DIATHLETE USA TOUR – PREVIEW

So upcoming is: 11 Flights, 7 back-to-back Marathon challenges, 6 U.S destinations and a series of diabetes community and speaking events!

It sounds a little bit like a Christmas song… (and a pear tree anyone..?)

Flying over to New York (via Amsterdam) on Friday (September 5th) the next 5 weeks is going to be extremely busy – and I am looking forward to it! Of course there has been a lot of planning, preparing, organising and daring to make this happen, with still a few more details to be confirmed as well, in this post I share how things are shaping up for the Diathlete USA Tour 2014!

Firstly I would like to say a big thank you to tour sponsors DEXCOM. Their support has made this all possible and as a result I will be trying out one of the latest break through’s in diabetes management, their Dexcom G4 Continuing Blood Glucose monitoring sensor (CGM), which traces my blood glucose levels as I travel and run. Having never used a CGM before, I’m excited about this opportunity. Dexcom have also adapted the device which previously only operated in mg/dl (milligrams per deciliter ) to suit me using mmol/L (millimole per liter). I appreciate that for in the UK it is most common to use mmol/Ls when managing your blood glucose levels, whereas the USA it is more common to use mg/dls.

…It is kind of like the fact that in the USA they drive on the right, in Britain they drive on the left.

We like to be different! And as far as the majority of the world is concerned… you drive on the wrong side of the road!

To help people’s understanding, here is a basic comparison of Mg/dl to Mmol/L levels:

Mg/Dl

Mmol/L

54 (hypo!)

3.0 (hypo!)

70

3.9

108 (spot on!)

6.0 (spot on!)

180

10.0

270 (hyper!)

15.0 (hyper!)

380 (way hyper!)

20.0 (way hyper!)

 

Where did the Idea for the ‘Manhattan Marathons’ challenge first come from?

Some point during 2013 I  became introduced to a charity named Marjorie’s Fund with a global type 1 diabetes initiative. I had succeeded in ‘the impossible’ or so I was told it was, in running the length of mainland United Kingdom in 30 days and my next venture was a trip to Australia, where I would become an IDF Young Leader in Diabetes representing the UK and would also embark on a ‘Diathlete Down Under‘ tour.  At that stage I had done a heck of a lot for charities in one year already! The 30/30 challenge was supporting Diabetes UK and JDRF UK, the Down Under Tour linked me with the International Diabetes Federation, I was fundraising for JDRF Australia and also spoke to Diabetes Australia at an event.

Supporting another charity, surely, was way out of the question!

But I looked at the initiative Marjorie’s Fund shared and to me it appealed in what their goals were. Many people with type 1 diabetes in the world are dying each year. Many are children. And it is preventable! It all comes down to the fact that in certain areas of the world the funds are not available. The resources are not provided. The education for control is not there. There is little care for the people with type 1 diabetes. There is much for discrimination. Ignorance comes into it, as a serious disease not being viewed seriously. It is not understood and there is a lack of awareness in many areas.

MFUND1

Marjorie’s Fund helps in these areas of the world – ‘thriving not just surviving’ being their motto. They support children and adolescents diagnosed with type 1 diabetes to not only receive care and education, to not just survive into adulthood – but to thrive into good health, or as good health as possible to go on and live full lives – as people with diabetes should be able to do. As I do in being someone who has the resources such as insulin and education to keep control.

I had shared emails with Dr Jason Baker and even had a few chats on Skype. He was intrigued with what I had managed to accomplish as ‘the Diathlete’ and the challenges I had endured, I was intrigued by what his charity that he had founded was doing. Jason also lives with type 1 diabetes and by founding Marjorie’s Fund, he was following what was in his heart from his experiences and the people, such as Marjorie, he had met along the way. We shared a lot in common there and decided to plan for the future. It just so happened that Dr Baker and Sandy of Marjorie’s Fund had a booth at the IDF World Diabetes Congress in Melbourne, where I was.  We set up a meeting and discussed plans and from there… Manhattan Marathons was created.

Dr Baker and Gavin

Likewise to all my challenges, the routes I run tend to be completely random. I would run around Long Island! It worked out the distance would endure 7 marathons, therefore, we had a weeks-long challenge set up.

I caught up with Jason again in my hometown, he was over in London and I had an event on to introduce my latest challenge – it was great as we had Jason share his story, I invited the then Mayor of Bexley along, Sharon Massey, who done great things for diabetes in our local area and she spoke, along with daughter Tori, 14, who lives with type 1 diabetes too. And Paul Farrelly came along, who lives with type 1 diabetes and once cycled from Portsmouth to Istanbul in 30 days – and also once capsized a rowing boat in front of Sir Steve Redgrave, with me in the back…

Event pic

Training and Preparations

It has taken a lot of planning and organising. As previously mentioned, still with one or two possibilities to confirm too. It is a bit like Transfer Deadline Day, as I try and make some last minute deals happen, only without the bizarrely, unnecessary dramatic impact of Sky Sports News ‘HQ’…

Whilst going over to the USA I figured it is great to go and do a challenge for a week, but here is the thing, I have never been the the USA on my own before – I want to see it all!

My message to others is to never let diabetes stop you from living life to the full. Therefore, instead of just going to New York City and then around Long Island, I decided to push it on with a tour! Travel is sometimes a big concern, especially for parents with children who have type 1 diabetes – a big worry. So I would like to demonstrate that I live with diabetes and yet am very comfortable travelling around, even to the other side of the world! And I am gaining new experiences, meeting new people, enjoying life – whilst living with diabetes. The Diathlete Tour came about. It took some work, as the initiative is to support and inspire diabetes communities, raise awareness of Marjorie’s Fund and involve other people with diabetes as much as possible. I had a few contacts and have managed to establish a few more which I am grateful to a number of volunteers for! And so the final decision had been made to go to Minneapolis, Miami, San Diego and San Francisco for a series of events. It is an exciting schedule and I’ve never been to any of these places!

It has taken a lot of work to set this up. An example is my email inbox – over 100 emails this week so far alone. I’ve been up taking Skype calls past midnight, to even as late as 2am in the morning – the time zone difference not helping me. But it is all coming together!

In addition to that I have also put in serious time toward another major project that I hope comes to plan in the future. But you will have to wait a while to hear anything on that!

Through doing many events over the years and crazy challenges, I have gained some great skills to effectively make events such as this one successful – so I have confidence going forward. If there has been a problem though, it has been the fact that my time has been consumed up organising everything – and not training as well as I needed to.

I also have to try and earn something of a living whilst committing to these things. That is the difficult part. I do these things because it is in my heart, I want to do them, I want to support people with diabetes as much as I can. There is nothing more rewarding than being at events speaking your story to others affected by diabetes, particularly children with type 1, and being able to pass on some inspiration to them. But it means I can never commit to a full-time job, as I don’t know where I’ll be next week!

So over the summer period, aside from all the organising, I had to get some random work. I spent a week sleeping in a tent working at a festival. And it rains a lot in England. The showers were cold too… I then spent 6 weeks living in a boarding school to work as an activity leader with foreign students. It was an enjoyable job, to an extent, I met great people who I worked with and kids are always entertaining. But it was more or less 24/7 work given that I was living on campus. This all meant that my training time was shredded right down.

But you gotta do what you gotta do.

So in all honesty, I am not coming into this Manhattan Marathons challenge of running 7 marathons in 7 days in the shape of my life – by any means! I also suffered an injury whilst playing football working in the summer. My Achilles heel if you like is my left ankle. I sprained it whilst working. So I had to take time strengthening it back up. It caused me some bother during the 30/30 challenge on the first week, but fortunately the Edinburgh group arranged a masseuse to check me over when needed it the most and the exercises I learned, which recovered and saved my 30/30 challenge, I’ve again put into practice here. 5 years back I tore the ligaments, so it is my one weak area. Yet, with the right exercises, as proven in the past, I can strengthen it to succeed. And that is what I’ve looked to have done.

Although my training time has not been enough, one thing I do have in abundance which I am confident about helping me to succeed in this challenge is experience. 30/30 was 30 ultra marathons in a row! And I’ve been running big challenges since the age of 16. 7 years! I also think the experience of running in Adelaide last year is a good help, as it was very hot! I think there are similarities in the settings of Australia and the USA too, seeing as the USA is a new experience to me, the Australian experience can be a great factor in experience. Roads and street-settings are a similar layout.

To add to my frustrations in final preparations, over the weekend I came down with a flu bug! I have been as sick as a dog! This was absolutely the last thing I wanted, as it weakens everything, my immune system to my muscles. But rest assured I have been dosing up on all vitamins to recover, it is still there but I have seen improvements. Hopefully a good sleep tonight and I can feel better tomorrow and ready by Friday.

diathlete warm up

Diabetes Management

Of course the key element of all of this is to manage my diabetes successfully. This is the soul reason why I am doing the challenge of 7 back to back marathons, to show that I can do it whilst living with diabetes. That is the soul reason as to why I run full stop! And my message through doing this is not to say I have diabetes but I can run marathons if I want, it is a statement to say I have diabetes but it is possible for me, or anyone else living with diabetes, to achieve anything in life. Not only in sport, but down any path.

To run Marathons with diabetes it takes a lot of know-how indeed, it takes a lot of planning and I believe you’ve got to take some gambles too. As previously mentioned I have plenty of experience, which is why Diathlete has developed so well, and this means in the past I have taken the gambles already – and learned from them. This provides me with many ‘Dia’-tricks up my sleeve.

An example is when hypo. Now the prime aim is to prevent hypo levels from happening altogether, but with diabetes if you are burning so much energy, as you tend to do when running marathons, hypos can happen. The key is to never panic. Luckily for me I am as laid back as they come and do not do that anyway. If out of glucose supplies, from energy bars, gels to energy drinks, which on this challenge I hope never to be in that situation and to always carry what I need with me, then I even have a plan for that too. Simply by changing my running pace I am able to raise my blood sugar levels. I can put in sprints, then walk, then jog, then a burst of pace and sprint again… by mixing it up and altering the pace I am likely to trigger the ‘adrenaline effect’ – where my liver reacts to the sudden changes of endurance and releases glucose into my body, which, without insulin intakes to counteract it, rises my blood glucose levels. Therefore, temporarily, keeping me safe from hypoglycemia.

That trick alt to buy me time to get help or get to a shop and buy more supplies.

As said though – I plan to do my best to prevent off those hypos! And for me insulin management in consideration to the level of exercise is the crucial factor.

Personally I am on multiple daily injections (MDI) and currently take the insulins Levemir and Novorapid for my basal and bolus rates. For my Levemir, basal insulin, I have a split dosage. On an average day I inject 14 units in the morning, 14 in the evening – roughly 12 hours apart. I see my basal (background) rate as the key solution for control in exercise and especially when out all day running. Too much basal for the level of exercise means CRASH – hypo will happen. Too little could mean gradual hypers take place, or the slightest energy boost could zap my levels far too high.

Diabetes is all about balance and even more so when running extreme challenges. Through my experience, the tactic I am putting into play with this challenge is to inject just 3 units of Levemir in the morning before running. Now that seems very little in comparison to the 14 units on an average day, but both timing and calculations take place here. In the evening I am going to inject 11 units of levemir. This means that in total I have halved my daily average of 28 units down to 14 units for the day – which in consideration to the level of endurance, I predict to be a good cut down – if anything I may need to lower the background units some more.

Timing is key as if I inject the night time dosage too late, say 11pm, and I start running at 9am, there is a good chance that the evening basal dosage will very much still be in the system along with the morning 3 units – and therefore could mean too much insulin is working whilst I burn energy running at a consistent pace. This puts me at risk of falling hypo early on. I will aim to have 8-9pm evening injections and 8am morning ones – starting the runs for 9am.

I think within that first hour or two of running I certainly have the biggest hypo risk, given that the insulin is fresh settling into my system and potentially some of the evening insulin will be around anyway, so this is the point where I consume more glucose in forms of gels or drinks – to keep a balance. The breakfast meal needs to entail slow release carbohydrates to last throughout the morning.

The evening meal likewise needs to be quite filling – for I will burn in region of 4000 calories per run! I need to get that back and keep my energy up!

My bolus insulin doesn’t need adjusting as much as people would think. I know many people adopt the tactic of lowering their bolus insulin right down to rise levels and then burn energy to bring them back down through the day. That can work, but for me I believe the key is in the basal insulin working in the background. Therefore, I aim to keep a check of my blood sugar levels and have target levels to be at.

In mmol/Ls the aim is to be between 7.0 – 12.0 to get things underway. So somewhere between 120 – 200 ml/dl. I think more towards 12 (or 200) is better. What needs to be in mind is that insulin can take a few hours to operate and bring the levels to where they will be after eating – as firstly comes the food into the system, which temporarily makes blood sugar levels rise, and then comes the insulin to bring it back to normal (if you’ve done your calculations correctly). So the calculations need to be on a basis that once these sugar levels come back down, when the insulin is working, it is coming back down in the planned range of between 7.0 – 12.0 mmol/Ls and not any lower than that. This may mean my starting blood sugar level could be a little higher, such as 13.0 or 14.0 mmol/Ls but on it’s way to 12.0 or slightly lower within the next hour. So in terms of injecting my quick acting Novorapid insulin, I probably want to adjust it, depending on the morning blood glucose level, to act with my breakfast meal and get to the level I want it to be. This may mean lowering it by injecting one unit less than what I would normally require for the meal.

Yeah I know, I’m pretty smart…

But know this: all this info did not come about from any medical professional – it came about from 15 years living with type 1 diabetes, 7 years of extreme challenges, sometimes getting it wrong and learning from that – it came from living with diabetes, taking a few risks to begin with and learning from it. And through that I have been very successful over the years!

In having the Dexcom G4 CGM I believe I have a great tool available here to help prevent hypos altogether, as I can keep a constant check whilst running.

The Schedule and How I feel ahead of the Journey…

You can see more information on the full schedule by clicking this link right here and checking out the official Diathlete USA page!

I arrive in the Big Apple on Friday September 5th. On the 6th we have the opening event taking place and I can’t wait to be there and hear the talks from Dr Jason Baker, Lauren Antonucci, Zoe Heineman and then give the first talk of the tour myself too! My USA debut! This is a free event too and takes place at The Cure Thrift Shop, 111 E. 12th Street, New York from 7pm until 9pm. I look forward to catching up with the likes of Paul Madden and Justyna Wozniak at the event too!

The challenge of running around Long Island, NY, begins Sunday Sept 7th, going from the Cure Thrift Shop to Rockville. The following day and route is from Rockville to Babylon. And then Babylon to Medford, Medford to Stony Brook, Stony Brook to Huntington, Huntington to Queens and Queens to Manhattan – finishing back at the Cure Thrift Shop 111 E. 12th Street for around 6pm! So if about – come along and be at the finish New Yorkers!

On Sept 14th I am off the Minneapolis – looking forward to catching up with Scott Johnson over there and also speaking at a JDRF Minnekotas event on 15th.

Next is Miami where I’ll meet Jamie Perez and her son Tyler, who has type 1 diabetes. I’ll be arriving there on Sept 18th and a series of events includes a tour of the Diabetes Research Institute.

After Miami it is a long journey across America – to California. I hit San Diego on Sept 26th and speak to the Dexcom team on 29th.

After that I then head to San Francisco where I look forward to catching up with fellow IDF Young Leader, Lucas Fogarty, and also fellow type 1 Fabiana Couto. I arrive there Sept 30th.

I return to New York City on October 6th and head back home on the evening of 7th.

Despite this rather frustrating flu I’ve had, I feel sure I’ll recover in the next day or 2. And ahead of the journey I am excited to get things going, it is the trip of a life-time that I hope can help inspire many communities and raise awareness and some funds to support the fantastic work of Marjorie’s Fund!

To make a DONATION please see this link here – I can’t thank you enough!!!!!!!!!

You can also FOLLOW ON TWITTER HERE and of course LIKE ON FACEBOOK!

55km finish point

 

image001

ALS ICE BUCKET CHALLENGE

It is a global awareness typhoon! And for a very worthy cause that I can only presume was not remotely as widely known as it now is… all through people simply filling up a bucket of cold water, adding some ice cubes and chucking it over themselves!

Amyotrophic Lateral Sclerosis is a progressive disease which affects nerve cells in the brain and spinal cord. It is awful what the people with ALS have to go through. I look at myself with type 1 diabetes and can only say I am fortunate, firstly because in the UK the resources such as insulin are available in order for me to survive – and through that it becomes my daily responsibility long term to keep monitoring my blood sugar levels, make the key decisions on how many units of insulin I need with particular meals, or when involved in exercise. The bottom line is I have the freedom to take control of myself with my condition and that is why I am fortunate.

Sure, I could be better off – I could live without a disease at all! But when looking at the facts of my own way of life, where I have always been able to eat good meals in being educated in my condition, knowing what to inject, I am able to go out and party, get away with a few beers, I endure extreme endurance challenges and have always been active and successful. Yes, a lot of work, effort and understanding has to take place for me to do those things in living with diabetes, but yes, I can do whatever I aim to in life. When you look at things such as ALS – that freedom just gets taken away from people. They can no longer speak clearly as they once could do, they can no longer participate in their favorite sports and rely on daily care from other people. So that’s why this Ice Bucket campaign is just brilliant – and it is important that the people taking part understand the real reason behind it and donate/raise awareness, it is not just a trend to look cool!

I was nominated this week by my sister Kaylie, I made my donation via text and accepted the challenge… wearing a Mankini and using a bin filled with icy water! To be fair, I had just finished training that day and was due an ice bath…

My nominations went to Lucas Fogarty over in California who lives with type 1 diabetes, is a fellow IDF Young Leader and is founder of DASH Camp, John Sjolund over in Stockholm so no biggy for him with the ice, he also has type 1 diabetes and is founder of Timesulin, and my Mother! She is over in Malaysia somewhere right now and hates the cold…

To see the video, go on my facebook page where it was uploaded!

ice buck

Is my Insulin Working?

That’s the question right there…

Insulin is a peptide hormone produced by Beta Cells in the Pancreas – type ‘insulin’ into Wikipedia and it will tell you just that…

This hormone is not something the average person, of course not living with diabetes, would think twice about. Screw that, they wouldn’t have to think once about it! Many may have never even heard of such a name as their body naturally produces insulin all of the time. Every meal is naturally weighed out by the non-diabetic body and the appropriate amounts of insulin are released – all this happens whilst the non-diabetic-dude hasn’t had to pay a single thought about it; non-diabetic-dude can just sit back, pat the tummy down and think about whether or not the chicken pie went down the right hole alright…

For those of us living with diabetes we think about it, make decisions on and repeat the word multiple times EVERY SINGLE DAY.

WE ARE INSULIN ADDICTS!!!

And with good reason of course: we need this hormone in order to survive long term as our body simply doesn’t produce it at all if living with type 1 diabetes and also in some cases of type 2, or else does not produce enough insulin in other forms of type 2 diabetes.

In living with type 1 diabetes I have to inject multiple daily injections – every meal I am counting away with mathematical equations to work out exactly how much carbohydrates I have consumed and what the levels of glucose are, in order to find the right answer to inject the appropriate amount of insulin to keep my blood sugar levels stable.

I literally sit there pointing with my finger and pulling some cross-eyed expression to do the maths in my mind – when in a restaurant the waiter always comes and asks “is everything okay sir?” when witnessing this maneuver.

“It’s all good Jose,” would be a reply before whipping out a pen with needle on top and injecting my arm.

By knowing your body, mainly through keeping regular enough check ups on the blood sugar levels throughout each day, you can take control of it. Diabetes is a big responsibility to add to life itself, however, with great responsibility comes great power – I believe through living with diabetes and keeping positive I have been more determined in my life to live well and achieve, therefore there are no negatives about living with this condition in my own life. Over the past couple of years I have been able to keep really well controlled, with only a few hiccups along the way – it happens, but overall the control has improved greatly and so too has my health as a result. I’m extremely confident and well educated in my diabetes.

Recently, however, I noticed my blood sugar levels which in mmls I aim to keep between 4.0 – 10.0mml on average, creeping up to regularly being in the teen levels or higher – unexplained! I had taken my insulin after counting my carbs, had done everything by my own book that had been working very well over the years… and yet – hyperglycaemia???

Pen

What happens when your insulin doesn’t seem to be working?

It was as though my quick acting (NovoRapid) insulin was not working? It just wasn’t setting into my system! I even tried injecting more units than what I would normally require and still… hyper blood sugar levels, over two or three hours later!

Surely my food would have settled into my system by then!?

This was in fact the problem… my own mistake of course, but why do we make mistakes? To learn from them.

I opened up too many pens at the same time. Meaning I had about two or three pens out at once, it was mainly through laziness – not being bothered to look for the pen I was currently using and opening up a new one. The problem from there was that when the pen was not in use, I had left it out, probably in trace of the sunlight, basically going to waste.

It went off. The needles was still on the top of it too with no lid!

I did not think twice about it. Once the original pen had been used up, I went back to the other pen that I had used as I couldn’t be asked to find my in-use pen, only to find that it had been left out for a long while and was no longer effective as insulin.

It took a while for me to figure this out. Injecting away with a confused look on my face a few hours later when finding hyperglycaemia blood sugar levels!

After a few nights of waking up in the early hours of the morning high, feeling it more than anything, the need for the toilet and quench of thirst – similar to the symptoms when first diagnosed 15 years ago, I decided the insulin pen needed to be changed as that had to be the problem.

It was clear this was the problem when my blood sugars were registering 20.0 in the early hours of the morning and after taking 3 units of quick acting insulin I woke up at 19.1mmls.

Surely 3 units would lower the levels more than just 0.9 levels! It is said that 1 unit is supposedly to lower blood sugar levels by around 3 levels (without consumption of anything)

I also knew it couldn’t be my background insulin, which was the other alternative, as my background insulin pen had only recently been changed and for a few years now has been the key to my good levels – getting the bolus insulin correct has done wonders for my control.

The quick acting pen it was – and once changed…. problem solved.

What I dislike is the fact an entire insulin pen went to waste. It happens of course, but it is a sour thought when considering the world – the world where in many, many areas people are lucky to just get a syringe to consume insulin, once per day.

Having my levels running hyper for a few days really made me think about what people in locations of the world where they have very little access to insulin altogether must go through. I felt my eyes ache a little bit, I did not feel comfortable in my body for a few days. What if that was every day? What if those symptoms and aches were much worse, on a regular basis?

I thought of my fellow Young Leader in Diabetes from India, Reghunath, who sadly recently passed away through high blood sugar levels. It was preventable, a change of pen for me and I was right back on track – but over in certain parts of the world, there is little information on that, if not, little resources available.

reg

With Reghu in Melbourne last December

My advice to everybody is to always keep on top of your health, especially with diabetes. For me I need to up my game too – I recently missed a clinic appointment and eye test, which are key parts to knowing your long term control, so I need to get back on that phone and rearrange before heading to the USA in a few weeks time. I am currently also fuming with my GP as he keeps on messing with my prescriptions – no test strips a month ago, not even a repeat prescription this month, what is he playing at? There are many great health care professionals, especially at many diabetes clinics, that give good advice and are supportive – I recall my childhood nurses Jan and Sarah always being friendly and reachable, yet, there are far too many in the world who believe they are the center of everything. I have a GP that always complicates matters, he wants to make the decisions… “I know diabetes” he says.

I know my diabetes. That is what I say.

Living with diabetes means yes, you need advice along the way of course, but you are in control of you. You make the decisions, you feel your own body. You take responsibility and inject what you need to inject for certain meals, you decide to test you blood sugar levels. It requires the resources to be free to do that, of course, but it also requires the strength to keep on top of your own health.

You get one life and diabetes should never stop it. In my life, diabetes has made it.

I look forward to supporting Marjorie’s Fund in this upcoming USA tour and running 7 marathons for them – as I know this is a charity that provides support in the areas of the world for diabetes where it is needed the most. Let’s do this!

Diathlete training 2

#ShowMeYourPEN

Recently there has been a brilliant campaign going around the social network for those pumpers with type 1 diabetes where people have been proudly showing off their insulin pumps. Using the hashtag #ShowmeyourPUMP it has been great to see so many get involved – and it was started by a beaming lady named Sierra Sandison who won a Swimsuit Competition as Miss Idaho, whilst attaching her pump to her bikini.

I can see how wearing a pump has that possibly nervy effect in terms of showing off your body and the fact that Sierra proudly showed it off to all in the competition, let alone won the whole thing, has been a real boost to the pumping diabetes world’s confidence.

MISS IDOHA

 

Sierra Sandison, Miss Idaho with her insulin pump attached

The way I’ve always seen it, people are who they are and if you’re living life you should live to be proud of who you are. Living with diabetes makes no difference to that, in fact, you should be more proud and determined through it – valuing life and good health that extra bit more.

I love all the keen pumpers following in Miss Idaho’s footsteps and showing those pumps off, yet, I also know the majority of the type 1 diabetes world are currently on Multiple Daily Injections (MDI), using needles with pens or syringes to inject their insulin into their systems several times each day. I am one of those people! So I feel we should all join in on this campaign too!

With the pump, perhaps in cases there could be that element of I-do-not-want-to-show-my-body-off-with-a-pump-attached… which Sierra has stood up against brilliantly. But also with MDI, there is the possibility of bumps and bruises on the body caused through injections (always change the injection sites as much as possible, on the legs, arms, tummy and bottom) which could also potentially lead to some forms of self-consciousness.

In addition to that, injecting in public locations is always a part of life which draws attention. Personally for me I have always just got on with it, but on many occasions, particularly out in restaurants, you’ll get many looks. This itself could lead to people being nervous or uncomfortable about injecting in public – I know people who choose to inject in private all the time, even leaving to inject in the toilets in order to not be gazed upon. I recall as a young, slightly crazy, boy, having someone give me a dirty look (it seemed that way anyway) as I took out my syringe (it was before my pen days) and plotted where to inject. So after acknowledging the stares for long enough, I decided to pull down my trousers and publicly inject in the top of my rear-end!

That woman may well have thought twice before next frown-gazing at people trying to ‘shoot-up’ at dinner tables…

My point here is that people with diabetes should never be made to feel uncomfortable about their medical condition. We are who we are! And not only in restaurants, but many public places it can be difficult to feel confident or comfortable when in front of others. Even in airports there is that fear of will I be stopped because I am carrying needles about???!!!

This is what we need to change for everyone.

For me, I would never have even ran had I not been diagnosed with type 1 diabetes. I wanted to do something about it and through acting on that and keeping positive in my life, I’ve had so many incredible moments and experiences in my life so far – experiences which most people living an entire life-time would have missed out on, and I am still just 2 weeks short of my 23rd birthday! There’s a lot more to come for me – because I live with type 1 diabetes. I say to all living life with diabetes, live it to the fullest because you can!

Those on the pump, keep those pics coming #ShowMeYourPUMP

And those like me on MDI, well, here I am #ShowMeYourPEN!!!

Pen

 

 

Diabetes Marathon Man

IMG_0616

I have been into long distance running to support and help inspire people with diabetes for over 7 years now. Until recent times, the often words I heard regarding my extreme challenges were ‘impossible’, ‘plucky’, ‘risky’… heck even ‘foolhardy’ – basically, the feelings from the outside world for all my previous challenges beforehand were that I had no chance. But I was never going to accept that, the soul reason I got into running was because I have type 1 diabetes and I can do things about it – more so, I can do things that ordinary people without diabetes couldn’t.

I’ve always enjoyed silencing those people and perhaps I’ve earned a right now for people to see it a different way, particularly after succeeding in the 30/30 challenge last year, running 30 miles a day for 30 days.

In light of this, it feels a little bit odd ahead of the upcoming 7 ‘Manhattan Marathons‘ in 7 days challenge that I am not being slaughtered and called mad, told it is impossible or labelled a fool. The expectation is almost as if it will be easy for me…

I can say that no marathon is easy, for any participant. Even Mo Farah!

west country

Succeeding in an ultra feat is always fulfilling, that buzzing adrenaline rush where you can’t help but punch the air and shout “come on!” – all the while knowing that you’ve defied your medical condition. It is something that serves as motivation to many others too, which is the most rewarding factor. Yet, when people say “well done” after the challenge and acknowledge the achievement, as appreciated as that always is, most showing their respect do not actually understand the full effort that has actually taken place towards reaching that final moment of “come on!!!”

Only if you live with diabetes can you ever really get an idea to understand it.

Over the years I have more or less educated myself in my diabetes management to keep control, particularly during extreme endurance challenges, and to share a taste for what that “come on” moment is all about – it all starts in the preparations. My body is like a Formula 1 race car and my brain is the constructor team, having to make the crucial decisions. Here’s an insight into the calculations of team Diathlete:

Education in Sports and Diabetes

Down Under Run

Here are some notes copied directly from my documents, reflecting the exact details of my methods for control of my diabetes during ultra marathon runs. This shows exactly what my brain has more or less worked out with experience, to now take control during marathons, and the level of workings out that there is to consider in being a ‘diathlete’!

How diabetes affects an ultra marathon runner with type one diabetes

For my type 1 diabetes management I take x2 different forms of insulin:

  1. Novorapid Insulin – This is my ‘quick acting’ insulin I take for meals (known medically as ‘Bolus Insulin’) counteracting the carbohydrates and glucose I intake. Novorapid lasts in the system more or less instantly for approx 1 hour.
  2. Levemir Insulin – This is my ‘background’ insulin I take at set times each day. Some diabetics take this once every day, I take it twice daily as the insulin lasts in the system roughly 12 – 15 hours. Medically this insulin is known as my Basal Insulin, and it works as a cushion for control with long lasting insulin in my body.

Controlling diabetes is about keeping a balance of your blood glucose levels (BGL) and I have to aim to keep my levels between a daily target ratio between 4.0mml/s – 10.0mml/s. If the blood glucose levels reads below 4.0mml/s this counts as a hypoglycaemia level and my body requires glucose (energy) to pick the levels back up again. If my blood glucose levels registers above 10.0mml/s this is a hyperglycaemia with too much glucose in my body. A more serious ‘hyper’ is when the levels read higher into the teen levels and when above 20.0mmls this is when the body can become at serious risk of Diabetic Ketoneasicdosis (DKA)

Ketones are an acid remaining after the body burns its own fat. When the body is burning too much fat, it may cause ketones to become active in the bloodstream.

When Running a Marathon, it is likely that blood glucose levels will gradually decrease in this form of aerobic exercise, as the body is burning energy at a consistent rate in running at the same pace for a long period. Alternatively, anaerobic exercise, which entails short bursts of energy such as sprints and changes of pace, can create the opposite affect and cause the body to rise blood glucose levels. This is known in diabetes terms as the Adrenaline Effect. What happens in the adrenaline effect is that the liver reacts to the sudden bursts of energy in anaerobic exercise and release Natural Glucose into the bloodstream. This will cause temporary spikes to rise blood glucose levels.

Running Marathons usually means that the Glucose Levels will lower in aerobic exercise and the rate that the levels lower can vary on the amount of insulin in the bloodstream. This means I have to work out what my Blood Glucose Levels are Pre Run by testing my Levels and inject an appropriate amount of insulin in both Novorapid (Quick Acting) insulin with my meal (looking for slow release carbohydrates such as beans on toast) and, most importantly for the days activity, my Levemir (Long Acting Background) insulin.

The Levemir (basal insulin) will be in my system throughout the entire run and as I am burning energy for the majority of the day in running the marathon, I am effectively replacing the job of this insulin and therefore do not require as much in my body.  If I have too much Basal Insulin whilst I run, this will be likely to cause my Blood Glucose Levels to crash.

Hyperglycaemia (high blood glucose levels) means when running, despite being safe from going hypo (low glucose) as well as the risk of the DKA it also becomes difficult to concentrate fully, with too much glucose in the bloodstream feeding the brain. Which may affect performance.

Hypoglycaemia (low blood glucose levels) is an essential must to avoid. A serious ‘hypo’ level will put me at risk of at worst case a Diabetic Coma – as the body has not enough energy to function. What happens in a hypoglycaemia is that the body begins to shut down as the Brain is not being fed any glucose (sugar) – meaning a lack of concentration, possible symptoms of shaking limbs and shivering and finally, falling unconscious. Blood Glucose Levels under 3.0mml/s are considered serious hypos.

When I am running the main aim is to Balance my Blood Glucose Levels, using appropriate Insulin Management for the level of activity and consuming the appropriate amounts of carbohydrates for the rate of energy that I will be burning.

WHEN RUNNING MARATHONS INSULIN RATIOS:

Average Day (not running): 14 Units Morning Levemir Dosage, 14 Units evening dosage (roughly 12hrs apart)

On a Marathon Day: 2 Units Levemir morning dosage, 1 unit Levemir early afternoon dosage, 11 units Levemir evening dosage. 

I figured that too much Levemir when running crashes levels rapidly. Too little causes hyperglycaemia. By adjusting to x3 Levemir injections per day instead of x2 daily, and lowering the total intake by roughly 50% I am able to keep more consistent control throughout and post Marathons. Timing of insulin intakes is crucial – it can lead to there being too much or too little insulin in the system when running. The 11 evening units are important to not be too late in the night, as will still be active when running in the morning, causing a hypo crash. Minimum 12 hours in advance for evening dosage vital.

So basically – living with diabetes and being active in sport makes you a mathematical genius!

Beach Running

Diabetes Awareness in Sport

The instant fear I had as an 8 year old after my diagnosis to type 1 diabetes was: CAN I STILL PLAY SPORTS!!???

For as far as I was concerned I was gonna be the next Sir Geoff Hurst, in fact, this very upcoming World Cup 2014 in Brazil was going to be the one that I played a big role in winning for England… I was always very imaginative as a boy. Diagnosis to diabetes complete with a lack of reassurance from medical professionals at the time, left me feeling uncertain of my dreams - could I still compete!!?? As far as I knew, this newly found type 1 diabetes in my body was going to be with me for life and affected my lifestyles, particularly during exercise.

I was back playing football on the school playgrounds within months and in an 11-a-side team within a year, going on to play against professional opposition during my teen years too – okay, it may not have been a World Cup Final, but facing the likes of Gillingham FC for me suggests that you can compete at any level in any sport whilst living with diabetes. Understanding your body and being educated in control is key, which the best part of that comes from experience in living with diabetes – how to prevent hypos or hypers, managing insulin and keeping regular blood sugar level checks.

The defining line here is that with the supplies such as insulin and blood testers, clinics on hand to monitor long term health and provide advice, and general self-experience in living with diabetes… you can master it. And when you master it, you can accomplish anything -in sports and life in general. It doesn’t always go to plan, but then you mark that down as experience and learn from it.

Sport Awareness Against Diabetes Discrimination

Over the past year or so I have been welcomed to many sports stadiums by professional clubs, particularly in the football world, in my Diathlete campaign to show the fight against discrimination towards people with diabetes. We can compete at the highest of levels the same as anybody else, we just have that added responsibility for our own health more than others too.

In many areas, unfortunately, there is a lack of understanding, particularly with type 1 diabetes. Many schools may be an example. I recall my School, Trinity, not having the greatest of understandings as far as diabetes was concerned, however, they took my word for it – and allowed me to compete in a Sports Day or PE sessions knowing I could control myself and would bring supplies such as energy drinks or gels and my testing meter with me. I won an 800m race once in Sports Day for my Yellow Tutor group, and won it by at least 200m in front of 2nd place! There are many schools though that do not let children with diabetes play in sports through fear something will happen, which I completely disagree with.

A story though which makes me proud is of a young lad with type 1 named Alfie Huke.

Alfie is now 6 years old and ran with my Olympic Torch to help me over the Bristol finish line during the 30/30 challenge last year. Last year he competed in 6 races and came first in 5 of them, 2nd in the last race (but he could have been a bit tired then so we’ll let him off!) – which to me states how diabetes can never hold you back, at any age, in any sport or part of life. A can do attitude is the key in keeping positive, keeping control and living life to the fullest!

This post will highlight some professional venues and sports clubs who have supported my Diathlete Awareness against Discrimination in Diabetes Campaign in the past few years:

Stadium: Selhurst Park
Club: Crystal Palace FC
Sport: Football
Division: Barclay’s Premier League

DSCN1412

Stadium: Camp Nou
Club: FC Barcelona
Sport: Football
Division: Liga BBVA

FC Barcelona

Stadium: Eton Dorney Lake
Club: National
Sport: Rowing

Eton Dorney

Stadium: Hamsworth Park
Club: Wick Academy FC
Sport: Football
Division: Scottish Highland Football League

Wick Academy FC

Stadium: Mosset Park
Club: Forres Mechanics FC
Sport: Football
Division: Scottish Highland League

Forres DUK

Stadium: Tulloch Caledonian Stadium
Club: Inverness Caledonian Thistle FC
Sport: Football
Division: Scottish Premier League

Inverness Caledonian Thistle

Stadium: Pittodrie Stadium
Club: Aberdeen FC
Sport: Football
Division: Scottish Premier League

Aberdeen FC

 

Stadium: Tannadice Park
Club: Dundee United FC
Sport: Football
Division: Scottish Premier League

Dundee United FC

Stadium: Ibrox Stadium
Club: Glasgow Rangers FC
Sport: Football
Division: Scottish First Division

Rangers FC 2

 

Stadium: Fir Park
Club: Motherwell FC
Sport: Football
Division: Scottish Premier League

Motherwell FC

Stadium: Brunton Park
Club: Carlisle United FC
Sport: Football
Division: English Football League 2

Carlisle United FC

 

Stadium: Highbury Stadium
Club: Fleetwood Town FC
Sport: Football
Division: English Football League 1

Fleetwood Town FC

 

Stadium: Ewood Park
Club: Blackburn Rovers FC
Sport: Football
Division: English Football League Championship

Blackburn Rovers

 

Stadium: Old Trafford
Club: Manchester United FC
Sport: Football
Division: Barclay’s Premier League

Manchester United FC 2

 

Stadium: Anfield
Club: Liverpool FC
Sport: Football
Division: Barclay’s Premier League

Liverpool FC

 

Stadium: Goodison Park
Club: Everton FC
Sport: Football
Division: Barclay’s Premier League

Everton FC

Stadium: Racecourse Ground
Club: Wrexham FC
Sport: Football
Division: English Skybet Conference

Wrexham FC

 

Stadium: Alexandra Stadium (Gresty Road)
Club: Crewe Alexandra FC
Sport: Football
Division: English Football League 1

Crewe Alexandra

 

Stadium: Molineaux Stadium
Club: Wolverhampton Wanderers FC
Sport: Football
Division: English Football League Championship

Wolves FC

 

Stadium: Villa Park
Club: Aston Villa FC
Sport: Football
Division: Barclay’s Premier League

Villa Park

 

Stadium: Memorial Stadium
Club: Bristol Rovers FC
Sport: Football
Division: English Football League 2

Bristol Rovers

 

Stadium: Country Ground
Club: Somerset County Cricket Club
Sport: Cricket
Division: County Championship

Somerset County Cricket

 

Stadium: St James Park
Club: Exeter City FC
Sport: Football
Division: English Football League 2

Exeter

Stadium: Plainmoor
Club: Torquay United FC
Sport: Football
Division: English Skybet Conference

 

Torquay United FC

 

Stadium: Home Park Stadium
Club: Plymouth Argyle FC
Sport: Football
Division: English Football League 2

Plymouth Argyle

 

Stadium: Wembley Stadium
Club: English National Football
Sport: Football

Wembley Stadium uk

 

Stadium: Adelaide Oval
Club: Australia National Cricket
Sport: Cricket

 

Adelaide Oval

 

Stadium: AAMI Stadium (former home to the Adelaide Crows)
Club: Adelaide Crows
Sport: Australian Football
Adelaide CrowsStadium: Coopers Stadium
Club: Adelaide United FC
Sport: Football
Division: Hyundai A-League

Adelaide United FC

 

Stadium: Murrayfield Stadium
Club: Scotland International Rugby
Sport: Rugby

Murrayfield

Diabetes Week

In the UK for this week it is Diabetes Week (8th – 14th June 2014) to help raise awareness of type 1 and type 2 diabetes throughout the nation and share support and encouragement across the UK’s diabetes communities.

Diabetes UK are launching a campaign through the week on the theme of ‘I can’ – a theme I very much agree with in my own life with type 1 diabetes. You can tweet them @DiabetesUK with your positive diabetes stories using the hashtag #Ican this week.

In regards to I can, I’ve always believed that in living with diabetes I can still achieve anything I set my mind to do in life. From graduating out of University after being predicted somewhat low grades during my earlier stages of education, getting a BA Hons in Media Writing when ironically enough as a young boy that couldn’t hold a pen the ‘normal way’ they made me write in pencil until the age of 8, to accomplishing ‘impossible’ feats such as running the length of Great Britain! With the right attitude to life, keeping positive, keeping focused, anything becomes a possibility – I believe that diabetes in my life now serves as an added motivation to go and accomplish more.

I have diabetes and I can do anything I set my mind to do.

IMG_0183

Over the weekend I was in Edinburgh to meet with the International Diabetes Federation’s Board and present the plan for my global Young Leaders in Diabetes project – which, of course, represents another major challenge! Although the time is not right to mention the project just yet openly, I finished my presentation with a Nelson Mandela quote:

“Education is the most powerful weapon that you can use to change the world.”

Where there are views such as discrimination in many areas of the world, where there are preventable hardships and many restrictions in areas to insulin or blood testing meters/strips and crucial medical supplies, with high costs for care and a general lack of understanding for people’s control… I intend to keep on running to one day educate the world that if the people living with diabetes in all areas are provided with the daily supplies they require in medication and knowledge for their health, there is absolutely no limitation to what people can achieve down any path of life – whilst living with diabetes.

I would like to thank the IDF Board for the opportunity to present the aims of my project to them and for having me at their board meeting. I look forward to cooperating with them on this throughout 2015!

Selfie taken at Murrayfield Stadium on Sunday, Edinburgh 

MurrayfieldI have diabetes and I can look like one suave git, whenever I like to.

Diabetes World Cup

With the World Cup 2014 coming up in a matter of days, I felt it a right time to post on my experiences with Football and Diabetes – for my life growing up was simply a case of: football, football, FOOTBALL!!! My hopes, like the rest of the English nation, aren’t too high this year for our National team – especially after the display against Ecuador in the warm-up friendly. We were playing with Ben Foster in goal though among a few other questionable names too (dare I say Rooney…) so maybe, with our first team on the pitch, we could do better. You never know…

Roy Hodsgon

I grew up supporting Crystal Palace as a boy living in the South East suburbs of London, so I am a loyal fan of the beautiful game to its truest, not-so-beautiful of meanings. After diagnosis to type 1 diabetes in January 2000, my childhood dream of playing football was under some pressure.

Every little child has a dream and football for me was it. I would constantly kick a ball around the house, the garden, the local park, the school… it was my life and soul. I loved going to Selhurst Park and watching Palace attempt to win games and to be fair, for the core of the 90s, we were a strong side. My long-term memory is very strong, for in the 90s I also remember growing up and watching the best England team I have probably seen in my life in Euro 1996 and again in France 98 with that epic match against Argentina, where we were absolutely cheated!!! Sol Campbell, the heroic Salmon, headed the ball in and Shearer never failed anybody! And as for David Beckham’s sending off… he went on to show the world after that HE IS DAVID BECKHAM – YOU CAN’T SEND HIM OFF!!!

Being diagnosed to diabetes I was left in hospital asking the question: can I still play football!!!???

A life-long medical condition, yes okay, but DO NOT TAKE AWAY MY FOOTBALL!!!

There was a lack of reassurance for me in leaving hospital. I guess at the time the levels of research were not as high as they are now in diabetes education and it was pointed out that I would have to closely monitor all daily activities – which had me fearing for my future career.

Within a matter of months though there was an advert in the local newspaper, Crayford Arrows wanted new players as they were going from 7-a-side Bexley A League champions, to an 11-a-side level.

My Old-Man suggested to go along, so I did.

I got in. We trained from the April through the summer and I never had any difficulties in health playing during that period. We had a bottle of energy drink available if I needed it, I had a good meal in the mornings and I was back playing football. If anything, it bettered my health being out exercising.

During that summer the future of Crayford Arrows became in doubt. The team split up, the players and coach left to form another side and the bare-bones of the team I was training with remained there. New trials commenced and we patched together a squad to compete in the Bexley D League – with one of the Dad’s, Big John, with a son we called Little John, becoming the gaffer. He planned to just be the manager for one season in order to keep things going until someone else could step in for the team…

8 years later, he was still the manager in our final season together.

Every club in any sport or activity has a responsibility for its members. With me having diabetes, it was important that there was some kind of responsibility to keep control, which meant John had to understand it a little – which is difficult for him as he wasn’t someone who had to live with it at all. But without bringing it up at all, he would have the energy drink on the side during training or games, if I seemed not myself he would ask but if not, we just got on and played football and he always said to just let him know if I felt I needed to test my blood sugars. For me this was the best approach. It was more my responsibility to let John know if I needed to, yet, wasn’t constantly asked about diabetes – so I felt like all the other lads, just there to enjoy football.

0067a

In my early years of playing football, it was more likely that I had a hypo (low blood sugar levels) than a hyper (high blood sugar levels) after a game; however, it did not happen all that often. There were a couple of incidences where my levels crashed after a match and I needed the Parents on the side-line to quickly aid me with drinks or energy bars, yet, we always had that handy. There was one incident on the pitch where I went hypo that I can recall, it resulted in an own goal, I desperately scrambled to clear the ball away and got my coordination all wrong as it bobbled off my shin pad and in the net.  I asked to be taken off then, not feeling too good, and in checking my levels was hypo. I believe this was the case in my earlier years for two reasons, the first being my insulin. In my younger days I was on an insulin which is not even in existence today – Mixtard 30, It is a concoction of what now is two separate insulins, Basal Insulin (long term acting) and Bolus (quick acting insulin). This mixture made it more likely for a hypo drop to take place, especially with the games on Match-days being in the Morning times soon after my injection.

My insulin then altered as a boy to Novomix, which was quite similar but perhaps an improved version.

To begin with, I was a left back. Whilst we had John Church, our Millwall supporting gaffer on the side-line barking out orders such as “if in doubt kick it the f**k out!” we also had a good team of supporting Dad’s involved. Eddie, a lad named Matt’s dad, was a fitness crazed Hell’s Angel and would have us doing press ups during training sessions… Richard, whose son Charlie played upfront, was the coach we all needed, doing the lino-flag whilst barking out motivation on the side: “don’t let him beat you Gav! He’s not getting past you is he Gav!” and then when the speedy winger knocked the ball past me to try and do me for pace, “take him down Gav!” and we also had Trev who was the calmest of the bunch and his son Bill played in Midfield, he was like our assistant manager.

On one of our training sessions former England, Crystal Palace and Arsenal legendary left back, Kenny Sansom, came down and trained us. It was a great experience for us all and he liked me as I had an Eagles hat on my head, played left back and had developed a nicknamed of “Chopper”.

kenny

Richard had come up with it, for my first key skill playing football was mastering the slide-tackle. They were usually perfect; I would time it so the ball would get taken first and then the follow through made sure the player felt the tackle and hit the deck. Nowadays this would be deemed a foul as football is a pantomime and players get hurt without even being touched. But, a real tackle kids, is when you take the ball first, before the man, then the man goes down afterwards. Football is a contact sport and it’s about time diving, which consists of pretending you are hurt and rolling about on the floor with no shame, was deemed the wrong and not perfectly good and solid tackles.

After a game in the mud of crunching tackles, Rich started to shout out: “go on Chopper!” when the opportunities to make tackles arose.

It helped give me more confidence.

In playing Left Back, it didn’t require a dramatic amount of running as perhaps other positions. I would work up and down the left side, mainly in the defensive areas, so this meant I didn’t create too much of an adrenaline buzz – which can have other affects I will mention in diabetes.

As my teenage years came about, eventually my insulin patterns changed with my body growing. I then took Levemir as my Basal insulin (long acting) and Novorapid as my Bolus (quick acting, for meals etc).

My position on the football pitch also changed, I played Centre Midfield. My role there was to simply keep on running!!! Something I am very used to in the present day!

I would wear other teams out more than anything, working hard, getting back and winning the ball, getting forward and creating goals or opportunities. I was box-to-box, up and down the pitch like a nutter. With all the running, it would seem my Blood Sugar levels would drop through burning so much energy, but instead it was quite the opposite. I would constantly be involved with the game, which meant my pace kept on changing – sudden sprints, to darting runs back or forward. This adrenaline rush meant that my body triggered the ‘Adrenaline Effect’ and my blood sugars would rise. This happens when the body reacts, possibly caused by the sudden sprints, and in that reaction the Liver releases Glucose which, without any quick acting insulin on hand such as when eating  meals, meant my levels shot up high.

DCF 1.0

I would come off the pitch with a Blood Sugar of around 20.0 sometimes, which was quite higher than the targeted range of 4.0 – 10.0mmls. The other lads without diabetes on the pitch would be keeping a blood sugar level of around 5.0 – 7.0mmls comfortably of course. So for me, I was battling my body and the opposition, and being hyper meant that concentration levels become much more difficult.

It was hard to notice though, it has to be said. In my latter years at Crayford, I was the main player in the team, being the midfield engine, and was a class-act!

But when playing football or any sport, to be at your very best you want full levels of concentration.

It was more and more frequent when I played for semi-professional standard Dartford FC. I had a successful trial with them and with it being a higher level, in being closely watched and monitored all the time and in a big squad, the pressure was always on and this meant much more adrenaline – so therefore, much higher sugar levels for me. I had to work out a way to overcome this, so I tested more regularly and decided that upping my Quick Acting insulin with meals would not do it as it would mean I crashed towards a hypo quite quickly. Instead, I looked at upping my Levemir, background Long Acting insulin.

The problem with this is that despite levels going higher in a game, within 2 hours I found that my levels went from the teens or possibly 20s in blood sugars to absolutely crashing down towards a hypo, under 4.0mmls, sometimes as low as 2.0mmls. This happens with the Adrenaline Effect, as hypos are delayed by the glucose release, yet, the energy has still been burned up.

In upping my background insulin by one unit, I found although it did help prevent the hypers during game-time, it meant the CRASH of blood sugar levels happened much more quickly – within an hour.

The key to defending this was to eat right after kick-off.

Fortunately, when at Dartford, it was the kind of level where sandwiches were always provided – so I would dig right in!!

I recall scoring an absolute wonder goal in a training game for Dartford against the age group below. It was still a high level game and the one goal decided it, but it deserves a mention as it was sensational. The ball was laid back to me along the smooth all-weather artificial grass pitch they had and I just stroked it with much belief and instinct perfectly… it looped up, curled and lobbed the goalkeeper. To do that my levels of concentration had to be at the maximum, supplied with self-belief. That was what I had in my game as a boy.

I returned to Crayford for their final season and enjoyed a year where we went on to win our League. I won a Jack Petchey achievement award that year too, which meant funds went towards an all-weather training pitch at the ground, the lads joked and called it ‘The Gavin Griffiths Pitch’ every time we trained on it.

I did have another stint back at a higher level in my later teen years before taking Long Distance running more seriously, but a part of me will always love a good kick about. To be honest I feel the modern professional game is filled with far too much money and greed, which is why although I look forward to the World Cup in Brazil, I don’t expect anything fantastic from any of the teams. But back in the days in the Sunday morning mud as Chopper – that was what real football was about to me.

942242_10151918038859517_1765006533_n[1]

The fact is I was a decent player as a boy – and diabetes never held me back. I even got to live my childhood dream in a sense and walk around Selhurst Park to an applause of the fans after being an Olympic Torch Bearer, it was through diabetes and keeping positive which earned me that honour too.

IMG_1125

Key facts in control with diabetes and football:

  • Make sure your club / coaches understand you do have a medical condition
  • Have supplies handy on the side-line such as Energy Drinks, Gels etc
  • Test your blood sugars regularly: before, at half-time and after
  • Do not panic: if sugars go low, take what you need to take and get back out there. If they go high, alter your running which is difficult but go for less sprints and more consistent running
  • Have a good energy meal before a game and have a good meal ideally within an hour after the game too. Do not adjust to more insulin after game if levels are high, keep it the same.
  • Go out and give it your all!

IMG_2170

Stefanie Cesile Diathlete Interview

Stefanie Cesile is an IDF Young Leader in Diabetes from Hobart, in Tasmania, Australia and after a Diathlete chat, I’m pleased to share some info on her project which intends to unite young people in the Tasmania Diabetes Community with cool activities…

 

Stefanie aims to reach out particularly to teenagers with type 1 diabetes down under, starting in her local community, and with many interesting activities – such as an upcoming Rock Climbing event – in getting people working together she targets the following outcomes through this project:

  • For teens and young adults already living with diabetes this will provide another opportunity to meet, grow friendships and strengthen the diabetic community.
  • For those teens and young adults recently diagnosed this will allow an avenue for meeting those already living with diabetes, as a means of an instant support network if they chose.
  • For all newly diagnosed teens and young adults to have the opportunity to connect in Hobart.
  • For 50% of newly diagnosed teens and young adults to join the regular activities in Hobart and surrounds

Stef, Shane and Franco YLDImage: Stefanie (left) rowing down under with fellow IDF Young Leaders in Diabetes, Shane (right) from Ireland and Franco (back) from Chile. 

Diabetes may be seen as a negative in being a serious medical condition, with constant responsibilities and no cure; however, all around the world you will meet incredible people living with diabetes creating this global community circle, which can turn life with diabetes by many means into positive too. Stefanie’s work definitely reflects this!

Awesome stuff Steph!

 

Still Running!

This weekend marks 1 year since I made it to Land’s End during the GBR 30/30 Challenge, which saw me take on 30 ultra marathons in as many days.

Time really does seem to whiz by sometimes, so make sure you make the most of it!

I’m pleased to say that 1 year since the feat of running the entire length, breadth and wrong-turn country lanes of the United Kingdom, I am still running – and I’ll always keep on running for the diabetes cause so long as I have legs and so long as I have heart!

The 30/30 Experience

Without a shadow of a doubt this was a once in a lifetime experience, which doesn’t happen in too many lifetimes at all! I feel this is possibly why to say it was a year ago seems crazy, as it was such an incredible experience that it continues to seem like just yesterday.

Run pic 1

Going into that challenge there were a number of feelings and thoughts, the key feeling being that I never had any doubt I would somehow succeed – even when counting up the marathons and miles in my head and thinking, is this humanly possible? Always from within there somewhere, I knew I could do it.

To be perfectly honest, in going into a challenge of running over 900 miles in the space of a month, the feeling I had was relief more than anything! Relief that the challenge was going ahead – there was very little help for me to organise such an endeavour, more or less, I worked alone to arrange everything. 30 events in 30 days is a big project for 1 person! I was motivated even more though by some individuals sitting on the ‘Political Thrones’ of diabetes and stating to me words such as ‘foolhardy’ and statements like ‘I don’t mean to p*ss on your parade, but there is no point trying to raise awareness of type 1 diabetes.”

I let those people know my thoughts, don’t you worry about that…

I was extremely grateful to a number of volunteers for getting involved and joining in, and this continued to grow in amazing numbers throughout the challenge. Matt Wood and his wife Clare were immense, just so keen to help out – Matt running the first marathon and last one, travelling from South London to both John O’Groats (the furthest Northern point in mainland Scotland in the North East) and Land’s End (the furthest Southern point in mainland England, in the South West). Gary Pettengell also was a key part as he put in time to help train me for many, many months beforehand and the fact I completed the feat and rose back to my feet each morning, declares that Gary’s work was effective. And there were SO MANY incredible people I met throughout the journey, each day.

On Day 2 I experienced the ‘danger’ zone for the first time, where I had to run on the main road into Inverness – a dual carriageway. It was quite terrifying at times, cars whistling by at speed right next to me! I remained safe there, but come Aberdeen on Day 5, where I had great support from Phil McLean – who had volunteered to be the saviour of that day for the challenge just hours beforehand, I unfortunately had a slight collision with a rather fast, black Mercedes vehicle. Basically he wasn’t stopping and there was no pavement… it was only minimal contact as I nudged towards a drop into the River but fortunately kept my balance! I didn’t actually realise the contact was made until that night in my hotel, where I came across the bruising on my elbow, but it shook me up a wee bit.

Fortunately I wasn’t hit by any more cars on the journey, not without the near misses though! Coming out of Liverpool, after a wrong ferry across the Mersey (which meant instead of simply crossing the river, we had a lovely tour of where-buildings-used-to-be in Liverpool) and then a wrong turn onto the Rock Ferry Bypass out of Liverpool. It is a fast main dual carriage way – absolutely not for pedestrians – that I found myself with support runner for the whole day, and fellow type 1 diabetic, Thomas Jones, in the back of a Police Car for running on… Now, if you are a Police Officer from Merseyside and have in the back a fellah with a London based ID and cheeky, common Southern accent, it may be a rumour, but surely that’s a bonus right there!? After speaking to the Officers of my mistake and challenge I was enduring, they opted to give a warning and put us back on the right path! With the cars coming at us at around 70mph down that Rock Ferry Bypass – we were lucky not to have been seriously injured, it has to be said.

On another occasion, on a Somerset route from Cheddar Gorge to Taunton, edging towards the final week where I had gained much road experience and lost all fears, I made an important call as my Sister Kaylie and support runner Jeff Astle, parent to Mimi who also has type 1 and ran with my Torch that day too, running behind in support:

“Cross Over!” was my order as we ran towards a wide bend on a main and pavementless country lane.

We crossed over and 2 seconds later a ploughing tractor came storming around the corner, taking all branches and hedges on the side of the lane with it!

Those were extreme experiences on the journey, which I’ll always remember, but the key part was what I was doing it all for. The people involved and showing support in each area, that really mattered to me. Especially with young people recently enough diagnosed with diabetes, coming to terms with it at young ages, out there supporting. Examples are of young Alfie Huke who ran with me a good few hundred meters holding my Olympic Torch, which was twice the size of him! He went a great pace and I’ve heard since from his Dad, Chris, who also ran 10 miles in support that day, that Alfie has gone on to compete in his School’s sports day and win 5 out of 6 races, finishing in 2nd in the other… diabetes certainly wasn’t stopping him in any form – which is the message of the challenge, keep positive, keep being yourself and don’t let diabetes stop you, and you can accomplish anything you want in life.

Bristol school

Another incredible example was young Amy Winchcombe, who then aged 12, cycled an entire day along side me, along with her Mother Jayne and Father, Kev. Kev cylced 4 days in a row of the final few days – and only fell off his bike about 4 times..! He was brilliant.

Amy completing that hilly, hilly, hilly… HILLY(!) route was amazing, the best bit though was how she finished it – obviously whilst all the way controlling her blood sugars. As the finish point at St Agnes beckoned, Amy hopped off her bike and had a sprint – UP the biggest hill of the day! Once I get my strides going at the end of races, you aren’t catching me for pace – especially in long distance, I’ll always finish sprinting. I tell you what, I might have opted to push Amy’s bike up the final part, but I was not catching her!

Family was the other key area – as well as family friends (kind of more family too in a way). Gary Gunner, my drink-cyclist! Gary cycled 8 days in a row on the tough second week after the ligament injury problem that had me limping. I needed family at that point and with my Dad, Vince, and Gary joining me for the week, it was great. Gary is old fashion and doesn’t believe in technology – so he had no mobile phones. On a few occasions we lost him! How do you lose a support cyclist I don’t know, one thing was for sure though, without fail he’d be parked up outside the first pub in the next town for a quick pint to refuel with!

ggv

He was immense, jokes aside, out with me in all weather conditions – and along the North West, it absolutely poured down non-stop! And my Dad was a support driver for a week, the pair made a great team for me, to wind down with afterwards too.  My Mum was there when she could be at 3 of the weekends too, so it was always a boost to see my parents – who of course had to deal with diabetes directly, so well, when I was diagnosed as a child.

My auntie Jayne was another exceptional Team Member for my final week in the West Country, her and sis Kaylie became my unofficial Support Team on the venture – and kept me supplied and amused!

It has to be said, there was a spiritual element of belief in me on this – as though, in a weird way, I was being protected (and boy did I need it!). The above experiences of dangerous roads and me being unharmed being an example, but things kept happening in my favour, such as a man called Esk coming out of nowhere on his bike for a casual Sunday cycle to end up guiding me safely through the first half of the 2nd route, avoiding the dangerous roads for a good section. The key bit was on 10th May, a date which has seen both my Grandad Harry pass away and also Michael, my Aunt’s husband and someone who supported every challenge of mine in the past, so an Uncle to me really, also sadly passed before his time in recent years. On the 10th, after struggles with an injury out of Scotland that was supported by a great physio called Cloutilde and miraculously recovered as I kept going, doing the assigned exercises as I went, I met a brilliant young girl also with type 1 diabetes named Angel – supporting me all the way! Angel’s mother, Bev, handed me a wooden Angel to carry with me for the rest of that journey, and the first day I ran with that was on the 10th! Now that’s an odd coincidence.  Coincidence or not, it gave me an added boost to have it in my pocket for the remainder of the challenge.

Some further incredible experiences was the support from the Sports world. I wanted to target sports clubs, particularly football team stadiums, because I love sport and it shows support against discrimination in a sense – having big clubs support me as someone with diabetes, enduring tough athletic feats, it resembles that the big professionals do care and won’t leave people out because of diabetes (it happens in the world). I went to many clubs, 28 from the football world and a cricket ground (Somerset County) and a music/entertain venue (Metro Radio Arena, Newcastle). There were clubs such as Wick Academy FC from the Scottish Highland League, who welcomed me in halfway through my first route with Matt and Clare, to absolute giants of the game – Glasgow Rangers at Ibrox being one, Manchester United FC at Old Trafford another. Man Utd gave me a guided tour around Old Trafford – so I probably added on about 3 miles that day.

942242_10151918038859517_1765006533_n[1]

To top it, after completing the run, the very next day I found myself at Wembley Stadium after travelling through the night – to watch my Crystal Palace beat Watford 1-0 and gain promotion to the Premier League. On a Sky Sports News interview by their reporter Kate Riley, she asked me my prediction, I said it would be tight and went for “1-0 to the Palace, Kevin Phillips to pop up late on.”

Miss Riley now knows I’m a psychic!

DSCN2206

Doing it Diabetes Style

The objective of the challenge was to complete it, but furthermore, to do so managing my diabetes and showing it wasn’t holding me back.

It wasn’t plain sailing by any means – there were some bizarre levels at times. But I think the fact I completed it, alive and well, shows my message how diabetes can’t stop you to any extreme with the right resources available – my Blood Sugar Meter and Insulin. The levels went up and down a fair bit, generally with Marathons levels lower, but there was so much adrenaline, so much passion and so much efforts to keep everything stable, in the extremest of endurances it wasn’t always to plan! My main aim though was to prevent the hypos and short-term affects that could hamper my progress out running. I think to say I had 7 hypoglycaemic levels (low blood sugars) shared across the 30 days, that says job done. It means on 24 days of running ultra distances (as the final day had x2 hypos) I prevented hypos from happening.

My insulin plan was crucial. I started keeping to my background insulin of Levemir split into 2 dosages. However, with a much lower amount than my average day. I saw the background insulin as key to my success in control. I had as little as 4 units in the morning to begin with and 12 units in the evening (down from my normal ratio of 14u in morning, 14u in evenings). I found this still meant hypos early on in the runs, or distinctive drops in levels – so I adjusted my plan. 2units in the mornings, 10 in the evenings (after runs) and the timings of the injections were key as it would measure how much insulin was in my body when running. As the morning background insulin wore out, and perhaps on many days the adrenaline also kicked in, my levels increased in the afternoons – sometimes as ridiculously high as 20mmls!

30 30 blood test

In running you are battling your own mind and levels of endurance as it is, in being hyperglycaemic it makes that mental fight even harder as your focus and concentration goes all over the place, your body feels differently and it became all the more challenging. I’d get frustrated and hot-headed with high levels! So I made a plan to inject for a 3rd time my Levemir, during runs. If I injecting quick acting insulin whilst high, even just a unit when as high as 20.0, I would crash immediately. If I injected 1 unit of Levemir, things actually gradually balanced out effectively. On one of the days, when running to Worcester I believe, my levels started at 6.7mmls and finished at… 6.7mmls – you can’t better that!

Another lad who deserves a mention and made me reflect really proudly on the challenge was young Danny Moon, then aged 15 he set out to run over 15 miles having never ran any long distance before, from Blackpool through to Preston. We were out in the pouring rain all day, yet, he kept trotting on with a brilliant attitude to just keep on going. He learned from it, I hope, which was also key – as he came out in the morning with no blood testing meter and a limited supply of energy boost. I made him use one of my spare needles to check his levels on my meter and of course, fortunately, had energy resources for emergencies – and his levels crashed to 4.0mmls, boarding the hypo. So the lesson on the day was always be prepared with diabetes – have supplies on hand, have your testing meter prepared and make sure your body is doing ok. In doing so, he was absolutely able to achieve a great feat in running that entire first half, keeping right up there with me. I was really proud of him.

IMG_2163

Overall I look back at this challenge 1 year on and do feel proud in accomplishing this. It is something I can tell my family about, something my families family in generations to come can talk about as a challenge I completed. And what counts with this, is I done it as someone who lives with diabetes. The feeling after doing it was of uncertainty I will admit, and more frustration in some respects – I had hoped to raise more money for Diabetes UK and JDRF UK, to support them more in consideration to the giant feat I had put myself through. But – it was a 7 grand or so they didn’t have beforehand! There were some feelings of being let down in some areas, a little welcome into the bad sides of the political areas of diabetes and it was hard for it all to sink in that I had actually completed what I had just completed. Every day afterwards I was waking up, even at the earliest hours of the mornings, thinking to myself… “I gotta run! I got another Marathon to get through!” It was difficult to comeback to reality.

Here’s the thing: screw reality, I’m living the dream! I’m achieving what people told me was impossible and diabetes, it can be all the negative things it is, but it will never beat me and has made me achieve in life and meet so many brilliant people through it – that’s an absolute positive in my book.

One Year On

There’s always something to run for in any path of life, right? I’m literally doing that for my cause; I live with diabetes every day, therefore I see it as my duty to beat diabetes every day – running super crazy distances is one of the best ways I enjoy doing so.

After the 30/30 challenge success, I went to Australia and had possibly an even more brilliant experience – becoming an IDF Young Leader in Diabetes, representing the UK, one of 70 nations, as 1 of 132 members in the Young Leaders. I met absolute legends from all over the world – you’ll never get the togetherness, bond and general friendship unity that the Young Leaders shared in so many different cultures, backgrounds and religions in any other aspect of the world really. It nearly makes me think if everyone in the world had diabetes and was a part of our circle, the world would be an incredible place. Of course, I do not wish diabetes upon anyone! But the feeling was because of diabetes we all instantly hit it off and became great friends.

circle

The stories of all the leaders touched my heart, something for each story I relate to, yet, being from the Western world it can be said there are experiences I do not have or that absolutely should not happen, yet, these Leaders and many people in their countries have been or go through all of the time. The IDF atlas statistics were worrying, 5.1 million deaths caused by diabetes in 2013 worldwide. By 2035, ONE BILLION people will have or will be at serious risk of developing diabetes – that counts for type 1, type 2 and pre diabetes. 1 Billion – that’s a Seventh of the world!

Over in Aussie I completed another Ultra Marathon in Adelaide too, it was hot – but I got through it in the end. I had some time out to work on projects, but, one year on, I am back in training, back saying “diet coke or water please” at bars instead of my notoriously preferred pints, and I am back as THE DIATHLETE – RUNNING FOR DIABETES.

I’ve a lot, lot more to offer, many more miles to run and all the while these horrific statistics exist and keep growing, the stories of hardships for people with diabetes and of discrimination go on, I’ve got a body to give for the cause – and I look forward to giving it my all.

My hand is out for anyone in the world to come and join me.

knackered

 

dia