all over Europe to experience different cultures and ways of managing the condition as well as playing the sport. It’s a tournament and message I believe strongly in…. I hope that in the future we can continue to develop it as a product and receive greater recognition & awareness of it. It was fitting that the final ceremony was conducted at the Olympic stadium and Ukrainian TV were there to film it. For me this tournament deserves that, the talent, commitment and statement that this tournament makes is epic… I just wish we could see our condition represented like this more regularly and through other sports too!

For me, another tournament and another step forward. Results may not have shown that but with the project, coaching and players there was every reason to come away from Ukraine full of optimism. I take great pride in representing my country and condition. For me it’s a special feeling which is hard to explain but one I hope I can continue to do on and off the court for many years to come.

Finally, I want to say a huge thank you to the players, Harley, JT, Milly and Rosie for all of their hard work and commitment in Ukraine. Without your efforts the experience wouldn’t have been what it was so thank you again for all that you do…. Whilst we must also say a big thank you to our sponsors Dexcom, Lift & JL Property Solutions who’s support we couldn’t have done without. Thank you so much for everything you did to help us get there!

And with my final words of this post I just want to look ahead to the 2 exciting projects still to come in 2019….

We have our children’s participation event and sessions based from the new Worcestershire FA HQ launching in autumn/ winter 2019, where we will for the first time encourage active participation in Football for children with type 1 diabetes, with support from adults and coaches fully aware of how to manage the condition. Hopefully an exciting step change for our community and if you want to register your interest in what’s ahead head to the below survey monkey:

https://www.surveymonkey.com/r/BR88G9P

Whilst we also have the #SporT1Day conference on the 17^thof November at the University of Worcester to come. A number of talented and inspiring individuals living with type 1 diabetes sharing their experiences and management techniques for their sports whilst managing the condition they live with. A fascinating insight and learning environment for anyone looking to expand their knowledge, further their exercise and sporting goals or even just get started. A wonderful day and you can find more info on the below link:

https://www.worc.ac.uk/about/events/sport1day-2019-by-1bloodydrop

Thank you for reading this lengthy post!

Chris

DiaEuro 2019: UK Player Perspective (Jon Peach)

Posted on August 4, 2019November 9, 2019 by thediabetesfootballcommunity in diabetes, Football, sport

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!

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

Posted on February 10, 2019November 9, 2019 by thediabetesfootballcommunity in diabetes, Football, sport

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.

Food Series Part 1 – Healthy Eating: Getting the balance right

Posted on August 22, 2018November 9, 2019 by thediabetesfootballcommunity in diabetes, Football, sport

My name is Jo Hanna and I am one of the Diabetes Dietitians working at Poole Hospital but also a huge exercise enthusiast! I’ve been a Dietitian for 8 years now and working in diabetes for 5. Secretly I always wanted to be a Sports Dietitian working for Manchester United! I grew up playing football and most of my childhood was spent as the token girl in the team, even playing for Dorset under 12s. Football was my true passion but sadly for me at the time football was still considered a ‘boys sport’ and once I reached the age of 12 I was told by my school I could no longer play football with the boys. I was devastated by this at the time and although I got back into football at University it was too late for me so I ended up running instead. I have pushed myself in this area, winning 6 of the Dorset Road League races last year in addition to my greatest achievement, a sub 3 hour London marathon.

Exercise for me, as I’m sure it is for many of you is my stress release and plays a huge part in my self-esteem and social life. It therefore really saddens me that 36% of people living with type 1 diabetes view exercising to be a challenge. To be honest I’m surprised it’s not higher! I decided along with our consultant Mike Masding that it was worth trying to target this group in a specific exercise clinic to allow tailored advice around nutrition and insulin adjustment, to enable those struggling to enjoy their exercise and de-stress rather than the opposite. Training as I well know is challenging enough without throwing diabetes into the mix! I’m keen to ‘even the playing field’ in any way I can.

I decided I wanted to write for the TDFC to see if I can help advise the wider sporting community and given my passion for football in particular I thought this would be the perfect place. It’s inspiring to see the UK’s first all Diabetic Futsal team (Click for Players’ Blog) competing this summer as well as the results they achieved. I work with children and teenagers with diabetes too and feel these players are a great role model.

My aim is to write a different blog every few weeks with a few tips and hints to help you get your fueling right both pre, during and after. Often we tend to base our advice around timing and quantity of carbohydrates but as I have come to understand the quality of the carbohydrates and protein and fluid intake are also key components I would like to cover. I’m keen to help and advise in any way I can so please if you have any particular topics you would like covered just let me know.

Firstly today let’s consider your overall daily intake as it’s always best to review this whether you have diabetes or not if you’re serious about your sport. Often I’m finding overall carbohydrate intakes are inadequate as the focus tends to be around the actual activity itself. Football is a classic example of a sport that can actually result in quite stable readings at the time due to the fact there is a mixture of slower jogging and sprints. The bigger risk here is hypos after the game or training due to depleted glycogen and increased metabolism, this is a really important aspect to consider when avoiding the dreaded nocturnal hypos. To help avoid this ideally if you’re training regularly you need 50% of your intake to come from carbohydrates (including fruit).Protein should contribute approximately 25% of your diet (timing is key with this) and the other 25% should come from your vegetables and salad. Fat is likely to come alongside your carbs and protein intake but can also be a useful tool in helping to alter the timing of peak absorption of glucose from any carbohydrate. Don’t forget your fluid either as even if you have your glucose levels perfect if you’re dehydrated, even by 2% this will impair your performance.

Over my next blogs we can look at;

Carbohydrates-type and quantity pre, during and post (this might be a few blogs).
Protein -why it’s important and timing of this.
Fruit and vegetables-why these are important too
Fluid-getting this right

Feel free to contact me at Joanna.hanna@poole.nhs.uk

The Adventure Awaits… DiaEuro 2018

Posted on July 19, 2018November 9, 2019 by thediabetesfootballcommunity in diabetes, Football, sport

Well here we are!!! It’s 3 days until we play our first match and after months of talking about this momentous project, it’s happening this weekend. The UK will be represented at the European Futsal Championships for people with Diabetes, for the very first time ( DiaEuro 2018 , www.diaeuro.org ).

I wake up every day feeling privileged to have started The Diabetes Football Community and to be leading projects like this…. They make all the difference to the people who interact with us and seek us out for support. I hope that our endeavours continue to provide comfort, inspiration and a smile for all those who share in the challenges of Diabetes on a daily basis… We want to prove that this condition holds no boundaries for those living with it as long as we achieve good management. Sometimes this is easier said than done, but it’s important we attempt to provide positive news stories for those with the condition when much negativity, ignorance and stereotyping is still evident throughout the media and society in the United Kingdom.

With so much going on I’ve found it very challenging to write anything on the blog for a while so it’s nice to find just an hour to share some thoughts ahead of DiaEuro and talk about our camp on the 14^th of July.

The day was all about bringing the squad together to get to know each other, enhance their tactical and technical understanding of Futsal and ultimately play their first ever game as a squad. For me, all of those things were achieved and more. The team really did surpass all of our expectations as a management team and with expectations for us at DiaEuro low, I’ll be encouraging the boys to just go and give a good account of ourselves, with a smile on our faces. The tournament isn’t all about winning (try telling our squad that!), because it’s also about raising awareness of type 1 diabetes, its challenges and trying to develop greater levels of support across Europe for those living with it. As a collective we can’t wait to participate in this wonderful event and win, lose or draw it’s an incredible opportunity for all of us to represent our condition firstly and our nation secondly at this tournament.

We’d set out a jam packed day where the guys needed to arrive at the university of Worcester at 8:45am (Sorry lads!) as we wanted to spend the morning developing their tactical knowledge before implementing it in our friendly in the afternoon. Myself and Paul had come up with a plan on Friday for delivery and having seen how the team performed in the friendly we were absolutely chuffed that they’d taken on the knowledge we’d shared with them as that’s all you want from a coach’s perspective!

Alongside the hectic morning of coaching, Harley and Jahna were also busy planning their sessions for our lunch time break. Harley wanted to deliver a session specifically aimed at team cohesion and bringing the squad closer together ahead of the European championships, whilst Jahna wanted to capture some more in depth information from a medical perspective about the squad. This gave the lads an opportunity to catch a break!! They also got the chance to come and collect their matchday kit and tracksuits from me!! I think this was one of the parts they were most excited about having had a preview over social media… I think the kit looks great and thank you to www.movingforwardsports.co.uk for supplying us with it.

After all that we were lucky enough to get into our first match, which was a resounding success and we came away with such positivity! A massive thank you to our opponents, Duncan our referee and the university of Worcester for hosting this momentous occasion for us…

Now we move onto Saturday the 21^st of July 2018… The day it all begins. The journey and the tournament await and we’re soooo excited.

My hope is that this team inspires people across the UK whom may be newly diagnosed or finding life with type 1 diabetes tough to think it is possible, the condition doesn’t have to stand in your way and that no matter what barrier it puts in front of us we can overcome it!

11 men all living with Type 1 Diabetes, pulling on a shirt to represent a condition and a country……. To know we’ve set about bringing that to life fills me with so much pride I find it hard to explain.

A huge thank you to our wonderful supporters and sponsors Dexcom, Gluco, Havas Lynx and the University of Worcester in allowing us to get us there because without you this wouldn’t have been possible!

Sunday the 22^nd of July 2018, history will be made.

Thank you as always for your support,

Chris

The First #SporT1Day Conference: Organiser’s Perspective (Chris Bright)

Posted on May 28, 2018November 9, 2019 by thediabetesfootballcommunity in conference, diabetes, Football, sport

After months of phone calls, organising, negotiating and talking about #SporT1Day, May the 13^th 2018 has been and gone…….But what a day!!! It was our first foray into creating an event which provided education and inspiration in one big dose! Before I even start talking about the day I’d like to say a big thank you to Paul Coker at www.1bloodydrop.com and the University of Worcester (www.worc.ac.uk) for partnering with TDFC to deliver the conference. I’d also like to extend the thank you to those people who helped us organise, run the day and tidy up afterwards!

Building up to it I’d spent the previous week stressed, writing my presentation and critiquing everything myself and Paul had put in place as I strove for perfection… I knew deep down this wasn’t possible but I wanted the event to look as professional as possible whilst delivering the overall objective of giving the attendees tips, guidance and education about Type 1 Diabetes management in sport. I think we did a good job at trying to deliver that!!!

The day itself was an absolute whirlwind for me but I loved every minute of it…

I arrived with Alex at about 8:30 to ensure that we had the venue looking smart and the registration process in place… It took us half an hour, but by 9 am we had it all sorted! At this time myself and Paul took up our places on the registration desk to welcome the delegates, check them in and give them their goodie bags! It was great to see so many smiley faces with an early start on a Sunday but I could sense the excitement in the attendees and in myself and Paul.

10 o’clock came around quick! This was the moment myself and Paul opened up the conference and after we’d rounded everyone up and guided them to the room it was time to begin the proceedings! We were keen to introduce and stress the importance of learning and education in our opening, with as few words as possible, due to the amazing speakers we’d lined up.

Following the warm-up we started as we meant to go on… With a cracker!

I’d spent the last few months getting to know Chris Pennell and his work with the Type 1 Diabetes academy based at Worcester Warriors, so it was only natural I should ask the first Type 1 Diabetic to score a try for England, to be the first speaker at #SporT1Day. Like Chris’ career, he did not disappoint!! We heard stories of Chris’ life and his approach to Diabetes management, which caused a stir in the room, whilst he talked about the endeavours of being a professional athlete with a chronic medical condition.

2 comments really stood out to me from Chris’ talk… The first was his reference to himself as a “plastic Diabetic” which he explained was because he felt he’d had an easy ride by being diagnosed as a 19 year old after the difficult years of school and being a teenager. I felt this was a direct reflection of Chris’ work with Type 1 Children in his academy and the stories he’s heard from countless families about the battles they face… It is difficult but we come through it stronger.

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Despite the amazement in the room at Chris’ dietary approach to type 1 combined with his athletic lifestyle, I actually felt he made a really interesting comment about becoming a better Rugby player because of living with the condition and the discipline it taught him. An interesting concept I’m sure many type 1 Diabetics won’t have considered. I’ve always thanked the condition for making me more determined and motivated to achieve whilst I understand the impact it’s had on my ability to plan and organise, so it wasn’t too much of a shock to hear Chris say that but I wonder how many others in the audience were expecting it? It was fascinating listening to Chris’ story and I can’t thank him enough for agreeing to share it with us! I appreciate it mate.

After Chris shared his experiences for us it was the turn of Matt Cook, our Sports Nutrition expert and senior lecturer from the institute of sport and exercise science at the University of Worcester. Matt isn’t an expert in type 1 Diabetes but I felt he did a great job in demonstrating the academic literature out there and how it corresponds with Type 1 Diabetes. It gave plenty of our audience quite literally “food for thought” as he demonstrated the recommendations and gaps in understanding for people living with the condition from his sports nutrition perspective… I really enjoy getting the perspective’s of people who aren’t well accustomed to the condition as it brings an unbiased representation of the facts, which is important for those of us living in the world of Diabetes. Matt did a great job of positioning what we do and don’t know about the condition in relation to sports nutrition and management and I think the whole room got a lot from his talk. Thank you Matt!

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Following a really quick coffee break… We moved onto the “Legends” of the type 1 diabetes world, Mr. Paul Coker, my co-organiser, and Mr. Pete Davies a man whom has lived with Diabetes over double my own lifetime! They both have epic stories to tell which I’d struggle to do justice with words so I’ll just try and describe the theme of their talks. I’d seen Paul speak a couple of times at other events about running 40 half marathons in one year to celebrate 40 years living with Type 1 Diabetes, but this was the first time he wanted to break down his routines and try and give the audience something tangible to take away and utilise in their own exercise regimes. I was watching many members of the audience frantically scribbling down, which was a huge indication of the quality of the information Paul was delivering. I think we all learnt something from Paul’s presentation. We won’t mention the fire alarm going off (a minor hiccup!).

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We then met the man who’s surpassed 60 years of living with Type 1 Diabetes, Pete Davies. What a guy and wow has he seen some change over the years! I saw Pete speak at TAD (Talking About Diabetes Conference) just a couple of weeks prior to our event and his talk was super inspiring so I was just pleased we’d secured him for our first conference. His presentation involved demonstrating the changes in Diabetes care over time as well as the amazing treks and expeditions that he’s been involved in. I think everyone in the room felt very lucky to have the access to technology surrounding Diabetes care that we now have within society. I certainly did! It’s a huge eye opener to think that 50/60 years ago people living with type 1 Diabetes weren’t expected to live much beyond 40 which is something I’ve certainly taken for granted! A quality presentation from Pete and a huge personal thank you from me for your support for the event!

After we’d spent the lunch break talking about the morning’s talks, I was preparing to take to the stage for mine! After watching some of the amazing presentations during the morning I felt I had a lot to live up to… The approach I took was to talk about the journey I’d been on from diagnosis at 8 years old through to founding the Diabetes Football Community with snippets of detail about diabetes management mixed into it. I just hoped that people that listened to me took something from the talk… It was honestly a pleasure and a privilege to be able to talk about my own experiences and views on the world of Diabetes. I felt the talk went pretty well, up until the moment technology let me down and didn’t play the videos I’d included!!! Alas, it’s in those moments you just adapt and crack on! Hopefully next time I won’t be let down in the same way! I thoroughly enjoyed it and as I finished up I had the honour of introducing Craig Stanley, a former professional footballer whom has lived with the condition for the majority of his career.

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Craig’s talk was a fascinating listen for me, as I’m sure it was for the audience, as I’d always dreamt of being a professional footballer and having missed out on that opportunity a couple of times, it was amazing to hear from a man who lives with the same medical condition I do and who’s lived that dream. Craig’s talk mixed in humour, stories from his career and a constant relation to his routines and experiences with type 1 diabetes within professional football. It was my personal highlight of the day, as a part time footballer and founder of a community based on Football and Diabetes, to have Craig there was extra special. He was a big hit with the audience and was asked a number of questions post presentation and throughout the day. I’ve had the privilege of getting to know the man over the last few months and he’s a really top bloke and I can’t thank him enough for his support for the conference and our UK all Diabetic Futsal team.

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Following the final break in the programme it was onto our final speakers… Georgia, Alex and Emma.

I’ve been in contact with Georgia for around a year or so now as she’s been really supportive of The Diabetes Football Community and spreading the word of what we’re doing, so it was only natural with her experiences as a Diabetic intent on living a healthy lifestyle encompassing weightlifting that we asked her to be a part of the day. Georgia quite openly expressed her experience with Diabulimia (google it if you haven’t heard of it) and her passion for exercise and a healthy lifestyle within her talk. With Georgia being a Radio DJ she showcased an engaging style and female perspective to an otherwise male type 1 diabetes line up which really captured the audience’s attention. You could see the impact she had on the attendees as her Q & A session was almost as long as her actual talk!!! It was wonderful to have Georgia with us and I’m just glad she said yes when I asked!! Thank you.

Georgia’s talk led quite nicely onto our penultimate speaker, Mr. Alex Richards. A good friend of mine and an expert in Sport & Exercise psychology whom has become a really important fixture in the work of The Diabetes Football Community over the last few months. His work has been appreciated and praised in the community for its unique and differing approach to the condition in sport. I think his work will become more and more important to diabetic athletes over the coming years and it’s definitely a “watch this space” message from me regarding the direction Alex heads towards over the next year. Much like the work he’s been producing, his presentation captured and engaged the whole room. His presentation focussed on sport, self-compassion and Type 1 Diabetes which to my knowledge is a subject seldom addressed by anyone before. This groundbreaking look into sports psychology for Type 1 Diabetic athletes is something that I believe can make a difference and Alex is passionate about contributing towards. He did a fantastic job on the day and I think he was just as excited about the reaction from the audience as the audience were about his ideas!!! Thank you buddy.

Last but by no means least, was our expert medical professional, Emma Innes. Emma has been a leading Diabetes specialist nurse amongst many other roles across her distinguished career, which has now led her into a role as a senior lecturer at the University of Worcester. I was certainly keen to involve someone from the medical profession in the day as they have such a big impact on the lives and approach of people living with type 1 diabetes to sport. Emma cross referenced her experience in the profession with the recommendations for people with the condition exercising. It was a really insightful viewpoint on which to bring this epic first conference to a close.

As myself and Paul wrapped the day up by thanking the speakers and audience for attending, I was absolutely buzzing from the excitement as well as being absolutely exhausted! It involved a lot of my time planning, organising, negotiating, communicating and ultimately delivering the day. In some ways I was pleased that it had come to an end but for the most part I was disappointed it had been and gone as I really enjoyed the experience.

As I drove myself and Alex home that night there was no doubt the positivity was radiating throughout our conversation and the question about the future prospects of another #SporT1Day conference was discussed… Why Not?!

After a day full of wonderful speakers, a great venue and with wonderful support from the Diabetes community, I’m not sure myself and Paul could say no to creating another conference. So our intention is to organise another #SporT1Day later this year… November is a month looking likely so keep your eyes peeled for our social media announcement and I hope it’ll be in a location where the community can continue to back us.

Lastly I must say a huge thank you to the University of Worcester for their support in hosting the event and allowing us access to staff members whom spoke, to Dexcom for supplying a starter pack prize to our most prolific Tweeter and to Gluco for supplying delegates with hypo treatment goodie bags.

An incredible day and the start of something quite special… Keep supporting us and who knows what we can achieve?!

Chris