Southend United footballer Ben Coker doesn't let diabetes hold him back

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Ben Coker, 26, developed Type 1 diabetes at 15
He has never let it hold him back from his footballing career
Type 1 diabetes affects around 350,000 people in the UK
Ben has an insulin pump, which makes his life easier

Published: 19:24 EST, 21 September 2015 | Updated: 20:37 EST, 21 September 2015

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Within days of being knocked unconscious for a few seconds on the football field, Ben Coker, then 15, developed an almost unquenchable thirst and a need to urinate more often than normal.

His mother took him to the GP, where tests revealed that he had type 1 diabetes.

'I had never heard of it and did not have a clue what that meant, but my first question was: "Will I still be able to play football?" ' recalls Ben, now 26 and a professional footballer with Southend United FC in League One.

Ben Coker, 26, is a professional footballer with Southend United FC in League One

Type 1 diabetes affects around 350,000 people in the UK. It is an auto-immune condition where the body mistakenly attacks the cells in the pancreas, damaging or destroying them. As a result, the body produces little or no insulin, the hormone that moves glucose (sugar) from the blood into cells.

Symptoms include tiredness, the need to urinate more and thirst because the kidneys are forced to work overtime and if they cannot keep up, excess sugar is excreted in urine, triggering thirst. While the cause is unclear, one theory is that it can be triggered by a viral infection.

Type 2 diabetes accounts for 90 per cent of cases in adults and occurs when the body produces too little insulin or the body's cells don't respond to it and is usually caused by poor lifestyle or obesity.

Type 1 is controlled by insulin injections, usually administered at least twice a day, but there is a newer alternative: an insulin pump, a wearable device no bigger than a smartphone, which dispenses insulin 24 hours a day.

It ensures blood sugar is kept stable, reducing the need for injections. Experts estimate that 42,000 people with type 1 diabetes could benefit from a pump, but only 18,400 have one. Ben is one of the lucky ones.

Ben, originally from Royston, Hertfordshire, was told he would have to balance the carbohydrates he ate with the correct insulin dose and inject himself at least twice a day for the rest of his life.

A potential problem for anyone with type 1 diabetes are hypos, or hypoglycaemia, where blood sugar drops too low to supply the body with enough energy. Symptoms include feeling shaky, sweating and lack of concentration. Severe attacks can lead to loss of consciousness and, more rarely, a coma.

Another risk is hyperglycaemia, when blood sugar rises too high. This can be a result of not taking medication, eating too many carbohydrates, stress or infections.

He developed Type 1 diabetes at 15 but hasn't let it hold him back in his career as an athlete

'At the time, I was playing a lot of football; 12 hours of training a week and a match on Saturdays and trying for a soccer apprenticeship,' says Ben. 'I couldn't take the risk of a hypo.

'For every 10g of carbohydrate I ate, I needed an extra unit of insulin to counter it. I also had to have a sugary energy drink close by for emergencies if my blood sugar dropped too low.'

Although he has had three mild hypos at home, Ben has never had one during a match or in training. For ten years, he used an injectable pen to deliver his insulin, but when his blood sugar levels became raised despite his careful efforts, his medical team suggested an insulin pump, which he has had for a year.

The pumps are computerised syringes that dispense doses. In most, insulin is sent from the pump to a cannula (a thin and flexible tube) or needle the patient inserts just under the skin. It is held in place by an adhesive patch.

Type 1 diabetes affects around 350,000 people in the UK. It is an auto-immune condition where the body mistakenly attacks the cells in the pancreas, damaging or destroying them

The patient still has to take blood sugar readings and estimate their carbohydrate intake. They then programme in the readings and the pump feeds a steady dose of insulin 24 hours a day to keep glucose levels in the healthy range overnight and between meals. The pump can also be programmed to deliver a booster dose, including before meals.

Evidence suggests insulin pumps can reduce the incidence of hypos and long-term complications of diabetes. The advantages vary according to each patient, but include fewer hypos and injections and a more flexible lifestyle, says Douglas Twenefour, clinical adviser to the charity Diabetes UK. 'Patients with pumps do not have to stick to such a rigid timetable with eating and injections,' he says.

The National Institute for Health and Care Excellence (NICE) recommends pumps for patients who meet strict criteria, including severe hypos or failure to control blood sugar with insulin injections.

Melissa Holloway, chief adviser to the charity INPUTdiabetes, which campaigns for greater access to diabetes technology, says: 'If your doctor makes a judgment that you need a pump, then your clinical commissioning group has a legal duty to provide one.'

Each pump is estimated to cost £2,700 per patient per year compared with £900 for insulin injections, but pumps may be more cost-effective because they mean fewer long-term complications, says Ms Holloway.

But not everyone will be better off with a pump. 'If they've been doing well on injections, have their blood sugar well controlled and have not been having regular hypos, then they may find the extra tasks, such as changing the cannula, more trouble,' says Ms Holloway.

Ben says: 'I'm more relaxed now I don't have to worry about injecting myself, and my football has improved. I do have to wear the device all the time - the only time I take it off is for a match in case it's damaged, but even then I reconnect it at half-time. That's a small price to pay for the freedom it gives me. And I haven't had any hypos since the pump was fitted.'

Ben is an ambassador for Diabetes UK and wants to show other young people that their condition is not a barrier to playing sport.

His agent Mark Blundell - the former F1 driver who runs sports management company MB Partners - says he is 'an incredible inspiration to every youngster growing up with a medical condition that with determination you can compete on the professional stage'.

inputdiabetes.org.uk