Adrenaline vs Humidity

Our duty in living with type 1 diabetes is to do the best we can to manage our own blood glucose levels; not such an easy challenge when our bodies fail to produce a key hormone called insulin.

Everybody has a different body but if you live with diabetes the condition does not control itself; you are the one who is ultimately responsible for your own control. As a little boy, when being diagnosed, my biggest fear at the time was if it would stop me playing sports – I was football mad growing up! The response from medical professionals in my hospital at the time wasn’t entirely convincing – all a kid wants to hear is “YES YOU CAN.” A big reason I do what I do today, with the runs and endurance challenges, is so I can say to others who perhaps are like I once was, YES YOU CAN – you can achieve anything in this life.

As an ultra-marathoner, a guy who has accomplished a number of whacky challenges all around the world, I know that you can achieve anything – I know diabetes brings up it’s own challenges and there is a lot to take on and learn, and that it doesn’t always go to plan, but ultimately you can achieve anything whilst living with diabetes. Before my years of running crazy distances like a type 1 Forrest Gump began, I was a keen footballer – and in this post I wish to share two affects on blood sugars which I’ve often experienced over the years: what can happen to blood glucose levels in both adrenaline and humidity.

In playing football I often found that on a match-day my blood sugars would spike. When starting out as a player the advice I received from the Doctors were to take less insulin, to avoid the risk of hypo. It is fair to say that this risk was absolutely avoided, I would come off the pitch with blood sugars way up in their 20s (mmol/ls)! When you consider that the other players on the pitch, living without diabetes, had their blood sugars probably somewhere between 5-7mmol/ls – in terms of concentration and performance, you’re at a great disadvantage. Now first and foremost that did not stop Gary Mabbutt in the 80s and 90s from a professional career for Tottenham and England – so once again, anything is possible – but of course we would prefer to be at our best and more so, we would prefer to be healthy.

The reason for the spikes were due to the movements on the pitch, sprinting for a ball and then jogging, walking, sprinting – sudden bursts and changes of pace continuously for 90 minutes. This causes the body to react and the liver can release glucose into the bloodstream, therefore spiking the levels. This is also made worse by the adrenaline reaction, causing the same effect. In training sometimes I would find I could go lower in blood sugars but on a match-day it was the opposite.

When I played at a semi-professional standard I found this was even worse – that adrenaline on a match-day was really strong, it was my dream as a boy, I would psyche myself right up and my blood would be pumping. This tended to mean higher blood sugars. So the teenage me during my years before being the DiAthlete had to figure things out for myself – what was clear was that the only way to achieve this was by testing my blood sugar levels more regularly, even at half time.

I began to up my basal insulin, on Levemir injections. I would take a unit more than normal in the mornings. I even went up to 2 units. What I found was that it helped control my blood sugars during the game, at half time I was okay and at full time I would be at around 11 mmol/ls at the worst; however, my blood sugars would crash towards a hypo much more rapidly after a game. The crash would normally happen, but usually much later on, often in the evenings. With more basal insulin my blood sugars would crash much harder, within an hour. I personally felt that it still worked as I could keep better control during the game – so I combatted the post-game hypo by stuffing my face with sandwiches after the game and had a large dinner, usually a Sunday Roast, with a unit or two less bolus insulin in the evening.

On my travels I have found that in the warmer conditions, where there is a lot of humidity, my blood sugars tend to drop much faster when walking around. Even more so when running around! The challenges I’ve taken on in various places, running in Australia, the U.S and Ghana for examples, I’ve needed much less basal (background) insulin in my system!

Last October in Ghana whilst over there I joined the locals in Tema, just outside of Accra, in a game of football. It has been some time since I played a proper game of football to be fair and I threw myself in the deep-end by playing centre midfield. It has to be said, those guys can play! I was so impressed by the standard of football on the bumpy, dry pitch – it wasn’t easy for me to settle into but everything about the game was pass, pass, pass… such a high tempo.

It was very humid, as the sun-light faded. As the darkness grew though, the temperature did greatly decrease. I came off the pitch and my blood sugars were at 5mmol/ls  – I hadn’t upped my basal insulin either. Charging about in the warmer conditions, in a climate I wasn’t familiar with,  perhaps meant my blood sugars didn’t spike.

As a teenager, when I was a good standard as a footballer, I was in Goa, India. I went on a wander by myself one afternoon; whilst all the tourists would be based by the hotel and main strip to the beach, I decided to head in-land to the nearby village. It was a quiet area, not a big place in Goa for travellers – and the reactions from the locals resembled that. Many had never seen a white European before.

After being invited into a house, which the man, who didn’t speak any English but pointed enthusiastically at things to show me, had welcomed me into as I walked by, I found a field. Very dry or dead grass on the field, hard ground and very unbalanced. On the field were two football goals, carved out of wooden logs. Further down the field were a few children playing between some cricket stumps in barefoot. I decided to join them, I had a ball with me and kicked the ball over – they were shocked.

I started playing the game with them and then, one by one, adult local men started coming out onto the field, with trainers or football boots in hand. A man named Godfrey, who spoke English, was my main contact – he explained that the two local villages were having a game of football and did this every month apart from in the Rainy season.

“We have not beaten them in 4 years, but today we will – we have you!”

I may have told them that I played for Crystal Palace… (but it is possible they wouldn’t have known who they were anyway…)

It was an incredible game – a range of locals from both towns playing the beautiful game, all age groups. Up front for our village team we had a man they called ‘Chief’, he was the oldest player on the pitch at 70. We won the game 4-0 and I scored all 4 goals – this may have given me folk-legend status in Managoa. Everywhere I went after that I heard my name. In the hotel every person from the barman to the cleaner would call me “GAVINNNNNN”; walking down the road the Taxi driver’s would toot by shouting “GAVINNNN” out the window; ordering a meal in the restaurant, the waiter would offer “GAVINNNN” a discount – I always tipped as the cost of a good meal out there would translate into no more than about £3..

They arranged a second game whilst I was there and it was crazy – the whole village turned out to watch it from the hill by the pieced-together-pitch! I got cheered when I got the ball. We won 5-3 in a much tighter game – the other village had some younger players who were also a good standard. For the last goal I ran through and squared it across to Godfrey, who absolutely hammered it through the goal from 3 yards out (and there was no net) and then ran around as though India had just won the World Cup – the shirt came off any everything!

I recall my blood sugars were a higher level in the good zone at the end, 8 or 9 mmol/ls – I was happy with that. It is possible that the combination of adrenaline and humidity was keeping a good balance of my levels; the movements of my body would have created that adrenaline effect for my liver to release glucose and spike levels, yet, with it being warm and humid, I was working up a great sweat and decreasing blood glucose during the game too. The meals were very high carbohydrate, so I would have also had much more glucose stored in my liver from the higher carbohydrate meals – potentially spiking the levels even more – but ultimately I worked so hard the levels kept well. I did drop towards a hypo shortly after the game, working hard in the warmer climates would mean that the crash in levels would be much stronger through burning more energy. Out there though I was in my element for a recovery – I love a curry!

india

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