The rain is coming in sideways, the mud is three inches and counting, a Sunday afternoon somewhere in the North of England. My rugby family. Amongst the rain, probably beneath four or five bodies, my seventeen year old daughter is having fun.
A whistle goes and a rain sodden, mud covered monstrosity jogs towards her family on the touch line. An upper arm extended, a mobile phone waved at a discreetly protected sensor and a blood glucose level read. Sometimes it’s an insulin pen to compensate for the adrenaline, other times a sports drink to refuel, such is the trial and error process of educating herself on what management routines work for training and matches. Blood glucose responses to physical activity for this recently diagnosed teenager with type 1 diabetes are highly variable based on activity type and timing and require different adjustments (Colberg et al, 2016)1. There are looks of course. Some parents are confused but a hurried whisper and the confusion is quickly replaced by respect. No mess, no fuss, just ordinary life. There are more important and more exciting things to do. Opponents to fell, tries to be scored. Rugby here, really has no barriers. A progressive, modern, attractive, dynamic and inclusive sport played by all (World Rugby, 2017-2025 vision)2.
Today is World Diabetes Day and the theme for 2019 is ‘The Family and Diabetes’. The aim, to raise awareness of the impact that diabetes has on the family and support network of those affected, as well as promoting the role of family in the management, care, prevention and education of diabetes. On the rugby pitch my personal and professional life comes into sharp focus. I have spent the last twenty years as a dietitian sharing the journeys of people with diabetes. From the familiar insulin dose adjustment which offers greater freedom to eat and exercise while minimising glycaemic excursions (changes in blood glucose levels), to the battle of weight management and diabetes polypharmacy (the use of multiple medications). Weight loss for those with type 2 diabetes unlocking a future without diabetes or at least the ability to rationalise the use of diabetes medications.
Willowy wings take to the pitch alongside broader hardier oaks. At its best they complement each other wonderfully. From helping to prevent and manage medical conditions to reducing the risk of type 2 diabetes, the benefits of sport and activity on a person’s physical wellbeing are huge. But only 63% of adults are physically active for the recommended 150 minutes weekly, with figures lower still for children (Department of Health and Social Care, 2019; Sport England, 2019)3,4.
Rugby helps to maintain or improve aerobic capacity (the ability of the heart and lungs to get oxygen to the muscles), strength and balance and bone health and contributes to meeting the physical activity guidelines. Other benefits to exercise include reduced stress and improved self-esteem. Rugby reminds these girls that nobody’s self-worth comes from how they look or the perfect make-up or beautiful hair or high fashion clothes of online celebrities. There is a wonderful freedom here but also a challenge. Obesity. There is a fine line between giving girls and women confidence in their bodies and shape while also encouraging those patterns of healthy eating that will allow them to play at their best and get the most out of their training and their life. We do not always get the balance right. Push come to shove however they are out there two-to-three-times a week, come rain or shine working incredibly hard, growing as team mates and women, and reducing their risk of developing type 2 diabetes by 30-40%. That has to be an excellent beginning.
On the pitch there is just the team, on the side lines the wider rugby family. Sometimes also the diabetes family. Nicknames abound. Banter flows. Yet there are no labels. There are no diabetics, no 'fat girls', just a team and its friendships, its victories and losses, its celebrations and of course, lots and lots of mud.
Ruth’s current doctoral studies seek to identify barriers and enablers to the implementation of diabetes remission strategies for adults with type 2 diabetes recently diagnosed within general practice in one of the most deprived local authority districts in England.
References:
- Colberg et al. (2016). Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care; 39(11): 2065-2079. https://doi.org/10.2337/dc16-1728
- Accelerating the global development of women in rugby 2017-25. https://www.world.rugby/womens-rugby/development-plan?lang=en
- Department of Health and Social Care (2019). UK Chief Medical Officers' Physical Activity Guidelines. https://www.gov.uk/government/publications/physical-activity-guidelines-uk-chief-medical-officers-report
- Sport England (2019). Active Lives Adult Survey: May 18/19 report. https://www.sportengland.org/media/14239/active-lives-adult-may-18-19-report.pdf
Images:
- 'Logo for the World Diabetes Day' by International Diabetes Foundation via Wikimedia Commons: https://commons.wikimedia.org/wiki/File:World_Diabetes_Day_logo.svg
- Published by: West Park Leeds Girls Rugby ‘Meet your #innerwarrior’ event, with thanks to Kurt Nutchey
Great Post! I think you should write more on this topic.
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