Shoot Up or Put Up

Big pharma encouraging the pancreatically challenged to play football, whatever next? Christine Michael reports from the Diabetes Junior Cup 2010 :

Take 24 children and teenagers with type 1, bundle them on a flight to Geneva, expose them to two days of partying, blazing sunshine, competitive football and weird Swiss food, and what do you get?  Surprisingly, not one case of emergency medical repatriation – but a super-successful international tournament and (the bit you really won’t believe) a championship-winning performance from a GB soccer team.

Proof that what every great footballer needs is a slightly broken pancreas

The Diabetes Junior Cup is the brainchild of Medtronic, insulin-pump makers to the stars, who hosted over 230 young people with diabetes, from 15 European countries and the USA, at a weekend footie fest on the shores of Lake Geneva.

Great Britain fielded three teams – 22 boys and two girls, aged six to 17 – all selected by JDRF, the event’s partner charity in the UK, which has since denied that it’s offering consultancy services to Fabio Capello. They travelled with an entourage of family and medics in true Premiership style – which could be the shape of things to come for the four players who are already signed up to professional academies. 

The tournament had all the hallmarks of a top international affair – silky skills, saved penalties, hand-of-God goals, bizarre refereeing, etc etc –  except that sinking feeling of despair at the end.

That’s because the Great Britain Junior Team (aged 11 to 14) won their group, the Senior Team (15 to 17) were just beaten in the final by some giant Slovakians, and the Kids’ Team (aged six to nine, cute but ferocious as ferrets) came a creditable fourth in their group.

As if the football, the fireworks, the lake cruise, the barbecue and Medtronic’s furry mascot Lenny weren’t enough, the arrival of Olympic rowing hero Sir Steve Redgrave was a fantastic surprise. Chelsea fan Sir Steve (well, no one’s perfect) spent the day with the GB teams and told them that their diabetes needn’t stop them following their dreams as he had done.

A collection of pancreatically challenged sporting marvels, plus Sir Steve Redgrave

Sir Steve’s visit was a major highlight, but for many families the Diabetes Junior Cup was their first chance to meet other children with type 1 on the sports field instead of in the diabetes clinic. Either way, it was pretty cool

Don’t forget, there’s still time to submit your question for our interview with Sir Steve – just post it in the forum

Exercise, yesterday

Exercise is good for you. Yes, I know, you don’t really want to hear it. When the DSN asks “Are you keeping active?” do your possible answers include:

• ‘Does walking from the sofa to the fridge count?’ No, she won’t buy that.
• ‘Of course I am, I walk to the pub every night!’ No, that’ll just lead to a lecture on drinking habits.
• ‘Not really – I mean, I do try, but I never have the time to do much on a regular basis.’ That’s what she expects.
• ‘Oh, absolutely. I go to the gym three times a week, go walking regularly, and am going on a week long cycling holiday in a couple of weeks.’ That’ll give an interesting reaction…

But to return to my original statement, why? What effect does exercise actually have on you, as a pancreatically-challenged individual? A quick search of the Internet gives the following suggestions:

1. Exercise reduces insulin resistance/increases insulin sensitivity. (Something to do with Fatty Acid Metabolism. Look it up.)
2. Exercise helps you to lose weight, or aids in not putting it back on. (Well, yes. Unless you have to eat loads before, so that you don’t go hypo whilst exercising. Surprisingly, that bit wasn’t mentioned anywhere.)
3. Exercise increases muscle mass, which uses up more energy when being used than when in its resting state. (Er, yes…)
4. Exercise is ‘known to be effective in managing blood glucose’. (So you do something, and your bg goes down. Thanks for that.)
5. Exercise can improve your circulation, especially in your arms and legs, where people with diabetes can have problems. (Now that’s an interesting one.)
6. Exercise can help reduce your cholesterol and high blood pressure. (True. But also true for non diabetics.)
7. Exercise helps reduce stress, which may raise your glucose level. (Good point. But in some people, stress lowers their bg level. In which case, more stress during exercise is called for. Rock climbing without safety ropes, anyone?)

So it’s either really technical, basic common sense, or nothing to do with diabetes at all, but just good for the populace at large. And of course, everyone’s diabetes is different. Every type of exercise affects BG levels in different ways. Where and when you do any particular form of exercise, what the weather conditions are at the time, how long you partake for, all of which will necessitate a different approach – reduce basal rate by W% for X hours, eat Y grams carbohydrate without bolusing/at a bolus rate of Z% of usual (‘Okay, so I’m cycling for 5 hours, its hot, I ate 3 hours ago, the terrain is moderate to steep, I am intending on an average speed of 8mph, now where’s my calculator…’)

Exercise is good for you, providing you can work out your diabetic reaction to it and what you need to do in order to balance energy output to insulin and carb intake. Maybe it would be simpler just to go back to the sofa-fridge run. At least you know there’s carbs at the end of it…

John O'Groats, last week

Before I mislead anyone about the title of this article, just to let you know that it’s not me that’s cycling from John O’Groats to Land’s End – it’s my chum Stephan. Just so that’s clear. I don’t want to give the impression that I’m enough of a loony to cycle just under a thousand miles in a fortnight.

Now that’s clarified, if you didn’t already know (I’m mainly aiming this at our non-UK readers) John O’Groats is in the very top right of the UK and Land’s End is way down in the bottom left. In between is about 350 miles of Scotland and about 650 miles of England, so it’s quite a long way.

Anyway, Stephan stopped off with us in Edinburgh on his way down this weekend. After filling him up with pasta, beer, cheese and other lovely carbs on Saturday night, I dusted off my bike and accompanied him on the first part of Sunday’s ride from Edinburgh to Langholm.

Unfortunately I wasn’t able to go wildly far as Stephan was taking a short cut over the Pentland hills – too rocky for my poncy roadbike with its tiny, thin tyres. So we said our goodbyes and I headed back via the many little lanes that thread their way through the Pentlands, which – despite the pissing rain – was rather nice.

However, this was my first trip out this year on my bike and unfortunately my pancreas decided not too co-operate. As usual, I stuffed in half my amount of insulin for breakfast and set off with a backpack full of Lucozade and Fruit Pastilles which I scoffed down from time to time. But on my return I was a lowish 4.0 – and dropping – so I had lunch without injecting anything. Up I went to a modest 11 two hours later, two units of humalog and I dropped like a stone back down to 2.9. Bah! Again for dinner I put in a very small amount compared to what I was eating and two hours later I was only up at 8.0.

So, there we have it, one bit of moderate exercise and I’m wildly sensitive to insulin. One post-cycling unit seems to be equal to about five lazy units. Judging the amounts is, as always, good wholesome fun and I made a mental note to seriously reduce the amounts I put in next time I’m out on the bike. What top tips do you have for exercising without hypo misery?

While I’m here, I’ll finish off by telling you that Stephan is doing his ride partly because he’s insane and partly to raise money for Macmillan Cancer Support and Dorothy House Hospice – both wildly worthy causes. If you fancy flinging him a few pennies, his donation page is here: http://uk.virginmoneygiving.com/stephanhunt. If you’re just interested in reading about what it’s like to cycle from John O’Groats to Land’s End his blog (which he’s updating from the road) is here: http://2010jogle.wordpress.com/. If nothing else, drop him a comment to say hello – it’s lonely out on them there roads!

After a summer diet consisting pretty much exclusively of whisky and protein I now resemble the character Greed in gory chucklefest Se7en. There are now two alternatives for me – I can either be tortured to death by a particularly inventive serial killer named John Doe, or I can cut out the whisky and do a bit more exercise.

After giving it some thought, and consulting with my wife, I’m going to go for the latter option.

The main problem with this is that I’m really not much into working out. The main flaws are that it’s boring, sweaty and time-consuming. Also in Scotland it’s not very nice outside after mid-September. And exercise hurts. Oh, and did I mention it’s as boring as hell?

I’m not a team player type of person and so the chances of me joining some sort of exercise or keep-fit club are next to zero. After all, if I wanted to spend a lot of time in a small room with a bunch of sweating, hairy men I would go to a Turkish prison.

So to try and combat these problems I’ve taken the effort to clean out our garage and turn it into a sort of pseudo-gymnasium. The effort of doing this left me puffed out and sweating like stalker focusing his night-vision goggles on an unsuspecting neighbour. Anyway, it’s given me more than enough room to put my bike up on its roller-wheel thing and I’ve set up an old set of speakers so I can connect up my MP3 player to provide phat choons (as I believe the young people of today call the Hit Parade).

So that takes care of the legs, but what about the top-half? After a considerable amount of research on the Intermaweb (about three minutes in reality) I came across “Shovelglove – the Sledgehammer Workout“.

Essentially the Shovelglove exercise regime consists of making “useful” movements with a bloody great sledgehammer. These useful movements consist of things like churning butter, chopping a tree down or driving in fence posts. As the author points out these movements are silly; but no sillier than, say, riding a non-moving bike or climbing a set of imaginary stairs in a gym.

I also quite like the concept of doing only 14 minutes of the regime at a time. The reason for this is that no calendar, such as Outlook, has an appointment period of less than 15 minutes – therefore at 14 minutes the session is the equivalent of no time at all.

The most important thing, however, seems to be the naming of your sledgehammer. After a quick look on godchecker.com and I had settled on “Magni the Mighty“. Rrrraaaagh! Prepare yourselves for the new slimline Timmy!

Professional cyclists - very difficult to take pictures of when moving fast

I’m a huge cycling fan. So much so that I even occasionally go out on my lovely Genesis road bike and tootle about the Pentland hills, which is always rather nice. But every July everything stops while we have the wondrous Tour de France and I’m always glued to the box to catch up on the latest developments.

It’s slightly different this year in that, for once, a British cyclist – the very talented Mark Cavendish – has actually won two stages already and is likely to break Chris Boardman’s British record of eight stage wins. However, being a sprinter he’ll probably drop out before the race hits the mountains and is unlikely to actually finish anywhere near the top of the rankings.

Also worthy of note is the truly remarkable Lance Armstrong. He won the Tour a ridiculous seven times, then he retired – having reasonably earned the right to a good rest. However, now he’s come out of retirement and entered the race again. I suspect he’s doing this just to take the piss. But he’s already looking to be a serious contender – probably much to the chagrin of Alberto Contador, supposedly Armstrong’s team leader.

Anyway, the thrills and spills of the Tour reminded me of Team Type 1 – a professional cycling team mostly made up of people with Type One diabetes. They’ve also recently expanded to include Team Type Two which is, you’ve guessed it, made up of competitors with Type Two.

As a diabetic I’m afraid I don’t find many things that raise the profile of diabetes particularly inspiring. If I read about a diabetic who raises £500 with a sponsored parachute jump, it’s undoubtedly a Good Thing, but it hardly makes me leap off my chair and be proud to be pancreatically-challenged.

However, my attitude is somewhat different when it comes to Team Type 1. I think this is because their determined aim is to seriously compete at a global level and they will not compromise simply because some of their pancreases don’t work. Given that cycling is surely the greatest and hardest endurance sport out there, I do actually find them hugely rousing. If they can train for and compete in a professional bike race with no ill effects then surely I can make it through the day in my office job without too much of a problem!

Team Type 1′s stated aim is to enter the Tour de France, and I’m hugely supportive of this. If that happened it would raise the profile of diabetes in a hugely, immeasurably positive way. And nothing would make me prouder as a diabetic than to see Team Type 1 heading down the Champs-Élysées in Paris thrashing the hell out of Lance Armstrong!

Allez, allez, allez boys!

http://www.teamtype1.org/