England rugby international Henry Slade has opened up about the constant mental and physical demands of living with type 1 diabetes, revealing that he thinks about his blood sugar levels “every five minutes”—even in the middle of high-pressure professional matches.
The 32-year-old Exeter Chiefs centre, who has earned 73 caps for England, says diabetes management is “24/7” and something he can never fully switch off from.
“It’s a constant thing. It’s not something you can forget about overnight,” Slade told BBC Sport. “Every five minutes, you’re wondering, ‘How is this going to affect me?’”
Slade is one of several elite athletes diagnosed with type 1 diabetes, an autoimmune condition in which the pancreas no longer produces insulin—the hormone responsible for regulating blood sugar. People with the condition rely on daily insulin through injections or pump systems.
According to Diabetes UK, more than 5.8 million people in the UK live with diabetes, including nearly 400,000 with type 1, marking the highest total ever recorded.
To mark World Diabetes Day, BBC Sport spoke with Slade and two other athletes who have learned to balance the intense requirements of elite sport with the complexity of type 1 diabetes.
A Diagnosis That Came by Accident
Slade discovered he had diabetes at 18, just one month before beginning his professional career. It happened unexpectedly—when he and friends jokingly tested their blood sugar levels using a friend’s glucose meter.
His reading was “pretty high.” The next day, it was even higher.
A doctor confirmed he was “about to develop diabetes.”
Slade’s first question was simple: “Can I still play?”
The answer was yes—and Slade vowed the condition would never stop him.
“It doesn’t affect how much you can lift, how fast you can run, or how fit you are, as long as your blood sugars are in the right zone,” he said.
But staying in that zone requires meticulous planning.
Planning Every Detail: Ratios, Weather, Stress & Adrenaline
Slade wears a continuous glucose monitor (CGM) on his arm, linked to his phone and smartwatch. It alerts him instantly if his blood sugar spikes too high or drops too low.
Every day involves constant calculations:
- How many carbohydrates will he eat for breakfast?
- How much insulin should he inject?
- What time of day is it?
- How cold is the weather?
- How high are his stress levels?
All of these variables can significantly impact glucose levels.
Match days are even harder. Adrenaline from high-intensity play pushes his sugar levels “through the roof.”
To manage this, Slade now injects insulin before kick-off and again at half-time, something he says has been a “game-changer” for performance.
“Blood sugar affects how you think, how you feel, your fatigue levels. Controlling it is essential.”
His mission now is to break down misconceptions. Many people still wrongly assume type 1 diabetes is caused by diet.
“People think it’s because I ate too many sweets as a kid. But it’s autoimmune—you can’t control it. Anyone can get it.”
Slade recently launched his “Tackle Diabetes” awareness campaign with healthcare provider Sanofi to promote early detection and reduce stigma.
Cyclist Sam Brand: ‘I Always Carry Emergency Sweets’
Professional cyclist Sam Brand, diagnosed at age 10, says diabetes has actually helped shape him into a stronger athlete.
Now riding for Team Novo Nordisk, the world’s first all-diabetic pro cycling team, Brand credits diabetes for giving him discipline and routine.
A standard cyclist’s fuelling strategy already involves precise timing and nutrition, but for Brand, an emergency sugar source is essential.
“I always carry Skittles. They’re fast-acting. Twenty-four years of Jelly Babies was enough,” he joked.
Brand admits he has experienced frightening lows where ambulances were needed:
- tingling in his face and hands
- loss of vision
- agitation
- difficulty speaking
- inability to ask for help
“Your brain goes into energy-saving mode. It’s difficult because you freeze up and can’t communicate properly.”
Despite the dangers, Brand has competed at two Commonwealth Games and continues to thrive at the elite level.
‘Anything Is Possible’: Basketball Star Georgia Anderson Inspires Others
Former Great Britain basketball player Georgia Anderson was diagnosed at age seven—and told she shouldn’t pursue sport because of her diabetes.
She refused to accept that.
Her father and coach, Jeff Jones, developed a system with her to monitor symptoms before she even noticed them herself.
“He’d ask, ‘Are you OK?’—which for other athletes is normal. But for me it meant, ‘Do you need to check your sugars?’”
Anderson faced her biggest battle during pregnancy, when hormones made her levels nearly impossible to control, forcing her to stop playing temporarily.
Now 35 and competing in the Super League for Manchester Basketball, she hopes to become the role model she never had.
“Growing up, I didn’t see diabetic athletes. I want young players to know they can achieve anything.”
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