Three years ago, sport loving Rio Thomas was diagnosed with diabetes. As a talented footballer, Rio was concerned it would really affect his ability to play at the level he wanted to. However, that was not the case. Since his diagnosis, Rio, now aged 14, has played football at county level and this season is playing football, rugby and is a long distance runner for his school Fowey River Academy.
In addition, Rio plays club football and rugby; 5 a side football and goes to the gym every week. This summer as part of his pre-season training, Rio ran 8 mile cliff top runs and – has recently been selected for his school’s gifted and talented sport programme.
So how does Rio manage his diabetes to enable him to enjoy this full calendar of sporting activity? Rio and his family work closely with RCHT’s Paediatric Diabetes Team, who have developed innovative approaches to help the young people in their care manage their diabetes.
The paediatric diabetes exercise clinic is run by Gemma and Michelle on a monthly basis, following feedback from service users asking for more exercise resources. The aims of this clinic include:
- Empowering families by increasing knowledge of exercise and diabetes
- Adjusting insulin levels before, during and after sport to better match exercise physiology and metabolism
- Calculating nutritional requirements to optimise performance
- Practical advice around food choices
- Provision of structured advice and access to follow up
Paediatric dietitian Gemma Burley commented,
“It is an absolute pleasure to work with Rio and his Mum. Rio is a great example of how diabetes should not stop you from doing the things you enjoy. Like all of the families on our caseload, they have to work incredibly hard at managing and living with diabetes.
Our knowledge of diabetes is increasing with current research and treatment is changing as a consequence of emerging technologies. It is therefore important that we adapt our services to meet the needs of families living with the condition in Cornwall. Our exercise clinic is a new addition to our multi-disciplinary service delivery and is a really great part of my role as a Dietitian”
Rio’s Mum Hayley commented,
“We get absolutely fantastic support from (RCHT Paediatric Diabetes Specialist Nurse ) Michelle Skews and (RCHT Paediatric Diabetes Dietitian) Gemma Burley. The guidance we have from them is invaluable in helping us manage Rio’s diabetes. There are lots of ways they help Rio, for example: exercise clinics and advanced carb counting sessions. When Rio takes part in less competitive sporting activity such as PE, his blood glucose levels are raised a little, but not significantly. Gemma and Michelle advised on a reduced correction of insulin in these situations. However, when Rio is playing an important competitive game of football, his blood glucose levels are higher as adrenaline and exercise levels are heightened. In this situation he has a 50% bolus of insulin which stops him going hypo (low blood glucose level), so doesn’t affect his sport”
How the paediatric diabetes team supports young people
- Regular specialist exercise clinics for young people like Rio that take part in elite sports and activities. In addition resources have been put into place to offer first-line advice to the entire caseload.
- Interactive, group education sessions for advanced carbohydrate counting. Families gain the knowledge and understanding required to match the rate of insulin delivery to the rate of glucose digestion and absorption
- Since 2014, Nurse led clinics have been held in senior schools throughout the county, ensuring regular accurate monitoring of teenage young people
- Use of Diasend technology has been introduced to be able to obtain patient’s meter readings remotely via a cloud based application
- The team has provided an insulin pump service in 2012 and patients on pumps can be seen in their locality clinic
- Clinics always have a multi-disciplinary team comprising Consultant, Nurse & Dietitian and patients have an HbA1C check every 3 months as a minimum
- Clinics are nearest to patient’s homes where possible. There are 7 satellite clinics, including one on the Isles of Scilly
For more information about the work of RCHT’s Paediatric Diabetes Exercise Clinic, contact: Gemma Burley, Paediatric Diabetes Dietician email: firstname.lastname@example.org