Hisako Saito has lived with type 1 diabetes since 2006, diagnosed during her studies in the UK whilst far away from her home in Japan – and recently England’s Henry Slade wasn’t the only person to play a role in this year’s Rugby World Cup living with type 1 diabetes, as Hisako was a volunteer for the media team of Osaka’s Hanazona Stadium fixtures. With a passion for ballet, Hisako shares how she has managed to rebuild confidence from diagnosis which has seen her become willing to put herself forward to experience many incredible life opportunities.

Having known Hisako since 2013, initially meeting at the International Diabetes Federation’s young leaders programme, I have always known her to be a positive and wise energy, with a bright smile on her face. Her partner, Satoru, likewise a pleasure to meet and an uplifting character. And so I was surprised in this interview when Hisako opened up about personal emotions in her early years after diagnosis, where she endured depression:

“I was diagnosed as a 21 year old during the start of my studies in Nottingham. At the time I was very worried about not being able to stay in the UK and returning home because of this disease, interfering with my studies – but the medical team at Queens Medical Centre helped and reassured me of what the responsibilities were and I was fine to receive my insulin, going on to complete my Masters at UCL. Initially I was on my “honeymoon” period, but in returning home to Tokyo that changed. My family did not know much about type 1 diabetes to begin, where I had been diagnosed abroad, but one thing that gave my parents reassurance, particularly my dad, was a baseball player who was often in the news living type 1 diabetes: Minoru Iwata, who played for the Tigers.

During this time post-honeymoon period I struggled the most. To begin I had been super positive all the time, but we are human. I needed counselling and eventually was put on tablets for depression. Close to my home however was a ballet class, and I started to go. To begin with I had some fears about hypoglycaemia, but in going to ballet I found it worked well with my diabetes, and more so there was a freedom in my emotions – I believe the body and the mind are very connected, and after being diagnosed the mind is also very negatively distracted, ballet was the key for me personally to express myself and I found this worked a lot better than any depression tablets. The music was a sense of healing, emotionally.”

How did Hisako adapt in regards to managing levels and being comfortable with doing with her passion for ballet?

“It did take me some years to adapt to ballet with diabetes, at first I thought having extra carbs for fuel to burn – to eat more carb and inject less – but it didn’t work: I went high during sessions and felt bad and then went hypo during the night after. After struggling in this adjustment for a year I looked for a mentor, and came across Zippora Karz from the United States, a ballet dancer with type 1 diabetes. I read her book, which had an enormous impact on my life, “The Sugarless Plum” sharing her memoirs, having met and been supported by Zippora, I’ve gone on to translate her book into Japanese. Zippora instantly said to eat more protein before you dance, to have less of a spike during and less risk of hypo after.

A lot of the time it’s all about ‘count carbs’ and a ‘inject more’ mindset, but I feel it should be to use insulin to a maximum effect: having a lot higher doses of insulin throughout the day brings about more risk of hypos, and it’s quite artificial and so you don’t truly know how often it lasts. So I recommend using this amazing gift that we as type 1s depend on in most effective ways, with timings and looking up what you eat – not restricting but looking for more healthy diet. Not just carbs but the whole meal: vitamins and proteins- and this is not just diabetes but people in general.”

Did any pressure build up for Hisako with her passion for ballet, after it had given her this emotional freedom with diabetes?

“From a young age I had a passion for ballet, but as a child I didn’t always enjoy it so much, my teacher was lovely but scared me a little ha ha. Rekindling the passion for it in the class local to me after diagnosis meant there was this emotional freedom but also a lot to learn. It is also a sport with a lot of ‘pressure’ as to how you should appear, perhaps in general girls are almost expected to be ‘thin’ and I was very slim already before diagnosis – you always see a lot of models or TV personalities looking this seemingly perfect way – I wasn’t healthy and not having a regular period at the time; with insulin I put on a little bit of weight and then with hypos and eating more often it was a struggle, I understand how easy it is for girls to get eating disorders with type 1 diabetes.

“One thing that helped in this area was deciding to change insulin doses with menstrual cycle, it’s good to be aware that as a girl you know when your period is coming and if it’s delayed to ask why; when levels are too high it’s important to change your dose with it. Don’t be afraid of your shape, you have to be healthy that’s the most important part – ‘shape’ comes after.”

And so, the interesting sponsored outfit that Hisako was wearing to greet me in, the volunteering for the Rugby World Cup:

“I was in media team helping out foreign press. There were volunteers in Osaka’s oldest rugby stadium with responsibilities of helping out the media interviews: my two areas were the ‘Captain’s Run’ (open practise) for the press on the day before fixtures, where teams would prepare in the stadium, and the ‘Mic Run’ during media interviews after fixtures. In total we had 800 volunteers at the stadium but only 30 allowed in for the Captain’s Run with press. One of the key guests I attended was the Mayor of Osaka. And for the Georgia vs Fiji game, I was the mic runner, passing the microphone to the press. The Georgian team were very big! The Fijians were beautiful, complete athletes.”

As a volunteer, were there any ‘diabetes hurdles’ that Hisako faced?

“Uniform was sponsored and you wasn’t allowed to wear other brands, with just two little inside pockets, and furthermore it was strictly no liquids allowed to be brought into the stadium even for volunteers. I had a locker and so I would test my levels at the start of the day and keep my glucometer in the locker, not having space for it in my pockets whilst working.

We were provided with a lunch box, which was quite high carb, so I tried to count the carbs and often left some portions of rice out. The work wasn’t active physically, so I decided to eat more of the veg and protein over the rice to avoid spiking a lot.

During the press conference I was slightly nervous, and that was when I found I went a bit high. When hyper, I feel stiff in the legs, and wanted the loo a lot and with that thirst for water, but had to be disciplined when interview were on! Excitement can also rise the sugars. The interviews were only half an hour, so I was able to hold and sort myself out afterwards.”

Best experience of the Rugby World Cup for her? – outside of Japan’s incredible displays!

“I got to know about rugby! I knew nothing of the sport beforehand and enjoyed learning a lot about it; it’s dangerous but exciting. One experience I was was with the photographers during the Tonga vs USA game, and based right on the Try line, which was a wonderful experience. With a passion for dance myself, I also really enjoyed watching the Fiji and Tonga team perform the Haka before the games started. And the colleagues I met, we are all very friendly and in contact with a WhatsApp chat group – after the Tonga vs USA game we went and watched the Japan vs Scotland game which meant a big celebration!”

Finally, Hisako is someone who has gone on a journey from being diagnosed overseas, away from family, returning and struggling to the point of depression; but now is clearly someone who has a presence of inner-happiness about her, a joy to be around and an independence to be willing to travel, to volunteer for new opportunities and to take part in what she loves doing particularly with that hobby and passion for ballet… so can she summarise this journey?

“In life it is not always about the good things that happen, but every experience is something to learn from, the good and the bad are areas that help you grow. Some people go faster, others slower, but you are still living your life. I got diabetes and it has taught me a lot – you can’t compare it to others, you have to learn to love your body, to love yourself and it will be applied to your diabetes in your own time.”

Nana korobi, ya oki… fall down seven times, get up eight times.